BOOK REVIEWS

Aiding Older Adults with Memory Complaints by F. Scogin and M. Prohaska. Sarasota: Professional Resource Press, 66 pp, $11.95 US, 1993.

The need to develop and provide novel specialized services to the elderly increases with the rise of an aging population. This fact is underscored by the authors of Aiding OlderAdults with Memory Complaints. Dr. F. Scogin, Associate Professor of Psychology at the University of Alabama, has pursued the field of geropsychology from both clinical and research perspectives, whereas M. Prohaska, M.S., a doctoral student and graduate research assistant to Dr. Scogin, has trained study participants in memory enhancing techniques. The book is intended for professionals involved in front line work who may lack formal training in geriatrics or gerontology and promotes an exhaustive and multisensory approach to treatment. It introduces the "non-gerontologically trained professional" to the most prominent complaint voiced by the older adult, that of impoverished and declining memory, and provides adaptive coping strategies. In the first third of the book, memory changes associated with normal aging are described using the information-processing model of memory (i.e. sensory, primary, secondary, and tertiary memory stores). Then follows a review of the gamut and frequency of memory complaints, the impact of depression on these and the threefold focus of their memory assessment (i.e. objective performance, subjective complaints, and affective status). The topic of cognitive training in brain injury and rehabilitation programs is alluded to only briefly in order to raise the issue of using complex novel mnemonics techniques on a system which has already proven to be less than optimal. Such a concern can readily be applied to the older adult. The position of the authors regarding this issue is obvious. Nonetheless, they argue that more research is necessary before we can truly determine whether memory training learned in an artificial situation generalizes to everyday living, and whether such techniques serve to enhance memory functioning. The memory training program detailed in the second third of the manuscript provides a description of three intervention strategies to enhance acquisition and retention of new information: 1. organizational techniques (categorization & Francine F-A.. Sarazin, Ph.D., C.Psych. chunking); 2. imagery techniques (method of loci & novel Ottawa, Ontario, Canada interacting images); and 3. physical reminders (writing things down, placing reminder objects in a prominent place and use of established locations). The latter third of the book details how to integrate memory training when providing Brain Biochemistry and Brain Disorders by Philip G. intervention to older adults. It also reviews the findings of Strange. Oxford, New York, Tokyo: Oxford University empirical studies on memory training programs and high- Press, 342 pp, $52.95, 1992. lights the limitations of such training. Finally, the book closes with suggestions for future investigations. I read and re-read this book several times - it is easy to read. On my first survey, I noted numerous excusable and
J Psychiatr Neurosci, VoL 19, No. 2, 1994 151

On the whole, the authors have provided a concise and relatively encompassing expose of a most important issue. Indeed, it is not sufficient to merely substantiate or disconfirm memory complaints experienced by the older person. One should also provide the means to compensate for such limitations. To do so, the clinician can readily refer to this resource work for a review of useful strategic techniques. The brevity of the book will make it a favorite of professionals constricted by time limitations as it may be more readily consulted than lengthy and comprehensive handbooks on the topic. Another positive aspect of this expos6 pertains to its emphasis on educating the older adult about the various aspects of memory and the expected changes associated with aging. In that regard, it may help alter inaccurate perceptions or beliefs regarding memory. Clinicians often encounter unrealistic expectations about memory performance in their elderly patients. Too often, these expectations are inappropriately elevated, particularly with the more educated individual. Unfortunately, this manuscript has failed to address the impact of education and/or high premorbid abilities on memory complaints, two most important contributing factors. Although reactions from participants of such training programs may well be summarized as positive overall, they constitute a selective subsample and may not be representative of the population of people who complain of memory disturbances. Another area which lacked adequate critical examination pertains to a general statement that memory changes on the whole are only mild in the aging population and that "the picture is not as grim as most believe" (p. 3). Reviews of normative data on frequently used standardized measures of memory functioning (e.g. WMS-R or CVLT) indicate a significant decline in the amount of information retained with increasing decades. Despite these minor shortcomings, the manuscript provides the clinician with a workable tool by which to instill practical methods of compensation to those who present with memory complaints. The clinician sensitive to the needs of the individual patient may consult this book to find practical coping strategies that may be proposed and for which they are less likely to encounter resistance. Finally, the book can easily be read by highly functioning individuals.

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Book reviews

March 1994

to all tastes. However, this spectacular growth and success represent the end result of a journey through a complex and winding path of psychotropic drug development and evaluation. In the process, conceptual, methodological and ethical issues have been explored, debated and at times resolved. The accumulated literature on the principles and practice of psychotropic drug research is widely dispersed among pharmacology texts, clinical trials monographs, statistical treatises and occasionally psychiatric journals. There have been few works solely dedicated to this subject; the publication of this book is a modest attempt to fill this void. The purpose, background, development, format, scope and limitations of the document are stated in the brief, well written introduction. This is followed by an overview of the drug evaluation process, summarizing the phases of drug six different disorders. development, testing and monitoring, and discussing the The author discusses artfully and, for purposes of psychi- surrounding methodological and ethical issues. This would atric residents and practitioners, sufficiently the cellular as- certainly help the novice to gain a comprehensive picture of pects of the brain tissue, the chemical and electrical the subject and lays a blueprint for the rest of the document. signalling, the neurotransmitter and receptor systems as well The successive phases of drug evaluation are succinctly as some research technologies, although the description of reviewed in the first four chapters and special issues involvthe restriction-fragment length polymorphism (RFLP) could ing children, elderly and transcultural studies are addressed in the remaining three chapters. The nuts and bolts of clinical have been made clearer. The author chose six diverse pathologies that are con- trials are well covered here, discussing the details ofprotocol nected along the mesostriatal, mesolimbic and mesofrontal preparation, varieties of study designs, sampling techniques, tracts. The totality of these six pathologies, and some others aspects of measurement and data gathering. The liberal use mentioned en passant, provides a base not only for the of tables, sub-headings and footnotes has helped to neatly understanding of these illnesses but also for the comprehen- summarize the abundance of information and facilitate an sion of these brain parts. The discussion of Parkinson's easy access for quick reference. The aim apparently was to consolidate the existing, estabdisease, including the MPTP, genetic aspects, rationale of tissue transplant, etc. is fairly complete, as is the chapter on lished knowledge on the subject, avoiding controversies. Huntington's disease and Alzheimer's disease. The chapter Thus, spelling out the scope and limitations of the document, on schizophrenia, as a brain disease, competently deals with the authors proceeded to organize the information with a the subject, although the contribution of Weinberger (men- logical plan and lucid style. The selected list of references tioned briefly on page 256) could have been more extensive. included, mainly for the scales and instruments, help students The chapter on depression, although thorough and interest- and young researchers to find their way around the confusing ing, is too speculative in relation to the septo-hippocampal field of measuring mental phenomena. However, achieving consensus and eagerness to avoid system. The last chapter, on anxiety, is probably the weakest. The illustrations, including the CT scans, are of good controversy has somewhat limited the scope and impact of quality. There are aspects of the quotations of original con- the book. The approach is too practically oriented, dealing tributors where one could disagree with the author. Consid- exclusively with methodological details and execution of ering that books rapidly become outdated, this book has a clinical trials. Conceptual issues are mostly avoided. A chapcertain philosophy and appeal - not to mention a modest ter on the contemporary confusion surrounding psychiatric classification, diagnosis and measurement would have been price - that will assure a measure of longevity. a valuable addition. The book would have benefited from an Erwin K. Koranyi, M.D. annotated bibliography at the end of each chapter. Ottawa, Ontario, Canada In spite of these limitations, the book certainly fulfils its purpose, serving as a useful reference guide for students of Clinical Evaluation of Psychotropic Drugs for Psychiat- psychopharmacology, pharmacy and psychiatry as well as ric Disorders; Principles and Proposed Guidelines, clinical investigators. The book is unconditionally recomVolume 2. Edited by P. Grof et al. WHO expert series on mended for all libraries but individuals tempted to buy it biological psychiatry. Hogrefe and Huber Publishers, 202 pp, should first check the price from their local book stores. In Toronto, the quoted price of $44.00 is slightly expensive. price not stated, 1993. WHO documents, widely referred to in the developing counIn the past decade, clinical psychopharmacology has en- tries, should no doubt be cheaper. tered an exciting era of development, rising hopes and expecL.N.P. Voruganti, M.D. tations. Second generation anti-depressants became the first A.G. Awad, M.D. choice drugs, new atypical antipsychotic drugs are beginning Toronto, Ontario, Canada of anxiolytics seems to cater to make their mark and the menu

many unforgiveable omissions (for example, only a brief mention of the dopamine D-3 receptors on page 239 and not even a word on the D-4 receptors that had been described by then). But I came to the realization that one cannot be an excessively critical judge. Any book of this size that comprises biochemistry, structure, research methodology and a wide range of pathologies of the brain can only be somewhat of a smorgasbord. There is nothing wrong with a neuroscience buffet, however, provided it is nutritious and served with style. And this must be recognized about this book, including the extremley well chosen cover illustration of Edward Munch's "The Dance of Life". The first seven chapters provide sufficient amounts of basic information and neuroscience facts that are required for the grasp of the second part of the book, which focuses on