Advancing the Research Agenda for DSM-V, Diagnostic Issues in
Dementia comprises nine chapters with research suggestions for
consideration for the upcoming DSM-V process, reflecting the
nascent effort toward a new diagnostic nomenclature in the still
rapidly evolving field of dementia.
Here, 18 experts provide critical pieces of the dementia
diagnostic story: - The all-important neuropathological criteria of
Alzheimer's disease and the aging brain; current epidemiologic
literature and the challenges of making even minor changes in the
general definition of dementia; and a scholarly review of the
diagnostic nomenclature across the existing criteria, with numerous
critiques and suggestion for future research- The growing evidence
for mild cognitive impairment as an identifiable entity suitable
for inclusion in DSM-V; the current neuropsychological profiling
that serves as the centerpiece of the diagnostic criteria for
dementia and suggests that new instruments evaluating even broader
aspects of cognition, including executive function, will be
important in helping to identify dementia at an earlier stage of
development- The various behavioral syndromes associated with
dementia, with emphasis on the need for great diagnostic clarity to
help focus appropriate therapy in this area of increased burden for
patients and family caregivers- Biomarkers in dementia that may
already be appropriate for inclusion in our diagnostic criteria;
the current diagnostic utility of specific imaging modalities,
which, combined with expanding ligand technology or markers of
genetic predisposition, might further enhance diagnostic accuracy-
A review of the tremendous explosion of information in this field,
asserting that, with the exception of the rare Mendelian disorders,
genetic profiles are not yet ready to make substantial
contributions to nosology
Despite all of these exciting findings, the editors state that
we are still dealing with primarily clinical syndromes and
therefore are still using clinical diagnostic criteria established
at consensus conferences. In the spirit of scientific humility,
they assert that these experts' views must be considered within the
vast and expanding literature related to the dementias. Given the
associated but still generally nonspecific biological mechanisms
underlying these syndromes, new scientific developments might occur
at any time and immediately affect the interpretations and
considerations presented here.
This remarkably concise and insightful collection reviews
today's -- and suggests directions for tomorrow's -- important
diagnostic and research issues in dementia, and as such is a "must
read" for clinicians and researchers alike.
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