Rom. J. Gerontol. Geriatr., 2017, Vol. 6, No.

BOOK PRESENTATION
“Geronto-Psihiatrie” (“Geronto-Psychiatry”)
by Covic Marcela, Ţaciu Simona, Covic Teodor Emil
Editura Universitară “Carol Davila”, Bucharest, 2017, 622 pages

"Geronto-psihiatrie" - "Geronto-
psychiatry" written by Marcela Covic,
MD, is the outcome of a lifelong
experience in treating older patients,
created over several years. It is the
result of an original act offering a
unique perspective: that of a
psychiatrist who became also a
geriatrician, with a deep involvement
in both medical specialties.
Even from the beginning one could
easily notice its systematic and well-
organized structure. For a better
understanding of the differences
between normal and pathologic the
author started with a broad review of
data regarding the process of brain
aging described in the general context
of aging and various theories that form
the basis for explaining the main
characteristics of older people. The
monograph continues with description
of the mechanisms underlying the
process of neurogenesis, neuronal
proliferation and formation of the
central nervous system, connected to
neuronal migration, synaptogenesis,
remodeling, neuroplasticity and
apoptosis. They are followed over the
whole period of human development
from intrauterine life to adulthood and
old age. Process of brain aging, considered as a normal aspect seen in older people, is
described in its various aspects: morphologic, vascular, biochemical, metabolic, regarding
neurotransmitters. There are several subchapters with many practical examples concerning
prevention of brain aging, factors favoring a "successful aging" and risk factors for brain
aging.
Often the characteristics of psychiatric disorders are less well known to young medical
graduates because of their complexity. Consequently the chapter regarding psychiatric
diseases is very useful as a solid background in this field. Corroborating characteristics of
psychiatric diseases with their classification together with highlighting the specific patterns of
psychiatric disorders in older people make a clear introductory picture mandatory for a better
understanding of this spectrum of diseases beyond the age of 65 years. An essential chapter is

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 Book Presentation - “Geronto-Psychiatry”

the psychiatric examination that combines theoretical aspects with an exceptional practical
experience of Dr. Marcela Covic in the field of old age psychiatry.
An important chapter is that regarding semiology of psychic functions. It contains a
systematic review of attention, perception, memory, thinking, graphic and verbal expression,
affectivity, will, motor activity, instinctive manifestations, consciousness and personality,
featuring the characteristics of older people. It continues with the main psychiatric syndromes
that are encountered in old age, followed by main neurocognitive disorders seen in geriatric
medicine.
Next there are two chapters very useful for the differential diagnosis of neurocognitive
disorders: delirium and depression. Besides clinical picture and positive and differential
diagnosis, the author presents various therapeutic options, possible drug interactions and an
algorithm for the treatment of depression.
Older patients often report sleep disorders. The chapter on this topic is therefore very
important for a geriatrician but also for any physician involved in dealing with patients
beyond the age of 65 years. It describes aspects of normal sleep in older people together with
a clear classification of sleep disorders and a positive and differential diagnosis of conditions
generating sleep alterations in old age, followed by therapeutic interventions.
The last chapter of the monograph presents psychopharmacology in the older people. It
describes specific patterns of pharmacokinetics and pharmacodynamics influenced by
transformations that accompany the process of aging.
The appendices at the end of the monograph contain several scales of assessment that are very
useful for daily activity of specialists involved in caring for older patients. They are dedicated
to evaluation of cognitive function, mood and functionality.
"Geronto-psihiatrie" - "Geronto-psychiatry" by Marcela Covic, MD, demonstrates a vast
experience in complex approach of older patients incorporating the perspective of an excellent
psychiatrist with that of a very good geriatrician. Moreover, it adequately combines a special
analytical mindset with an exceptional capacity of synthesis. All these qualities can be found
in this monograph that one can read easily and with pleasure because of the clarity of the
ideas presented. In addition it is a very useful tool for day to day medical activity of
geriatricians, psychiatrists, but also other specialists that deal with the difficult task of taking
care of older patients.

Prof. Gabriel-Ioan Prada, MD, PhD

Head of the Chair of Geriatrics and Gerontology
National Institute of Gerontology and Geriatrics "Ana Aslan", Bucharest
University of Medicine and Pharmacy "Carol Davila", Bucharest
President Romanian Society of Gerontology and Geriatrics

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