Geriatric Neurology

762 Pages·2014·35.45 MB·English

by  Anil K. Nair

Geriatric
NeuroloGy
edited by
anil k. nair | marwan n. sabbagh

Geriatric Neurology
I dedicate this book to my patients and mentors. This book would not be
possible without my grandfather who carried me on his shoulders daily to an
elementary school miles away and my very supportive family.
AKN
I dedicate this work to my mother and father, who nurtured my unquenchable
thirst for knowledge.
MNS
Geriatric
Neurology
EDITED BY
ANIL K. NAIR MD
Director, Clinic for Cognitive Disorders
and Alzheimer’s Disease Center
Chief of Neurology, Quincy Medical Center
Quincy, MA, USA
MARWAN N. SABBAGH MD, FAAN
Director, Banner Sun Health Research Institute
Research Professor of Neurology
University of Arizona College of Medicine – Phoenix
Sun City, AZ, USA
This edition fi rst published 2014
© 2014 by John Wiley & Sons, Ltd
Registered offi ce: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex,
PO19 8SQ, UK
Editorial offi ces: 9600 Garsington Road, Oxford, OX4 2DQ, UK
The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
111 River Street, Hoboken, NJ 07030-5774, USA
For details of our global editorial offi ces, for customer services and for information about how to
apply for permission to reuse the copyright material in this book please see our website at www
.wiley.com/wiley-blackwell
The right of the author to be identifi ed as the author of this work has been asserted in accordance
with the UK Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system,
or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or
otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior
permission of the publisher.
Designations used by companies to distinguish their products are often claimed as trademarks. All
brand names and product names used in this book are trade names, service marks, trademarks or
registered trademarks of their respective owners. The publisher is not associated with any product
or vendor mentioned in this book. It is sold on the understanding that the publisher is not engaged
in rendering professional services. If professional advice or other expert assistance is required, the
services of a competent professional should be sought.
The contents of this work are intended to further general scientifi c research, understanding, and
discussion only and are not intended and should not be relied upon as recommending or promoting
a specifi c method, diagnosis, or treatment by health science practitioners for any particular patient.
The publisher and the author make no representations or warranties with respect to the accuracy or
completeness of the contents of this work and specifi cally disclaim all warranties, including without
limitation any implied warranties of fi tness for a particular purpose. In view of ongoing research,
equipment modifi cations, changes in governmental regulations, and the constant fl ow of information
relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate
the information provided in the package insert or instructions for each medicine, equipment, or
device for, among other things, any changes in the instructions or indication of usage and for added
warnings and precautions. Readers should consult with a specialist where appropriate. The fact that
an organization or Website is referred to in this work as a citation and/or a potential source of further
information does not mean that the author or the publisher endorses the information the organization
or Website may provide or recommendations it may make. Further, readers should be aware that
Internet Websites listed in this work may have changed or disappeared between when this work was
written and when it is read. No warranty may be created or extended by any promotional statements
for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.
Library of Congress Cataloging-in-Publication Data
Geriatric neurology (Nair)
Geriatric neurology/edited by Anil K. Nair and Marwan N. Sabbagh.
1 online resource.
Includes bibliographical references and index.
Description based on print version record and CIP data provided by publisher; resource not viewed.
ISBN 978-1-118-73064-5 (ePub) – ISBN 978-1-118-73065-2 (Adobe PDF) – ISBN 978-1-118-73068-3 (cloth)
I. Nair, Anil (Anil Kadoor), 1970- editor of compilation. II. Sabbagh, Marwan Noel, editor of
compilation. III. Title.
[DNLM: 1. Nervous System Diseases. 2. Aged. 3. Aging–physiology. 4. Nervous System
Physiological Phenomena. WL 140]
RC451.4.A5
618.97’68–dc23
2013038615
A catalogue record for this book is available from the British Library.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print
may not be available in electronic books.
Cover images: top row - copyright Wiley; bottom - courtesy of Anil K. Nair
Cover design by Andy Meaden
Set in 9.25/12 pt Palatino by Aptara Inc., New Delhi, India
1 2014
Contents
About the Editors, vii 7.2 Functional Imaging in Dementia, 146
Adam S. Fleisher and Alexander Drzezga
List of Contributors, viii
7.3 Amyloid Imaging, 162
Preface, xii
Anil K. Nair and Marwan N. Sabbagh
Acknowledgments, xiii
8 Clinical Laboratory Investigations in Geriatric
Neurology, 170
Part 1 The Aging Brain in Neurology, 1 Geoffrey S. Baird and Thomas J. Montine
1 The Biology of Aging: Implications for Diseases
Part 3 Neurologic Conditions in the
of Aging and Health Care in the Twenty-First
Elderly, 181
Century, 3
Douglas F. Watt
9 Cognitive Impairment and the Dementias, 183
2 Functional Changes Associated with the Aging 9.1 Mild Cognitive Impairment, 187
Nervous System, 38 Ranjan Duara, Miriam Jocelyn Rodriguez, and
Julie A. Schneider and Chunhui Yang David A. Loewenstein
9.2 Alzheimer’s Disease, 200
Part 2 Assessment of the Geriatric Neurology Martin R. Farlow
Patient, 69
9.3 Dementia with Lewy Bodies, 208
Clive Ballard
3 Approach to the Geriatric Neurology Patient: The
Neurologic Examination, 71 9.4 Vascular Cognitive Impairment, 224
Marwan N. Sabbagh and Anil K. Nair Helena C. Chui and Freddi Segal-Gidan
4 Assessment of Cognitive Status in Geriatric 9.5 Frontotemporal Dementia, 239
Neurology, 85 David Perry and Howard Rosen
4.1 Mental Status Examination in the Geriatric
9.6 Primary Progressive Aphasia, 251
Neurology Patient, 87
Maya L. Henry, Stephen M. Wilson,
Papan Thaipisuttikul and James E. Galvin
and Steven Z. Rapcsak
4.2 Neuropsychology in Geriatric Neurology, 98
9.7 Prion Diseases, 267
Donald J. Connor and Marc A. Norman
Michael D. Geschwind and Katherine Wong
5 Cognitive Reserve and the Aging Brain, 118
9.8 Normal Pressure Hydrocephalus, 281
Adrienne M. Tucker and Yaakov Stern
Norman R. Relkin
6 Gait Disorders in the Graying Population, 126
10 Depression in the Elderly: Interactions with
Joe Verghese and Jessica Zwerling
Aging, Stress, Chronic Pain, Infl ammation, and
7 Imaging of the Geriatric Brain, 136 Neurodegenerative Disorders, 287
7.1 Structural Neuroimaging in Degenerative Douglas F. Watt
Dementias, 138
11 Cerebrovascular Diseases in Geriatrics, 302
Liana G. Apostolova
Patrick Lyden, Khalil Amir and Ilana Tidus
v
vi Contents
12 Movement Disorders, 313 23.1 Evidence-Based Pharmacologic Treatment of
12.1 Parkinson’s Disease, 315 Dementia, 557
Robert Fekete and Joseph Jankovic Jasmeet Singh, Marwan N. Sabbagh, and
Anil K. Nair
12.2 Essential Tremor and Other Tremor
Disorders, 325 23.2 Immunotherapy for Alzheimer’s Disease, 574
Holly Shill Michael Grundman, Gene G. Kinney, Eric Yuen,
and Ronald Black
12.3 Progressive Supranuclear Palsy, 333
Virgilio Gerald H. Evidente 24 Geriatric Psychopharmacology, 586
Sandra A. Jacobson
12.4 Corticobasal Degeneration, 344
Katrina Gwinn 25 Nonpharmacologic Treatment of Behavioral
Problems in Persons with Dementia, 615
13 Sleep Disorders, 347
Gary A. Martin and John Ranseen
Sanford Auerbach
26 Expressive Art Therapies in Geriatric
14 Autonomic Dysfunction and Syncope, 358
Neurology, 630
Rohit R. Das
Daniel C. Potts, Bruce L. Miller, Carol A. Prickett,
15 Geriatric Epilepsy, 370 Andrea M. Cevasco, and Angel C. Duncan
David V. Lardizabal
16 Vertigo and Dizziness in the Elderly, 379
Part 5 Important Management Issues Beyond
Terry D. Fife and Salih Demirhan
Therapeutics in the Geriatric Neurology
17 Disorders of the Special Senses in the Elderly, 396 Patient, 645
Douglas J. Lanska
27 Dietary Factors in Geriatric Neurology, 647
18 Nervous System Infections, 460
Yian Gu and Nikolaos Scarmeas
Ronald Ellis, David Croteau, and Suzi Hong
28 Exercising the Brain: Nonpharmacologic
19 Delirium, 478
Interventions for Cognitive Decline Associated
Alan Lerner, Stefani Parrisbalogun, and Joseph Locala
with Aging and Dementia, 669
20 Headache in the Elderly, 486 Brenna A. Cholerton, Jeannine Skinner, and
Brian McGeeney Laura D. Baker
21 Neuromuscular Disorders, 494 29 Driving Impairment in Older Adults, 682
Heber Varela and Clifton Gooch Anne D. Halli-Tierney and Brian R. Ott
30 Elder Abuse and Mistreatment, 699
Elliott Schulman, Ashley Roque, and Anna Hohler
Part 4 Therapeutics for the Geriatric
Neurology Patient, 519 31 Advocacy in Geriatric Neurology, 707
Glenn Finney and Anil K. Nair
22 Neurosurgical Care of the Geriatric Patient, 521
David Fusco, Rasha Germain, and Peter Nakaji
Index, 713
23 Treatment of Dementia, 556
Color plate section appears between pages 50 and 51
About the Editors
Anil K. Nair, MD, is the director of TheAlzCenter.org Marwan N. Sabbagh, MD, FAAN, is a board-certifi ed
and chief of neurology at Quincy Medical Center. He is neurologist and geriatric neurologist. As the director of
also the site director for clinical trials in neurology. He the Banner Sun Health Research Institute, Dr. Sabbagh has
completed his fellowship from Mayo Clinic, Rochester, dedicated his entire career to fi nding a cure for Alzheimer’s
MN, and his neurology residency at the Cleveland Clinic and other age-related neurodegenerative diseases.
and Temple University after graduation from JIPMER, Dr. Sabbagh is a leading investigator for many promi-
Pondicherry, India. His interest area is early and preclin- nent national Alzheimer’s prevention and treatment tri-
ical detection, prevention, and treatment of Alzheimer’s als. He is senior editor for Journal of Alzheimer’s Disease,
dementia, and other neurocognitive disorders and BMC Neurology, and Clinical Neurology News, and has
dementias. authored and coauthored more than 200 medical and sci-
Dr. Nair oversees the clinical and research facil- entifi c chapters, reviews, original research articles, and
ity called TheAlzCenter.org (The Alzheimer’s Center) abstracts on Alzheimer’s research. Dr. Sabbagh has also
serving the south shore of Boston. The center aims to authored The Alzheimer’s Answer—the book’s foreword
advance the fi eld of geriatric neurology and reduce the was written by Justice Sandra Day O’Connor—and edited
costs of debilitating diseases such as Alzheimer’s dis- Palliative Care for Advanced Alzheimer’s and Dementia:
ease and other related dementias. In addition to provid- Guidelines and Standards for Evidence Based Care and coau-
ing preventive, diagnostic, and therapeutic services to thored The Alzheimer's Prevention Cookbook: Recipes to Boost
patients with neurodegenerative and related diseases, Brain Health (RandomHouse/TenSpeed, 2012).
Dr. Nair runs clinical trials in multiple indications, pri- Dr. Sabbagh is research professor in the Department of
marily in Alzheimer’s disease. He is dedicated to pro- Neurology, University of Arizona College of Medicine–
viding healthcare and referral services of the highest Phoenix. He is also an adjunct professor at Midwestern
quality and is committed to building partnerships that University and Arizona State University. He earned his
increase the independence and quality of life for patients undergraduate degree from the University of California
with dementia. Berkeley and his medical degree from the University of
Dr. Nair is also an investigator for the stroke and mem- Arizona in Tucson. He received his internship at the Ban-
ory project at the Framingham Heart Study, which aims ner Good Samaritan Regional Medical Center in Phoenix,
to identify the risk factors involved in such diseases as AZ, and his residency training in neurology at Baylor
Alzheimer’s disease and related dementias. College of Medicine in Houston, TX. He completed his
f ellowship in geriatric neurology and dementia at the
UCSD School of Medicine.
vii
List of Contributors
Khalil Amir MD Helena C. Chui MD
Department of Neurology Department of Neurology
Cedars-Sinai Medical Centre Keck School of Medicine
Los Angeles, CA, USA University of Southern California
Los Angeles, CA, USA
Liana G. Apostolova MD, MS
Department of Neurology Donald J. Connor PhD, PhD
David Geffen School of Medicine Independent Practice
University of California Consultant in Clinical Trials
Los Angeles, CA, USA San Diego, CA, USA
Sanford Auerbach MD David Croteau MD
Departments of Neurology Department of Neurosciences and
Psychiatry and Behavioral Neurosciences HIV Neurobehavioral Research Center
Boston University School of Medicine University of California
Boston, MA, USA San Diego, CA, USA
Geoffrey S. Baird MD Rohit R. Das MD, MPH
Departments of Laboratory Medicine and Pathology Indiana University School of Medicine
University of Washington Indianapolis, IN, USA
Seattle, WA, USA
Salih Demirhan MD
Laura D. Baker PhD Marmara University School of Medicine
Department of Medicine - Geriatrics Istanbul, Turkey
Wake Forest School of Medicine
Winston-Salem, NC, USA Alexander Drzezga MD
Department of Nuclear Medicine
Clive Ballard MBChB MMedSci MRCPsych MD University Hospital of Cologne
Wolfson Centre for Age-Related Diseases Cologne, Germany
King’s College London
London, UK Ranjan Duara MD, FAAN
Wien Center for Alzheimer's Disease and
Ronald Black MD Memory Disorders Mount Sinai Medical Center
Chief Medical Offi cer Miami Beach;
Probiodrug AG Department of Neurology
Halle, Germany Herbert Wertheim College of Medicine
Florida International University, Miami
Andrea M. Cevasco PhD, MT-BC and University of Florida College of Medicine
School of Music University of Florida
College of Arts and Sciences Gainesville, FL, USA
University of Alabama
Tuscaloosa, AL, USA Angel C. Duncan MA-MFT, ATR
Cognitive Dynamics Foundation
Brenna A. Cholerton PhD Neuropsychiatric Research Center of
Department of Psychiatry and Behavioral Science Southwest Florida
University of Washington School of Medicine Albertus Magnus College
and Geriatric Research, Education, and Clinical Center American Art Therapy Association
Veterans Affairs Puget Sound Health Care System Fort Myers, FL, USA
Seattle, WA, USA
viii