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Dementia is a frightening experience for those afflicted and provokes anxiety for those approaching the later years of their lives when the potential for such a disease increases. Dementia ravages families and social networks, stealing our loved ones long before their final passing. For this reason, along with the monetary hardships associated with dealing with dementia, a book on the disease itself, as well as potential tips for avoiding the disease seems a promising resource. The book Defying Dementia attempts to meet this need. Unfortunately, while packed with interesting and potentially useful information, this book falls sadly short of its own specified goals as a book for "intelligent lay people" and "of interest to caregivers and family members of impaired patients" due to its near constant reliance on medical terminology.
There are two major parts to the book: the first focuses on describing the different types of dementia as well as providing case studies of patients with that specific disorder while the second provides the reader with helpful tips regarding what might alleviate or prevent symptoms of dementia. The intention of this design is to give the reader a thorough background on the clinical presentation of the different forms of dementia before delving into what one can do to change their lifestyle and prevent dementia symptoms. What actually happens as one reads through the despairing case studies, disturbing symptoms and bleak prognosis for dementia sufferers is an increasing fear of the disease for oneself as well as others. Part one of the book ends up serving the purpose of frightening the reader into taking any advice given in the second section, regardless of its advisability. While some negative affect may help to motivate comprehensive lifestyle changes like those suggested in second section of the book, it takes away from the valuable information conveyed in the first section and may especially do so for someone dealing directly with the disease.
Focusing more specifically on the first part of the book several chapters deal with specific forms of dementia. The author provides a wealth of information on the neurological causes of the diseases, the symptoms associated with each type, and medical tests that can be used to make the most accurate diagnosis. This section of the book is thorough dealing with normal cognitive impairment due to age, mild cognitive impairment (a form of cognitive impairment that occurs in later age that may precede dementia) through more commonly known dementias like Alzheimer's and Parkinson's. However, as noted earlier, the terminology and writing make these chapters difficult. While in some cases medical terms are explained or the reader is referred to the glossary in the back of the book, more often they are left to puzzle their way through the terms or to look them up in an outside resource. The author often assumes knowledge of more complex terms (e.g., hydrocephalus) while defining simpler ones (e.g., neuron) making the readings at times confusing and frustrating for those unfamiliar with neurology. In his attempt to make this book useful for both clinicians interested in dementia and lay people potentially dealing with disease in some form in their own lives, the author has not quite separated himself enough from the medical profession to really address the latter.
Moving to the second section of the book, a handful of chapters address the current knowledge of what may prevent dementia. These chapters are full of specific and well-meaning advice based on research examining what differs between groups of individuals that go on to develop dementia versus those that do not. All too often recommendations are made for lifestyle changes that may or may not actually benefit the individual (e.g., internet use). While the author acknowledges in a great many places that the "jury is still out" on whether these things help an individual avoid dementia, he inadvertently advises individuals to do them through his endorsement of these for his own patients. The author also tends to treat each of the potentially beneficial behaviors as though it exists in a vacuum. It is more likely that a combination of factors (i.e., healthy diet plus exercise plus cognitive stimulation) is responsible for the any protective effects found in the research on these lifestyle factors. By not noting this, the author gives a less than comprehensive picture of how lifestyle factors play a role in the prevention of dementia without the reader ever knowing there are pieces missing.
Overall, Defying Dementia is an informative book that might be useful to clinicians familiar with the disease and who would like to know more. A good deal of important dementia-related research is summarized in a succinct and readable way given a background in neurology or related fields. However, I would not recommend it for lay people of any sort as there is chance of it doing more harm than good for individuals unfamiliar with neurology and medicine in general. The reliance of the book on primarily medical research and terminology makes it a difficult read and potentially confusing, making an already difficult topic all the more overwhelming.
© 2007 Jacqueline Mogle
Jacqueline Mogle, M.S., is a PhD student at Syracuse University where her primary focus of research is cognition-emotion relations and aging.
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