In their introduction, the editors point out that much research and clinical attention is being directed at early diagnosis and treatment of the mild and moderate stages of the disease and, as a consequence, severe dementia is a relatively neglected area. A motivating factor behind this book was to redress this imbalance and bring together the key issues and current knowledge of severe dementia. The contributions of experts from a variety of backgrounds have succeeded in this.

The early chapters of the book cover assessment, diagnosis, brain chemistry and molecular pathology. These chapters are not entirely specific to severe dementia, but do give an up-to-date account of current knowledge. Similarly, the section on clinical features includes material relevant to the earlier stages of the illness, but the chapters on staging and function in severe dementia include considerable detail and are rich with information.

The final section covers the management of severe dementia and includes chapters on drug treatments, non-pharmacological interventions, palliative care and health economics. Those on drug treatments highlight the relative dearth of robust research in severe dementia, but the topics are comprehensively covered. Drug treatments for behavioural and psychological symptoms are well covered and are followed by a general overview of non-pharmacological treatments and then an interesting chapter detailing the behavioural and environmental interventions of the Seattle protocols. There follows a short chapter on ‘Care by families’ – research in this area is relatively scant but what there is, and the issues brought to the fore by the authors, are very pertinent. The remainder of the book is very much specific to severe dementia, with thought-provoking chapters on person-centred care, end-of-life issues and narrative ethics. The final chapter on health economics reminds the reader that the severe stages of dementia are the most costly, yet little is known about resource use and cost-effectiveness of interventions for the late-stage illness.

In summary, this is an excellent book that truly brings some focus back onto the nature of, and issues associated with, severe dementia. It will be a valuable resource for specialist clinicians and those directly providing care to people with severe dementia, such as general practitioners and staff of nursing homes.