INTERNATIONAL J O U R N A L OF GERIATRIC PSYCHIATRY, VOL 3: 73-74 (1988)

BOOK REVIEWS

New Concepts in Alzheimer’s Disease. Edited by M. B R I ~ FY, A. KATO and M. WFBBER. Pierre Fabre Monograph Series Vol. 1. MacMillan Press, Basingstoke, 1986. Price: f40.

In recent years the neurobiology of Alzheimer’s disease has advanced by quantum leaps. This book, which was published in 1986 and referring as it does to the proceed- ings of a conference held in Castres in South West France in 1985, might well have been considered out of date by the time it reached reviewers and readers throughout the world. However, by focusing on concepts adequately backed by empirical studies the editors have avoided this danger. Indeed, even the chapters on molecular biology and genetics which are admirably clear have retained their freshness in spite of the spate of papers which appeared in Science and Nature in February 1987. The authors can congratulate themselves on the accuracy of their forecasts.

The editors have brough together a distinguished group of research workers who have discussed the most important areas of interest and have made accessible to the reader widely dispersed material which hitherto has been difficult to obtain. An added bonus is the very high proportion of contributors from Europe mainly France and Switzerland. This acts as a much needed corrective to the sometimes excessively Americocentric nature of other similar publications in this field. The book is strongly recommended for clinicians and others who wish to be in a

being.’ ‘Look a t our use of words in relation of old age; they are almost invariably infantilising, derogatory or pitying.’ ‘It has been argued that ageism and racism spring from the same roots - from stereotyping, pre- judice, discrimination and minority group status.’

She makes an important distinction between those rights which are normally just, and rights which are legally granted. Between the two ‘there is the grey area of the customary and the possible’. There is an excellent example of the contrast between ‘unctuous expressions of public good intentions and the reality of service provision’. Social work with elderly people, it appears, is still regarded as an unskilled task, while ‘GPs are con- spicious by their absence at conferences concerned with the provision of services for elderly people’. Particularly depressing are the observations on the quality of longstay care - ‘we are caring for your body, but you as a person d o not really exist’. There is even denial of older people’s expectation and experience of death - ‘You’ve got years yet, you musn’t talk like that’. Not only does Ms Norman vividly present the problem, but she has three very basic and practical ways in which improved professional practice could tackle ageism at its roots. These are:

I . An honest approach to the management of risk. 2. An honest contract with ‘informal’ carers. 3. An honest and open debate about the way in which

resources are allocated.

position to evaluate the nature of recent advances in a field which is sometimes impenetrably complex to those not directly involved.

I cannot commend this paper too highly. Its cheapness and brevity should mislead no one into thinking that it might be trite or superficial. It is important to anyone who lives in an ageing society, but particularly for those who plan and manage the care of the elderly. Let us hope that it will reach those who need it most.

PROFESSOR RAYMOND LEVY Insfiture of Psychiatry.

London PKOFFSSOR BRICE P I T I

Si Mar)> j. Hospital Medical School, London

Aspec,i.s ofAgeisni, a discussion paper by AISSON N O K M A U Centre for Policy on Ageing. Price: f l .OO.

As Eric Midwinter remarks in his Foreword to this pamphlet, ‘CPA without Alison Norman is not so much like Hamlet without the Prince of Denmark, as Hamlet without William Shakespeare’. She left the Centre in December, 1986.

Her swansong is a characteristically sagacious and dis- turbing essay about the lowly status of the aged and those who care for them in our society. ‘We find it extremely difficult t o be honest about our attitudes to old age and old people. There is an ambivalence at the root of our

Geriatric Medicine,for Students, 3rd edn. J . C. BROCKI E H U R . I S and S. C. A I I F U

Churchill Livingstone, Edinburgh. No. of pages: 246. Price: f7.95.

The definition of geriatrics given by the British Geriatrics Society is ‘the branch of general medicine concerned with the clinical, preventative, remedial and social aspects of illness in the elderly’. One would, therefore, expect a book on this subject to incorporate these facets. While the clinical and social aspects are clearly dealt with here, there is only a limited amount of preventative medicine.

0 1988 by John Wiley & Sons, Ltd

74 BOOK REVIEWS

The book gives a good general overview of the various problems encountered by the geriatric patient. It is concise and easy to follow. However, there are occasions when the authors seem to assume no knowledge or very little; for example, the chapter on the theory of ageing includes much elementary information and many of the definitions are superfluous (one hopes that post 2nd M B medical students have acquired some medical know- ledge). It might have been more useful t o have a glossary of terms to which one could refer if required.

The tables and flow diagrams incorporated into the text are clear and an excellent aide-mhmoire. though if

diagrams are to aid explanation or exemplify a point, then some fall short of this as they are too basic with too little information.

From the student's point of view it would have been useful to have a separate chapter on pharmacokinetics rather than drug information throughout the text.

As successful geriatric medicine involves a multi- disciplinary approach, the section on the services for the elderly is a very useful and succinct one.

In summary, this is a book covering most of the aspects of medicine encountered in the elderly, and if it is at a rather simplified level it is consequently easy reading.

M f - K Y i DAVIS St. Murj , 17 Hospitul Medi id School, London