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Neuropsychological evaluation of the child.

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Mild Cognitive Impairment: Aging to Alzheimer’s
Edited by Ronald C. Petersen
New York, NY, Oxford University Press, 2003
269 pp, illustrated, $55.00
studies that will be published in the coming years. More important, that neurologist will be better prepared to care for
the many patients with mild memory loss who will be seeking diagnosis and treatment in the near future.
Howard Chertkow, MD
Montreal, Quebec, Canada
DOI: 10.1002/ana.20057
Mild Cognitive Impairment represents the first cohesive review of all aspects of mild cognitive impairment (MCI), a
clinical syndrome which is rapidly emerging as one of the
major clinical challenges to neurologists in this decade. MCI
is a controversial concept: is it a disease state of its own, or
simply an earlier stage of Alzheimer’s disease, or conceptionally best viewed as a high-risk state for Alzheimer’s disease, or
a transient label that will be doomed as being too vague,
fuzzy, and heterogeneous? Clinical neurologists are certainly
being asked to see increasing numbers of elderly patients
with increasingly mild degrees of memory loss, often driven
by a growing public awareness of Alzheimer’s disease as a
now treatable condition. This flow of MCI patients could
turn into a torrent if current trials of cholinesterase inhibitors
such as donepezil in MCI yield positive results!
For this reason alone, Mild Cognitive Impairment should
be of considerable interest to both community and academic
neurologists as well as geriatricians and geriatric psychiatrists.
Petersen has assembled a strong set of writers to cover all
aspects of the MCI question. An excellent first section addresses the complex clinical and conceptual problems surrounding MCI and fairly presents the concept in its historical framework. Petersen acknowledges that there is
considerable confusion surrounding this transition state between normal aging and dementia and discusses the main
contributing factors, the heterogeneity of patients with MCI,
the different sources of study participants, uncertainty regarding the limits of “normal aging,” and the use of different
rating scales for diagnosis. There are strong chapters addressing the varied neuropsychiatric syndromes that present in
early AD (by Jeff Cummings) and detailed reviews of the
pathology and neuroimaging of the MCI state and early Alzheimer’s disease. In addition, there are a set of chapters by
neuropsychologists from the Mayo Clinic (Smith and Ivnik)
and Syracuse and Albert Einstein Universities (Sliwinski,
Lipton, Buschke, and Wasylyshyn) addressing the crucial issue of how we can define “normality” in the cognitive functioning of the elderly. The potential of sophisticated neuropsychological approaches to “shore us” the validity of MCI is
emphasized. Although the uninitiated may find these two
chapters on cognitive aging hard reading, the chapters will
intrigue dementia specialists and effectively demonstrate that
complementary skills of neurologists and psychologists are
needed in MCI.
Ultimately, neurologists hope we will have simple predictive tests that will indicate which elderly individuals will develop Alzheimer’s disease during life (along with effective
therapies that can prevent this). Until such time, however,
MCI represents the transitional zone which is likely to increasingly become the target for disease: modifying medications for AD. Any neurologist reading Mild Cognitive Impairment will be well prepared for the multitude of MCI
Neuropsychological Evaluation of the Child
By Ida Sue Baron
New York, NY, Oxford University Press, 2004
429 pp
Neuropsychological Evaluation of the Child arrives to considerable fanfare within the pediatric neuropsychological community, perhaps because its author, Dr Baron, is one of our
most respected members, but also because it fills a great need
in our profession. The enthusiasm is warranted. This compendium provides an up-to-date summary of available norms
for virtually every neuropsychological test we use, a Herculean effort. The supporting literature is as current as it can
be. To have these data available in one source as opposed to
hundreds of articles and bad photocopies is truly satisfying!
The current status of child neuropsychology and a discussion of general testing considerations provide a context for
considering the many specific measures presented. The specific measures are organized into domains: screening measures, intellectual function, executive skills, attention, language, motor and sensory-perceptual skills, visuoperceptual,
visuospatial, and visuoconstructional functions, and learning
and memory.
The organization of Neuropsychological Evaluation of the
Child is compatible with the process an experienced clinician
uses in deciding which measures to use for a given child. It
allows concise but critical comparison of similar measures
within a domain. In addition, for the beginning examiner or
for those who use neuropsychologists as consultants, the general principles of evaluation presented, and, particularly, the
emphasis on how qualitative observations are elicited and interpreted is very helpful. Neuropsychological Evaluation of the
Child is an excellent textbook for training clinicians.
Within each domain (memory, language, etc.) is a
thoughtful review of prevailing theoretical models. The anatomical discussions are appropriate to the limits of localization in children. The comments about developmental aspects
of skills in each domain are particularly interesting. The appreciation of the limitations of tests designed for adults and
subsequently applied in children is very appropriate. Moreover, Dr Baron provides an excellent understanding of the
vicissitudes of diagnosis given the multiple potential origins
of problems in a particular domain.
Neuropsychological Evaluation of the Child will be a classic
on the desks (not just in the bookshelves) of all neuropsychologists working with children as well as in our training
Lynn J. Speedie, PhD
Baltimore, MD
DOI: 10.1002/ana.20046
© 2004 American Neurological Association
Published by Wiley-Liss, Inc., through Wiley Subscription Services
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