Book review: Pick's Disease and Pick Complex. Andrew Ketesz and David G. Munoz. Wiley-Liss, 1998....
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Practical Geriatric Assessment.HOWARD M. FILLIT and GLORIA PICARIELLO. Greenwich Medical Media, London, 1998. No. of pages: 184 index. Some books miss their target by being too general, some by being too specific. Unfortunately, this short but information-packed book manages both at the same time. Too general, because in reaching for the widest possible readership within elderly care the authors have produced a work which is not ideal for any one professional group. Too specific, because so much of the content is relevant mainly in the context of managed care in the United States. The structure of elderly care in a large health maintenance organization is very dierent from that in other countries. This is a pity, as the authors—a geriatrician and an elderly care nurse specialist—clearly have a comprehensive knowledge of their subject. The pages have the aura of many years’ clinical experience at the ‘coal face’ of geriatric practice in the US, and this is the book’s main strength. After an introduction comes a section which basically deals with how to get an older patient through the maze of eligibility criteria for HMO care. I found this part instructive as a terrible warning of what can happen if clinicians allow others to tell them their jobs. The bulk of the book describes structured assessments directed to most of the key problems in elderly care, starting with a basic ‘risk screening’ questionnaire intended for use over the telephone. They then progress to more detailed functional assessment and then to specific assessment instruments for more than 30 individual health problems. Although this approach has the merit of clarity, I found it dicult to reconcile with the intrinsic ‘messiness’ of caring for these people who scorn diagnostic categories and rigid structures. All in all, this is a valiant attempt to produce a usable tool, but it is too context-dependent for an international readership. I am sure it will find a niche as a ‘how to’ guide for those dealing with HMOs in the US. FRAZER H. ANDERSON University of Southampton Southampton General Hospital Pick’s Disease and Pick Complex.ANDREW KETESZ and DAVID G. MUNOZ. Wiley-Liss, 1998. No. of pages: 301. Pick’s disease is like the proverbial elephant. When blind men are asked to define it, one, feeling a leg, calls it a tree; another, touching the trunk, a snake; and the third, encountering the body, a wall. The term means dierent things to dierent people. So says Andrew Ketesz in the opening chapter of the book entitled Pick’s Disease and Pick Complex. To honour Arnold Pick’s recognition of the clinical syndromes of focal lobar atrophies, Drs Ketesz and Munoz are keen to provide an overarching eponymic term to encompass the many (indeed 20 listed in the book—and still counting) terms which have been used to describe the clinical syndromes or pathological findings of these disorders. However, this is at a time when there seems to be something of a consensus forming around the alternative terms of either fronto- temporal dementia or frontotemporal lobar dementia. Chapter contributions are by leading researchers in the field, are well written and provide a valuable source of information for the clinician wishing to mug up on the rarer syndromes included under the rubric of Pick complex (for example primary progressive aphasia, semantic dementia and corticobasal degeneration). There are also useful chapters on the pathology, bio- chemistry and genetics of these conditions. Of greater familiarity to the old age psychiatrist is the syndrome of frontal dementia; descriptions of such patients always make interesting reading and often remind one of occasional friends or relatives! My only, slight, criticism concerns the degree of repetition and the rather confusing array of terms that continue to be used by dierent contributing authors. In summary, this book would make a useful addition to a postgraduate psychiatry library, of most interest to clinicians dealing with dementia patients, but at the end of it I was left wondering whether Pick’s complex is a collection of a tree, a snake and a wall or a whole animal. CAROL GREGORY Addenbrooke’s NHS Trust Copyright # 1999 John Wiley & Sons, Ltd. Int. J. Geriat. Psychiatry 14, 1080–1082 (1999) BOOK REVIEWS 1081
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Transcript of Book review: Pick's Disease and Pick Complex. Andrew Ketesz and David G. Munoz. Wiley-Liss, 1998....
Practical Geriatric Assessment. HOWARD M. FILLIT andGLORIA PICARIELLO. Greenwich Medical Media, London,1998. No. of pages: 184 � index.
Some books miss their target by being too general, someby being too speci®c. Unfortunately, this short butinformation-packed book manages both at the sametime. Too general, because in reaching for the widestpossible readership within elderly care the authors haveproduced a work which is not ideal for any oneprofessional group. Too speci®c, because so much ofthe content is relevant mainly in the context of managedcare in the United States. The structure of elderly care ina large health maintenance organization is very di�erentfrom that in other countries. This is a pity, as theauthorsÐa geriatrician and an elderly care nursespecialistÐclearly have a comprehensive knowledge oftheir subject. The pages have the aura of many years'clinical experience at the `coal face' of geriatric practice inthe US, and this is the book's main strength.
After an introduction comes a section which basicallydeals with how to get an older patient through the maze
of eligibility criteria for HMO care. I found this partinstructive as a terrible warning of what can happen ifclinicians allow others to tell them their jobs. The bulk ofthe book describes structured assessments directed tomost of the key problems in elderly care, starting with abasic `risk screening' questionnaire intended for use overthe telephone. They then progress to more detailedfunctional assessment and then to speci®c assessmentinstruments for more than 30 individual healthproblems. Although this approach has the merit ofclarity, I found it di�cult to reconcile with the intrinsic`messiness' of caring for these people who scorndiagnostic categories and rigid structures.All in all, this is a valiant attempt to produce a usable
tool, but it is too context-dependent for an internationalreadership. I am sure it will ®nd a niche as a `how to'guide for those dealing with HMOs in the US.
FRAZER H. ANDERSON
University of SouthamptonSouthampton General Hospital
Pick's Disease and Pick Complex. ANDREW KETESZ andDAVID G. MUNOZ. Wiley-Liss, 1998. No. of pages: 301.
Pick's disease is like the proverbial elephant. When blindmen are asked to de®ne it, one, feeling a leg, calls it a tree;another, touching the trunk, a snake; and the third,encountering the body, a wall. The term means di�erentthings to di�erent people. So says Andrew Ketesz in theopening chapter of the book entitled Pick's Disease andPick Complex. To honour Arnold Pick's recognition ofthe clinical syndromes of focal lobar atrophies, DrsKetesz and Munoz are keen to provide an overarchingeponymic term to encompass the many (indeed 20 listedin the bookÐand still counting) terms which have beenused to describe the clinical syndromes or pathological®ndings of these disorders. However, this is at a timewhen there seems to be something of a consensusforming around the alternative terms of either fronto-temporal dementia or frontotemporal lobar dementia.
Chapter contributions are by leading researchers inthe ®eld, are well written and provide a valuable source
of information for the clinician wishing to mug up onthe rarer syndromes included under the rubric ofPick complex ( for example primary progressive aphasia,semantic dementia and corticobasal degeneration).There are also useful chapters on the pathology, bio-chemistry and genetics of these conditions. Of greaterfamiliarity to the old age psychiatrist is the syndrome offrontal dementia; descriptions of such patients alwaysmake interesting reading and often remind one ofoccasional friends or relatives! My only, slight, criticismconcerns the degree of repetition and the ratherconfusing array of terms that continue to be used bydi�erent contributing authors.In summary, this book would make a useful addition
to a postgraduate psychiatry library, of most interest toclinicians dealing with dementia patients, but at the endof it I was left wondering whether Pick's complex is acollection of a tree, a snake and a wall or a whole animal.
CAROL GREGORY
Addenbrooke's NHS Trust
Copyright # 1999 John Wiley & Sons, Ltd. Int. J. Geriat. Psychiatry 14, 1080±1082 (1999)
BOOK REVIEWS 1081
