When confronted with a neurological or psychiatric disorder in an elderly individual, a clinician or researcher is likely to ask how the processes of ageing have influenced the aetiology and presentation of the disorder, and will impact on its efficient management. There are many urban myths about ageing, and some of these apply to the brain. The reviews included in this book are an attempt to flush out some of these myths, and arm the clinician and general researcher with the empirical facts that can be mustered to substantiate claims about ageing. There are many salient questions: is cognitive change to be expected in an elderly individual? Is this change progressive, relentless and unselective, or is it focal and constrained? Would every person who lived long enough develop Alzheimer’s disease? Do our neurones die as we get old? What happens to the size of the brain and its metabolic activity? How do our hormones change with age? Can anti-oxidants slow or even stop the process of ageing? Are genes important in the ageing brain or is it all in the environment? How much of what we are is due to what we eat? The contributors to this book, each an expert in their field, have addressed some of these questions in a language simple enough for a general reader to understand.
The book also deals with some of the most prominent brain disorders of old age - Alzheimer's disease, Parkinson's disease, vascular dementia, and depression. The focus is on the impact of ageing on these disorders. The discussions lay out a broad map for the clinician dealing with neuropsychiatric disorders, and the future researcher of brain ageing. In a field in which the developments are too numerous for any one individual to keep pace with, this book presents up-to-date summaries that can be a useful starting point. The field of brain ageing abounds in tabloid science. This book counters this by providing a strong empirical grounding and considered synthesis of the research.
Section 1. Introduction. P.S. Sachdev, The Ageing Brain. G.A. Broe, Population Ageing, Human Lifespan and Neurodegenerative Disorders: A Fifth Epidemiologic Transition. Section 2. Characteristics of the Ageing Brain. J.J. Kril, Structural Changes in the Ageing Human Brain. J.C.L. Looi, P.S. Sachdev, Structural Neuroimaging of the Ageing Brain. S.R. Lord, R. St George, Neurophysiological, Sensory and Motor Changes with Ageing. H. Christensen, R. Kumar, Cognitive Changes and the Ageing Brain. J.N. Trollor, P.S. Sachdev, Ageing of the Human Brain as Studied by Functional Neuroimaging. G.A. Smythe, Neuroendocrine Aspects of Brain Ageing. V.K. Srikanth, G.A. Donman, Cerebrovascular System and the Ageing Brain. Section 3. Factors Influencing Brain Ageing. J.B.J. Kwok, P.R. Schofield, The Molecular Basis of Alzheimer’s Disease and Frontotemporal Dementia. J. de Haan, R.C. Iannello, P.J. Crack, P. Hertzog, I. Kola, Oxidative and Free Radical Mechanisms in Brain Ageing. J. Bryan, The Role of Nutritional Factors in Cognitive Ageing. P.W. Schofield, The Brain Reserve Hypothesis. Section 4. Clinical Interface. C. Brayne, Will We All Dement if We Live Long Enough? G.W. Small, Detecting Alzheimer’s Disease at the Pre-Symptomatic Stage. J.G.L. Morris, M.A. Hely, G.M. Halliday, Parkinsonism and Ageing. J. Snowdon, Age Variation in the Prevalence of Depression: Are Study Findings Meaningful? P.S. Sachdev, Vascular Dementia. P.S. Sachdev, Conclusion.