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)

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