The Neuropsychology of Dementia: A Clinician’s Manual

Book Title: The Neuropsychology of Dementia: A Clinician’s Manual

Author: Simon Gerhand

Publication Details: Cambridge University Press, 2024, 196 pp., $49.99, paperback

Finding a neuropsychology reference book designed for practicing clinicians who are not neuropsychologists is difficult. The only practical and easily accessible options for family physicians are narrowly focused, brief articles on topics such as determining a patient’s mental capacity or using the Montreal Cognitive Assessment (MoCA) or a similar assessment tool in a primary care setting.^1-4

Fortunately, Dr Gerhand’s practical and accessible new book is available to fill the gap between quick how-to articles and imposing neuropsychology tomes. A slim paperback volume, it’s designed for health professionals who need to know more about dementias and how to assess them. For family medicine clinicians, it hits that sweet spot, enabling practitioners to become more sophisticated in their knowledge of dementias and choice of assessment tools, without being too burdened. Given our aging population and the increasing incidence of dementia, along with a shortage of neuropsychologists, a need exists for better detection of progressive cognitive impairments at the level of primary care and other relevant specialties. This book would be valuable for any family physician, as well as for psychiatrists, psychologists, and geriatricians.

Gerhand divides the book into four sections: essential knowledge (eg, psychometrics and functional neuroanatomy), types of dementia (Alzheimer’s, vascular, Lewy body, Parkinson’s, frontotemporal, and alcohol-related), intervention (rehabilitation and pharmacology), and recent developments and contemporary issues (biomarkers, imaging, and determining capacity).

Gerhand’s website⁵ reports that he is a consultant clinical neuropsychologist living in Wales. He works for the National Health Service and in the private sector. He has extensive experience doing research and teaching, and he is clinically and professionally active. Apparently, his years of consulting with health care providers from all disciplines motivated him to develop a neuropsychology reference book that puts accessibility and clarity foremost. He describes the goal of the book as making essential dementia and assessment knowledge available to all health care professionals, with all the key information in one place. He succeeds admirably at this task.

So many features of this book make it a great new resource. The book is quite short, and Gerhand’s writing is concise and clear. He includes tables throughout the book that summarize key differences between concepts. For instance, his discussion of primary progressive aphasia subtypes gets somewhat difficult to understand, but he follows it with a table that clarifies the distinctions immediately. Each chapter concludes with excellent case studies that demonstrate the reasoning behind choosing one diagnosis over another. In addition, every chapter ends with a key points summary that reinforces learning. Even the choice of fonts and the layout make for a clear and enjoyable reading experience, so the book never feels text-heavy or ponderous.

The final chapter on determining mental capacity is excellent, highlighting fundamental ethical and legal principles that underlie such assessments. Because Gerhand is based in Wales, his very helpful legal comments refer to laws from the United Kingdom. For the reader based outside of the United Kingdom, particularly in the United States, those laws vary by jurisdiction, which complicates identifying local laws considerably. Including an appendix with links to laws from other countries would have been useful, but that would be an enormous task. Probably best is that Gerhand simply notes that local laws will vary, leaving his readers to familiarize themselves with the laws related to mental capacity determinations in their regions. Nevertheless, his thoughtful comments on how to navigate decisions about capacity are useful to health professionals anywhere.

Apart from selfishly wishing that the section on mental capacity was written for an American audience, my only regret about this book is that it stands alone. An excellent contribution to the field would be for Gerhand to write companion volumes, for instance on the neuropsychology of acquired brain injuries, the neuropsychology of developmental disorders, and so on. I look forward to reading any of Gerhand’s books that might be forthcoming.