This pocket-sized book is part of the new series of specialist handbooks that aim to provide up-to-date practical management advice to specialist trainees and their colleagues. The book starts with an introduction to the specialty, which sets the scene with some demographics of aging and an epidemiological overview. It then runs through the main psychiatric disorders encountered in the older adult population.
Dementia receives the most attention with a chapter that offers clear descriptions of the syndrome and up-to-date clinical diagnostic criteria for the main subtypes as well as sections on neuropathology and genetics. There is also practical guidance on prescribing cholinesterase inhibitors and on using medication for non-cognitive symptoms of dementia. It would have been useful to see a little more about non-pharmacological approaches to managing the behavioral and psychological features of dementia as these symptoms are so commonly seen and medication is often unsafe or ineffective.
The other disorders covered are delirium, mood disorders, anxiety and behavior disorders including alcohol use and squalor syndrome. Much of each chapter is devoted to management of the disorders and the approaches are firmly rooted in real life practice. Case examples are used throughout to illustrate the typical presentations and course of common disorders. There are helpful tips on how to manage patients in different settings such as general hospitals and residential homes. The authors also acknowledge the challenges and, where appropriate, the limitations of treatment in some patient groups. Their management principles for patients with paranoid illnesses are particularly helpful in this respect.
The final section of the book contains an excellent chapter on ethical and legal issues relevant to old age psychiatry including how to assess capacity in various commonly encountered scenarios. Unfortunately the recently implemented legislation in the U.K. on Deprivation of Liberty Safeguards has not been included but will no doubt make it into future editions.
Overall, the book succeeds in its aims and is full of practical and relevant advice covering a wide range of clinical situations. Like the original Oxford Handbooks it uses a clear user-friendly format and a succinct but readable style which avoids using pages of lists. The authors have tried to include research findings relating to treatments and they give prompts for further reading in most chapters. Although it is quite expensive this book is ideal for trainees in psychiatry or geriatric medicine to carry around with them for guidance in their day-to-day practice and as a stimulus for more in-depth reading. It would also be a useful reference for doctors in primary care who are almost certain to be looking after older adult patients with dementia or depression.
