Diagnosis and Management in

Dementia: The Neuroscience of

Dementia, Volume 1 1st Edition Colin R.
Martin
Visit to download the full and correct content document:
https://ebookmass.com/product/diagnosis-and-management-in-dementia-the-neurosci
ence-of-dementia-volume-1-1st-edition-colin-r-martin/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...

Zika Virus Biology, Transmission, and Pathways Volume

1: The Neuroscience of Zika Colin R. Martin

https://ebookmass.com/product/zika-virus-biology-transmission-
and-pathways-volume-1-the-neuroscience-of-zika-colin-r-martin/

Zika Virus Impact, Diagnosis, Control, and Models Colin

R. Martin

https://ebookmass.com/product/zika-virus-impact-diagnosis-
control-and-models-colin-r-martin/

ABC of dementia Second Edition Coope

https://ebookmass.com/product/abc-of-dementia-second-edition-
coope/

Dementia, Narrative and Performance: Staging Reality,

Reimagining Identities 1st Edition Janet Gibson

https://ebookmass.com/product/dementia-narrative-and-performance-
staging-reality-reimagining-identities-1st-edition-janet-gibson/
Learning from the Talk of Persons with Dementia: A
Practical Guide to Interaction and Interactional
Research 1st ed. Edition Trini Stickle

https://ebookmass.com/product/learning-from-the-talk-of-persons-
with-dementia-a-practical-guide-to-interaction-and-interactional-
research-1st-ed-edition-trini-stickle/

Innovative Research Methodologies in Management: Volume

II: Futures, Biometrics and Neuroscience Research 1st
Edition Luiz Moutinho

https://ebookmass.com/product/innovative-research-methodologies-
in-management-volume-ii-futures-biometrics-and-neuroscience-
research-1st-edition-luiz-moutinho/

Six Steps to Managing Alzheimer's Disease and Dementia:

A Guide for Families Budson Md

https://ebookmass.com/product/six-steps-to-managing-alzheimers-
disease-and-dementia-a-guide-for-families-budson-md/

Sex Differences in Cardiac Diseases: Pathophysiology,

Presentation, Diagnosis and Management Niti R. Aggarwal

https://ebookmass.com/product/sex-differences-in-cardiac-
diseases-pathophysiology-presentation-diagnosis-and-management-
niti-r-aggarwal/

Memory Loss, Alzheimer's Disease and Dementia: A

Practical Guide for Clinicians 3rd Edition Andrew E.
Budson Md

https://ebookmass.com/product/memory-loss-alzheimers-disease-and-
dementia-a-practical-guide-for-clinicians-3rd-edition-andrew-e-
budson-md/
DIAGNOSIS AND
MANAGEMENT IN
DEMENTIA
The Neuroscience of Dementia
VOLUME

1
Edited by

COLIN R. MARTIN
Institute for Clinical and Applied Health Research (ICAHR)
University of Hull
Hull, United Kingdom

VICTOR R. PREEDY
King’s College London
London
United Kingdom
Academic Press is an imprint of Elsevier
125 London Wall, London EC2Y 5AS, United Kingdom
525 B Street, Suite 1650, San Diego, CA 92101, United States
50 Hampshire Street, 5th Floor, Cambridge, MA 02139, United States
The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, United Kingdom

Copyright © 2020 Elsevier Inc. All rights reserved.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic
or mechanical, including photocopying, recording, or any information storage and retrieval system,
without permission in writing from the publisher. Details on how to seek permission, further
information about the Publisher’s permissions policies and our arrangements with organizations such
as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website:
www.elsevier.com/permissions.

This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical
treatment may become necessary.

Practitioners and researchers must always rely on their own experience and knowledge in evaluating
and using any information, methods, compounds, or experiments described herein. In using such
information or methods they should be mindful of their own safety and the safety of others, including
parties for whom they have a professional responsibility.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume
any liability for any injury and/or damage to persons or property as a matter of products liability,
negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas
contained in the material herein.

Library of Congress Cataloging-in-Publication Data

A catalog record for this book is available from the Library of Congress
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
ISBN: 978-0-12-816043-5 (Set)
ISBN: 978-0-12-815854-8 (Volume 1)
ISBN: 978-0-12-815868-5 (Volume 2)

For information on all Academic Press publications visit our

website at https://www.elsevier.com/books-and-journals

Publisher: Nikki Levy

Acquisitions Editor: Natalie Farra
Editorial Project Manager: Timothy Bennett
Production Project Manager: Paul Prasad Chandramohan
Cover Designer: Matthew Limbert

Typeset by TNQ Technologies

Colin R. MartindI would like to dedicate this book to my beautiful daughter
Dr. Caragh Brien, of whom I am so proud.
Contributors

Athanasios Alexiou
Novel Global Community Educational Foundation, Hebersham, NSW, Australia; AFNP
Med Austria, Wien, Austria
Francesco Amenta
Clinical Research, Telemedicine and Telepharmacy Centre, School of Medicinal and Health
Products Sciences, University of Camerino, Camerino, Italy
Nicola Amoroso
Dipartimento Interateneo di Fisica “M. Merlin”, Universit
a degli studi di Bari “A. Moro”, Istituto
Nazionale di Fisica Nucleare - Sez. di Bari, Bari, Italy
Jessica L. Andrews
Office of the DVC Research, The University of Sydney, Sydney, NSW, Australia
Francesco Arba
Stroke Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Ubaldo Armato
Histology & Embryology Unit, School of Medicine, University of Verona, Verona, Italy
Ghulam Md Ashraf
King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
Lapo Attardo
Music Therapist at ASP Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, Milan, Italy
Thiago Junqueira Avelino-Silva
Division of Geriatrics, Department of Internal Medicine, University of Sao Paulo Medical School,
Sao Paulo, Brazil
Annelise Ayres
Postgraduate Program in Health Sciences, Universidade Federal de Ci^encias da Sa
ude de Porto
Alegre, Porto Alegre, Rio Grande do Sul, Brazil
Giacinto Bagetta
Section of Preclinical and Translational Pharmacology, Pharmacotechnological Documentation
and Transfer Unit (PDTU), Department of Pharmacy, Health Science and Nutrition, University
of Calabria, Rende, Italy
Marta Balietti
Center of Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
Gopi Battineni
Telemedicine and Telepharmacy Center, School of Pharmacological Sciences and Health
Products, University of Camerino, Camerino, Italy

xiii
xiv Contributors

Siamak Beheshti
Department of Plant and Animal Biology, Faculty of Biological Science and Technology,
University of Isfahan, Isfahan, Iran
Lazaros Belbasis
Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina,
Greece
Vanesa Bellou
Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina,
Greece
Leandro Bueno Bergantin
Department of Pharmacology, Universidade Federal de S~ao Paulo (UNIFESP), S~ao Paulo, SP,
Brazil
Waleska Berríos
Department of Neurology, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
Virginia Boccardi
Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia,
Italy
Andrea Bosco
Department of Education Science, Psychology, Communication, Università degli Studi di Bari
“Aldo Moro”, Bari, Italy
Robert Briggs
Centre for Ageing, Neurosciences and the Humanities, Tallaght Hospital, Dublin, Ireland
Johannes Burtscher
 cole Polytechnique
Laboratory of Molecular and Chemical Biology of Neurodegeneration, E
Federale de Lausanne (EPFL), Lausanne, Switzerland
Martin Burtscher
Department of Sport Science, University of Innsbruck, Innsbruck, Austria; Austrian Society for
Alpine and High-Altitude Medicine, Innsbruck, Austria
Alessandro O. Caffò
Department of Education Science, Psychology, Communication, Università degli Studi di Bari
“Aldo Moro”, Bari, Italy
Nohelia Cajas-Salazar
Department of Biology, Research Group Genetic Toxicology and Cytogenetics, Faculty of
Natural Sciences and Education, University of Cauca, Popayan, Cauca, Colombia
Michele L. Callisaya
Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia;
Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria,
Australia
Afonso Caricati-Neto
Head of Laboratory of Autonomic and Cardiovascular Pharmacology, Department of
Pharmacology, Universidade Federal de S~ao Paulo (UNIFESP), S~ao Paulo, SP, Brazil
 Contributors xv

Cecilia Carlesi
Neurology Unit, Versilia Hospital, Camaiore (Lucca), Italy
Willian Orlando Castillo-Ordo~ nez
Department of Biology, Research Group Genetic Toxicology and Cytogenetics, Faculty of
Natural Sciences and Education, University of Cauca, Popayan, Cauca, Colombia
Victor T.T. Chan
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong,
Shatin, Hong Kong
Stylianos Chatzichronis
AFNP Med Austria, Wien, Austria; National and Kapodistrian University of Athens, Department
of Informatics and Telecommunications, Bioinformatics Program, Zografou, Greece
Carol Y. Cheung
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong,
Shatin, Hong Kong
Anna M. Chiarini
Histology & Embryology Unit, School of Medicine, University of Verona, Verona, Italy
Virginia Cipollini
NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome,
Rome, Italy
Gabriele Cipriani
Neurology Unit, Versilia Hospital, Camaiore (Lucca), Italy
Sylvie Claeysen
IGF, Univ Montpellier, CNRS, INSERM, Montpellier, France
Paul Claffey
Centre for Ageing, Neurosciences and the Humanities, Tallaght Hospital, Dublin, Ireland
Roger Clarnette
Medical School, University of Western Australia, Crawley, WA, Australia
Maria Tiziana Corasaniti
Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
Elise Cornelis
Department Gerontology, Vrije Universiteit Brussel, Brussels, Belgium
Ilaria Dal Prà
Histology & Embryology Unit, School of Medicine, University of Verona, Verona, Italy
Sultan Darvesh
Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada; Department
of Medicine (Neurology), Dalhousie University, Halifax, NS, Canada
Drew R. DeBay
Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada; Department
of Medicine (Neurology), Dalhousie University, Halifax, NS, Canada
xvi Contributors

Paolo Del Dotto

Neurology Unit, Versilia Hospital, Camaiore (Lucca), Italy
Jacques De Reuck
Degenerative & vascular cognitive disorders. Lille, France
Patricia De Vriendt
Department Gerontology, Vrije Universiteit Brussel, Brussels, Belgium
Thanuja Dharmadasa
Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
Kathryn Dovey
Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
H. Fred Downey
Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort
Worth, TX, United States; Scientific Educational Center for Biomedical Technology, South Ural
State University, Chelyabinsk, Russia
Adam H. Dyer
Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
Claudio Eccher
Villa Bianca Hospital, Surgery Unit, Trento, Italy
Kristina Endres
Department of Psychiatry and Psychotherapy, Medical Center, Johannes Gutenberg-University
of Mainz, Mainz, Germany
Evangelos Evangelou
Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina,
Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College
London, London, United Kingdom
Francesca Fernandez
Faculty of Health Sciences, School of Behavioural and Health Sciences, Australian Catholic
University, Nudgee, QLD, Australia
Alycia Fong Yan
Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
Emily Frith
Physical Activity Epidemiology Laboratory, Exercise & Memory Laboratory, Department of
Health, Exercise Science and Recreation Management, The University of Mississippi, University,
MS, United States
Flavia Barreto Garcez
Division of Geriatrics, Department of Internal Medicine, University of Sao Paulo Medical School,
Sao Paulo, Brazil
Patrizia Giannoni
EA7352 CHROME, University of Nîmes, Nîmes, France
 Contributors xvii

Franco Giubilei
NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome,
Rome, Italy
Oleg S. Glazachev
Department of Normal Physiology, I.M.Sechenov First Moscow State Medical University
(Sechenov University), Moscow, Russia
B.E. Glynn-Servedio
Clinical Pharmacy SpecialisteAmbulatory Care, Durham VA Health Care System, Raleigh 1
Community-Based Outpatient Clinic, Raleigh, NC, United States
Angel Golimstok
Department of Neurology, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
Ellen Gorus
Department Gerontology, Vrije Universiteit Brussel, Brussels, Belgium
Rebecca F. Gottesman
Departments of Neurology and Epidemiology, Johns Hopkins School of Medicine, Baltimore,
MD, United States
Shizuo Hatashita
Department of Neurology, Shonan Atsugi Hospital, Atsugi, Japan
Bernhard Holle
German Center for Neurodegenerative Diseases e.V. (DZNE), DZNE site Witten, Witten,
Germany
Mahboobeh Housseini
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South
Wales, Sydney, New South Wales, Australia
William Huynh
Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia; Prince of Wales
Hospital, Randwick, NSW, Australia
Elena Caldarazzo Ienco
Neurology Unit, Versilia Hospital, Camaiore (Lucca), Italy
Caroline Ismeurt
IGF, Univ Montpellier, CNRS, INSERM, Montpellier, France
Oshadi Jayakody
Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
Pabiththa Kamalraj
Health and Rehabilitation Sciences, Western University, London, ON, Canada
Karin Wolf-Ostermann
University of Bremen, Department 11, Human and Health Sciences, Bremen, Germany
Kazunori Kawaguchi
School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
xviii Contributors

Sean P. Kennelly
Centre for Ageing, Neurosciences and the Humanities, Tallaght Hospital, Dublin, Ireland
Matthew C. Kiernan
Bushell Chair of Neurology Department of Neurology Royal Prince Alfred Hospital, Sydney,
NSW, Australia
Anna E. King
Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS,
Australia
Nobuya Kitaguchi
School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
Shinsuke Kito
Department of Psychiatry, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
Franziska Laporte Uribe
German Center for Neurodegenerative Diseases e.V. (DZNE), DZNE site Witten, Witten,
Germany
Yue Liu
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South
Wales, Sydney, New South Wales, Australia
Antonella Lopez
Department of Education Science, Psychology, Communication, Università degli Studi di Bari
“Aldo Moro”, Bari, Italy
Paul D. Loprinzi
The University of Mississippi, Physical Activity Epidemiology Laboratory, Exercise & Memory
Laboratory, Department of Health, Exercise Science, and Recreation Management, 229 Turner
Center, University, MS, United States
Lee-Fay Low
Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
Robert T. Mallet
Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort
Worth, TX, United States
Eugenia B. Manukhina
Laboratory for Regulatory Mechanisms of Stress and Adaptation, Institute of General Pathology
and Pathophysiology, Moscow, Russia; Laboratory for Molecular Mechanisms of Stress, South
Ural State University, Chelyabinsk, Russia; Department of Physiology and Anatomy, University
of North Texas Health Science Center, Fort Worth, TX, United States
Gabriella Marucci
School of Medicinal and Health Sciences Products, University of Camerino, Camerino, Italy
Jordi A. Matias-Guiu
Department of Neurology, Hospital Clínico San Carlos, San Carlos Institute for Health Research
(IdISSC), Universidad Complutense, Madrid, Spain
 Contributors xix

Wong Matthew Wai Kin

Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South
Wales, Sydney, New South Wales, Australia
Patrizia Mecocci
Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia,
Italy
D. William Molloy
Centre for Gerontology and Rehabilitation, St. Finbarr’s Hospital, University College Cork,
Cork City, Ireland
Domenico Monteleone
DG Animal Health and Veterinary Drugs, Ministry of Health, Rome, Italy
Luigi Antonio Morrone
Section of Preclinical and Translational Pharmacology, Pharmacotechnological Documentation
and Transfer Unit (PDTU), Department of Pharmacy, Health Science and Nutrition, University
of Calabria, Rende, Italy
Michele Moruzzi
School of Medicinal and Health Sciences Products, University of Camerino, Camerino, Italy
Thomas M€ uller
Department of Neurology, St. Joseph Hospital Berlin-Weissensee, Berlin, Germany
Braidy Nady
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South
Wales, Sydney, New South Wales, Australia
Akihiko Nunomura
Department of Psychiatry, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
Angelo Nuti
Neurology Unit, Versilia Hospital, Camaiore (Lucca), Italy
R
onan O’Caoimh
Clinical Sciences Institute, National University of Ireland Galway, Galway City, Ireland;
Department of Geriatric Medicine, Mercy University Hospital, Cork City, Ireland
Paul O’Halloran
School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
Marina Padovani
School of Speech-Language Pathology and Audiology, Santa Casa de S~ao Paulo, School of
Medical Sciences, S~ao Paulo, Brazil
Graziano Pallotta
Clinical Research, Telemedicine and Telepharmacy Centre, School of Medicinal and Health
Products Sciences, University of Camerino, Camerino, Italy
Lucia Paolacci
Department of Medicine, Institute of Gerontology and Geriatrics, University of Perugia, Perugia,
Italy
xx Contributors

Helen Parker
Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia
Sachdev Perminder Singh
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South
Wales, Sydney, New South Wales, Australia; Neuropsychiatric Institute, Euroa Centre, Prince of
Wales Hospital, Sydney, New South Wales, Australia
Couratier Philippe
Service Neurologie, Centre de reference SLA et autres maladies du neurone moteur, CHU
Limoges, Limoges, France
Anne Poljak
Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South
Wales, Sydney, New South Wales, Australia; Bioanalytical Mass Spectrometry Facility (BMSF),
University of New South Wales, Sydney, New South Wales, Australia; School of Medical
Sciences, University of New South Wales, Sydney, New South Wales, Australia
Alfredo Raglio
Music Therapy Research Laboratory, Istituti Clinici Scientifici Maugeri, Pavia, Italy
Innocenzo Rainero
Aging Brain and Memory Clinic, Department of Neuroscience “Rita Levi Montalcini”,
University of Torino, Torino, Italy
Bridget Regan
Lincoln Centre for Research on Ageing, Australian Institute for Primary Care & Ageing, School
of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
Larry D. Reid
Department of Cognitive Science, Rensselaer Polytechnic Institute, Troy, NY, United States
Sven Reinhardt
Department of Psychiatry and Psychotherapy, Medical Center, Johannes Gutenberg-University
of Mainz, Mainz, Germany
Jochen Rene Thyrian
German Center for Neurodegenerative Diseases e.V. (DZNE), DZNE site Rostock/Greifswald,
Greifswald, Germany
Valentina Rinnoci
Stroke Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; IRCCS Don Gnocchi
Fundation, Florence, Italy
Sergio del Río-Sancho
Instituto de Ciencias Biomedicas, Departamento de Farmacia, Facultad de Ciencias de la Salud,
Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
Laura Rombol
a
Section of Preclinical and Translational Pharmacology, Pharmacotechnological Documentation
and Transfer Unit (PDTU), Department of Pharmacy, Health Science and Nutrition, University
of Calabria, Rende, Italy
 Contributors xxi

Maira Rozenfeld Olchik

Department of Surgery and Orthopedics, Speech Language Pathology Course, Universidade
Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
Elisa Rubino
Aging Brain and Memory Clinic, Department of Neuroscience “Rita Levi Montalcini”,
University of Torino, Torino, Italy
Kazuyoshi Sakai
School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
Tsukasa Sakurada
First Department of Pharmacology, Daiichi College of Pharmaceutical Sciences, Fukuoka, Japan
Shinobu Sakurada
Department of Physiology and Anatomy, Tohoku Pharmaceutical University, Sendai, Japan
Marie Y. Savundranayagam
School of Health Studies, Western University, London, ON, Canada
F
ulvio Alexandre Scorza
Department of Neurology/Neurosurgery, Universidade Federal de S~ao Paulo (UNIFESP), S~ao
Paulo, SP, Brazil
Damiana Scuteri
Section of Preclinical and Translational Pharmacology, Pharmacotechnological Documentation
and Transfer Unit (PDTU), Department of Pharmacy, Health Science and Nutrition, University
of Calabria, Rende, Italy
Tatiana V. Serebrovskaya
Department of Hypoxic States, Bogomoletz Institute of Physiology, Kiev, Ukraine
Masahiro Shigeta
Department of Psychiatry, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
Shunichiro Shinagawa
Department of Psychiatry, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
Giuseppina Spano
Department of Education Science, Psychology, Communication, Università degli Studi di Bari
“Aldo Moro”, Bari, Italy; Department of Agro-Environmental and Territorial Sciences,
Università degli Studi di Bari “Aldo Moro”, Bari, Italy
Kimberley E. Stuart
Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS,
Australia
Kenji Tagai
Department of Psychiatry, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
Toshio Tamaoki
Department of Neuropsychiatry, Graduate School of Medical Science, University of Yamanashi,
Chuo, Yamanashi, Japan
xxii Contributors

Dylan Z. Taylor
Department of Cognitive Science, Rensselaer Polytechnic Institute, Troy, NY, United States
Enea Traini
Telemedicine and Telepharmacy Center, School of Pharmacological Sciences and Health
Products, University of Camerino, Camerino, Italy
Fernanda Troili
NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome,
Rome, Italy
Alessandro Vacca
Aging Brain and Memory Clinic, Department of Neuroscience “Rita Levi Montalcini”,
University of Torino, Torino, Italy
James C. Vickers
Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS,
Australia
Alicia A. Walf
Department of Cognitive Science, Rensselaer Polytechnic Institute, Troy, NY, United States
Keenan A. Walker
Department of Neurology, Johns Hopkins School of Medicine. Baltimore, MD, United States
Yvonne Wells
Lincoln Centre for Research on Ageing, Australian Institute for Primary Care & Ageing, School
of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
Randall J. Woltjer
Department of Neurology, Oregon Health Science University and Portland VA Medical Center,
Portland, OR, United States
Paul L. Wood
Metabolomics Unit, Associate Dean of Research, College of Veterinary Medicine, Lincoln
Memorial University, Harrogate, TN, United States
Foreword

I am gratified to write the foreword to this comprehensive book on dementia. Pro-

fessors Preedy and Martin’s purpose is to improve and enhance the care of individuals
who have been diagnosed with dementia.
Given the scope of what dementia isda catch-all term for a constellation pathologies
that impact deleteriously and chronically on brain functiondunderstanding the spectrum
of what we consider the disease and process of dementia is inevitably a complex task. Yet,
as this inspiring new book reveals, we are making significant headway.
The two professors, one from the University of Hull and the other from King’s College
London, leading authorities themselves in applied health research, have brought together
other leading authorities from around the world who specialize in dementia clinical and
applied research. Their focus is on contemporary treatment, management, and research
innovation from a primarily physiological perspective, whilst implicitly emphasizing that
the fundamental purpose is enhancing and improving the understanding and care of those
with a diagnosis of dementia.
They have not forgotten the vital role that family, friends, and other carers play in
supporting the patient with dementia and that these carers are often long-term partners
who are themselves very elderly, maybe with multiple pathology themselves, or
offspring, no longer in the first flush of youth. Their needs are vital. Improving the
outcomes for each individual patient with dementia integrates the patient, family, friends,
and other carers with health and social care practitioners in a unique partnership aimed at
improving care and quality of life for both patient and those close to the patient.
The impact of the dementia diagnosis is likely to be met by fear, anxiety, and
trepidation and perhaps, shame. I am old enough to remember when a diagnosis of
cancer was met with the same emotions and, to some extent, stigma. We have learned
so much more about cancer, the care of patients with a diagnosis of cancer, and the needs
of carers. This book helps move us along the road to an increasingly evidence-based
treatment of dementia, a recognition of the trauma of the diagnosis. It enables improved
education and support of family, carers, and the public, and, not least, practitioners and
researchers.
Surprisingly, though we know much regarding the psychosocial aspects of dementia
care from an integrated perspective, the underlying biological substrates and layers of
dementia are less clearly understood, particularly from an integrated perspective.
This book has special resonance for me at many levels. It balances the biological
aspects of disease, evidence-based treatment, the care of patients and carers, and
acknowledges the complex web that enables effective care.

xxiii
xxiv Foreword

My own journey through nursing and health visiting led me to research the role of
the health visitor with older people. It makes me smile, even now, as I remember the
lady who opened the door and I asked to see her mother. “She’s dead,” the lady replied.
I quickly discovered the lady to whom I was speaking was 90. Hale and hearty. But there
were others, very ill in their fifties and sixties. Others too, desperately caring for their
partners. Feeling frightened and alone. Patients with dementia who had other illnesses
not diagnosed. So much to do.
I understand well the complex web that produces integrated care, as I went on to
research interprofessional, interorganizational relations, as with this book, with the sole
purpose of assisting with the development of care for patients and their carers. Influencing
policy and advocating are as important as the “hard” sciences, social sciences, in
improving care. It is exciting. Fundamental is to be caring, this is my interest in ethics,
moral behaviordwhy are people ill-treated?
It has been a pleasure to write the foreword for this stimulating new book. Victor
Preedy and Colin Martin have produced a work of considerable value to both clinicians
and researchersdoften the same people. The discovery of new knowledge is always
exciting, and in this instance, it can help also to prevent ill treatment.
Carolyn Roberts
Lady Roberts is Pro Chancellor at the University of Hull.
Her career has straddled clinical practice, research, consultancy, and management. She
has a keen interest in clinical ethics and bioethical issues. As well as experiencing the ups
and downs of life, she is ever seeking to overcome disadvantage, to be holisticdas this
book does, integrating all aspects of lifedplus of course, always interested in the exciting
search for new knowledge, new skills, and continuous improvement.
Preface

There are many different types of dementia, and the most common of these include
Alzheimer disease and Lewy body, mixed and vascular dementias. Together they account
for about 90% of all dementias, though there are others, such as those associated with
Parkinson’s, Creutzfeldt-Jakob, and Huntingdon diseases. Globally there are 50 million
people living with dementia. In the United States there are 5 million people with demen-
tia costing an annual 250 billion dollars, or more. The present trajectory suggests that by
2050 the number of people in the United States with dementia will reach 16 million.
Connected with this are the unpaid carers, who currently number 15 million in the
United States alone.
Whilst the day-to-day impact of dementia on the individual and family unit is known,
the neuroscientific basis and different methods of diagnosis and treatment are diffuse,
appearing in different scientific domains. This is addressed in Diagnosis and Management
in Dementia: The Neuroscience of Dementia, which brings together different fields of demen-
tia into a single-source material. The book covers a wide range of subjects that encompass
and interlinks general aspects, methods of diagnosis, and treatment protocols. The book
has wide coverage and includes descriptions of the different types of dementias, mortality,
gait, environmental factors, biomarkers, imaging, questionnaires, cholinesterase
inhibitors, calcium channel blockers, receptor antagonists, group therapies, exercise,
cognitive behavioral therapy, and other areas too numerous to list here. The book has
over 50 chapters and is divided into the following subsections:
[1] Dementia: Introductory Chapters and Setting the Scene
[2] Biomarkers, Psychometric Instruments, and Diagnosis
[3] Pharmacological Treatments, Other Agents and Strategies
[4] Nonpharmacological Treatments and Procedures
There are of course always difficulties in ascribing chapters to different sections and
placing them in order. Some chapters are equally at home in more than one section.
However, the excellent indexing system allows material to be rapidly located.
Diagnosis and Management in Dementia: The Neuroscience of Dementia bridges the
multiple disciplinary and intellectual divides as each chapter has:
• Key facts
• Mini-dictionary of terms
• Summary points
Diagnosis and Management in Dementia: The Neuroscience of Dementia is designed for
research and teaching purposes. It is suitable for neurologists, psychologists, health
scientists, public health workers, doctors, pharmacologists, and research scientists.

xxv
xxvi Preface

Those working in the fields of biomarkers, psychometric instruments, imaging, diagnos-

tics, and nondrug treatments will also find the book of interest. It is valuable as a personal
reference book and also for academic libraries, as it covers the domains of neurology and
health sciences. Contributions are from leading national and international experts
including those from world-renowned institutions. It is suitable for undergraduates, post-
graduates, lecturers, and academic professors.
The Editors
CHAPTER 1

Mixed dementia: a neuropathological

overview
Jacques De Reuck
Degenerative & vascular cognitive disorders. Lille, France

List of abbreviations
AD Alzheimer disease
ALS amyotrophic lateral sclerosis
CAA cerebral amyloid angiopathy
CBD corticobasal degeneration
CoMBs cortical microbleeds
CoMIs cortical microinfarcts
FTLD frontotemporal lobar degeneration
FUS type fused sarcoma type
LBD Lewy body disease
MRI magnetic resonance imaging
PET positron emission tomography
PSP progressive supranuclear paralysis
TDP type TAR DNA-binding protein type
VaD vascular dementia
WMCs white matter changes

Mini-dictionary of terms
Mixed dementia severe cognitive deficiency due to a combination of different neurodegenerative and/or
cerebrovascular diseases.
Neuropathological examination postmortem evaluation of the brain to confirm the clinical suspected
diagnosis.
Postmortem MRI this allows the detection of additional postmortem brain lesions, in particular the
distribution of small cerebrovascular lesions, and the iron content.
Neurodegenerative diseases progressive diffuse diseases affecting mainly neurons, leading to a global
cerebral dysfunction.
Vascular dementia severe cognitive disturbances due to the progressive accumulation of small and large
cerebrovascular lesions.

Introduction
The etiological diagnosis of mixed dementia diseases can be made with certainty only
after death by an extensive examination of the brain ( Jellinger & Attems, 2007). Accord-
ing to several clinicopathological surveys, the main clinical diagnosis is confirmed in 43%

Diagnosis and Management in Dementia © 2020 Elsevier Inc.

ISBN 978-0-12-815854-8, https://doi.org/10.1016/B978-0-12-815854-8.00001-X All rights reserved. 3
4 Diagnosis and Management in Dementia

up to 86% of cases by the neuropathological evaluation (Suemoto et al., 2017). This cor-
relation has increased significantly from 65% up to 96% since the development of new
biomarkers such as magnetic resonance imaging (MRI), positron emission tomography
(PET), cerebrospinal fluid analysis, and genetic markers ( Jellinger, 2009).
In the Lille Memory Clinic the clinical diagnosis of Alzheimer disease (AD) is confirmed
in 94% of the cases, Lewy body disease (LBD) in 80%, vascular dementia (VaD) in 100%, and
mixed ADeVaD in 93% by the neuropathological examination (Bombois et al., 2008).
Early previously obtained informed consent from the patients themselves or later from
the nearest family allows the autopsy for diagnostic and scientific purposes. The brain tissue
samples are acquired from the Neuro-Bank of Lille University, federated to the Centre des
Resources Biologiques, which acts as an institutional review board.
The standard procedure for the neuropathological diagnosis of the dementia types
consists of examining samples from the primary motor cortex; the associated frontal,
temporal, and parietal cortices; the primary and secondary visual cortex; the cingulate gy-
rus; the basal nucleus of Meynert; the amygdaloid body; the hippocampus; the basal
ganglia; the mesencephalon; the pons; the medulla; and the cerebellum. The slides
from paraffin-embedded sections are stained with hematoxylineeosin, Luxol fast blue,
and Prussian Perl. In addition, immunostaining for protein tau, b-amyloid, a-synuclein,
prion protein, TDP-43, and ubiquitin is performed (De Reuck, 2012a). Fused sarcoma
(FUS) histochemistry is carried out in the cases of frontotemporal lobar degeneration
(FTLD) that are tau and TDP-43 negative (De Reuck et al., 2016d). In addition, small
cerebrovascular lesions can be quantified on microscopical examination of a large
complete coronal section of a cerebral hemisphere at the level of the mammillary body.
Postmortem 7.0-tesla MRI is an additional useful tool. Three to six coronal sections
of a cerebral hemisphere, a sagittal section of the brain stem, and a horizontal section of
the cerebellum allow an extensive evaluation of the whole brain. The brain sections,
previously cleaned with formalin, are placed in a plastic box filled with salt-free water.
The boxes are inserted in an issuerereceiver cylinder coil, with a 72-mm inner diameter,
of a 7.0-tesla MRI Bruker BioSpin SA (Ettlingen, Germany). Three MRI sequences are
used: a positioning sequence, a spin-echo T2 sequence, and a T2* sequence. The
positioning sequence allows determination of the three-directional position of the brain sec-
tion inside the magnet. The spin-echo T2 is used to demonstrate hyperintensities
corresponding to cortical microinfarcts (CoMIs) and white matter changes (WMCs). The
T2* detects cortical microbleeds (CoMBs) and iron deposition (De Reuck et al., 2011a).
MRI improves the evaluation of the degree and distribution of the cerebral atrophy
and the WMCs, compared with the neuropathological examination. It also allows the
detection of lesions that can be selected for histological examination. In addition, small
cerebrovascular lesions, such CoMBs, CoMIs, and lacunes, can be quantified according
to their location. The degree of iron load can be evaluated in the basal ganglia and the
brain stem structures, but not in the cerebral cortex (De Reuck, 2016a).
Another random document with
no related content on Scribd:
The Project Gutenberg eBook of Tumbleweeds
This ebook is for the use of anyone anywhere in the United
States and most other parts of the world at no cost and with
almost no restrictions whatsoever. You may copy it, give it away
or re-use it under the terms of the Project Gutenberg License
included with this ebook or online at www.gutenberg.org. If you
are not located in the United States, you will have to check the
laws of the country where you are located before using this
eBook.

Title: Tumbleweeds

Author: Hal G. Evarts

Illustrator: W. H. D. Koerner

Release date: February 9, 2024 [eBook #72909]

Language: English

Original publication: Boston: Little, Brown, and Company, 1923

Credits: Tim Lindell, David E. Brown, and the Online Distributed

Proofreading Team at https://www.pgdp.net (This file
was produced from images generously made available
by The Internet Archive/American Libraries.)

*** START OF THE PROJECT GUTENBERG EBOOK

TUMBLEWEEDS ***
TUMBLEWEEDS
 By Hal G. Evarts
The Cross Pull
The Yellow Horde
The Passing of the Old West
The Bald Face: and Other Animal Stories
The Settling of the Sage
Fur Sign
Tumbleweeds
It was quite evident that all her thoughts centered round
the younger brother.
frontispiece. See page 54.
TUMBLEWEEDS
BY
HAL G. EVARTS

WITH FRONTISPIECE BY
W. H. D. KOERNER

BOSTON
LITTLE, BROWN, AND COMPANY
1923
 Copyright, 1923,
By Hal G. Evarts

All rights reserved

Published January, 1923

Printed in the United States of America

TUMBLEWEEDS
 TUMBLEWEEDS

I
In all that vast expanse of country west of Fort Riley clear
to the Sierras of California there are not over four hundred
thousand acres of arable land.
This extract from McClelland’s report, later appearing as preface to
some fourteen volumes of Pacific Railroad explorations, evidently
acted as a direct challenge to the pioneering spirit of a country that
was young. Following immediately upon its publication, as if in a
concerted effort of refutation, the great westward trek across a
continent set in, the determined advance of a land-hungry horde
intent upon seeking out and settling that four hundred thousand
acres of arable land; and in the brief space of thirty years there were
thirty million acres under fence while the swarming multitude of
hopeful settlers continued to surge westward across the face of the
earth.
Thus do even wise men frequently fail to vision the immensity of the
future which stretches forth ahead within the puny span of their own
remaining years.
Another few decades and old Joe Hinman, himself accounted a wise
man among his fellows, sat his horse on a little rise of ground and
lamented his own lack of foresight. Donald Carver, his younger
companion, gazed off across the flat where several riders held some
two thousand head of steers. Hinman had come with the vanguard of
the invaders and had watched succeeding waves of home seekers
swarm past on all the ancient trails, the bull trains stretching almost
without a break from the Missouri to the Colorado hills, when
Cheyenne, Kiowa and Comanche contested the advance at every
crossing of the Republican and the Smoky Hill, at the Great Bend of
the Arkansas, and historic Pawnee Rock; had watched the bull
teams and the prairie schooner giving way to freight cars that rattled
past on steel rails which spanned a continent. He had seen the
rolling plains of Kansas, once constituting the first reaches of the
Great American Desert, lifted bodily into statehood and wondrous
fertility, so long since that younger men had almost forgotten that
their native State had ever been other than a prosperous agricultural
community. While the main tides of settlement had swept on to the
west and north, Hinman had turned aside and traveled south on the
Chisholm Trail till he reached a point where the floods of home
seekers were halted by some invisible barrier. There he had settled
and prospered, but even now, thirty years after driving his first claim
stakes through the prairie sod, that same barrier resisted all
advance. Just outside his dooryard a vast tract, sixty miles by two
hundred in extent, remained undeveloped and untouched. The land
was rich and beckoned temptingly to those who sought a scrap of
ground which might constitute a home, yet beyond Hinman’s
holdings the virgin sod extended to the far horizon with never a
ribbon of smoke by day or a twinkling window by night to indicate the
friendly presence of a settler’s cabin,—the Cherokee Strip, upon
which the white man was forbidden to settle by the terms of an
ancient treaty. This great tract had been set aside to serve as
insulation between warring whites and reds, its status still the same
even though the necessity for such insulation had been long since
removed,—an empire lying dormant and awaiting only the magic
word which should strike off the shackles and permit its broad miles
to blossom into productiveness.
“There she lays, son,” Hinman said, waving an arm in a
comprehensive sweep toward the unowned lands. “Some day right
soon they’ll open her. Every land-hungry party in four States has his
eye on the last frontier and whenever she’s throwed open to
settlement you’ll see one hair-raising mad stampede. So if you’re
going off somewheres, like I heard it rumored, why I’d cancel the
arrangements and sit tight.”
The younger man nodded without comment.
“Fortune always beckons from some place a long ways remote,”
Hinman rambled on. “When likely she’s roosting right at home, if only
we’d have a look. Now I quit Ohio as a youngster because there
wasn’t any land left open but hardwood swamp lands, which could
be had for about a dollar an acre, but I couldn’t see its value at a
dollar a mile. To-day that Ohio swamp land is selling round two
hundred an acre while what ground I’ve got under crop out here
would average right at thirty and raw grassland not over three or
four.”
“But owning the most part of two countries,” Carver commented,
“you can maybe worry along.”
“Likely,” Hinman confessed. “But that’s not the point. I could have
stayed right at home with those swamp lands and without ever
exerting myself, except maybe to keep entertained with a brace of
coon hounds, I could have growed into more wealth by considerable
than what I’ve accumulated out here by steady work. That’s the real
point; so it appears that my leaving there was sheer lack of foresight.
So it’s likely that your best chance to get ahead and lay up an honest
dollar is by staying right here instead of stampeding off somewheres.
That’s the real reason I sent for you.”
“Since I’ve never even considered leaving, and you well aware of it,”
said Carver, grinning, “then the real reason you sent for me was to
engage me to perform something you didn’t want to do yourself—
which in turn is related to the possibility of my accumulating an
honest dollar. We’ve rambled all the way from timbered swamp land
on down to the surrounding short grass. What sort of country lays
beyond? My curiosity is fairly foaming over.”
Hinman regarded him quizzically and Carver bore the scrunity
undisturbed. The older man knew that Carver was dependable; that
once committed he would follow any mission to its termination and
defend the financial interests of his employer with every resource at
his command. It was only in his own affairs that he evidenced
supreme carelessness. Older men forgave his irresponsibility in that
quarter and accorded him a certain measure of respect for the
reason that even in the midst of some bit of recklessness he retained
an underlying sense of balance and proportion. And he had worked
intermittently for old Joe Hinman for the past twelve years.
“It’s not that I don’t want to do it myself,” Hinman denied, reverting to
Carver’s mild accusation. “It’s only that it wouldn’t look right on the
surface. Now whatever property is down in the Strip is legally non-
existent, you might say, and consequently untaxable,” thereby
disproving his oft-lamented lack of foresight. “And it’s drawing right
close to the first of March.”
“So you want me to move a thousand head of steers across the line
and hold ’em till after you’ve been assessed.” Carver hazarded.
“Two thousand, son,” Hinman corrected. “Two thousand head. You
couldn’t hold ’em in the quarantine belt for long without getting
jumped, but you know the boss of every outfit off to the south and
you could maybe trade deals with one of them. You’ll know how. It’ll
save me taxes on two thousand head and give me a few weeks’ free
grass. That much for me and a thousand nice dollars for you if you
put it across.”
“An hour after dark I’ll be shoving those cows across the line,”
Carver promised. “Meantime you might advance a hundred.
Unfortunately I’m just out of funds.”
“Unfortunately,” said Hinman, “you’re just always out.” He counted off
the money. “You’ve worked for me on and off ever since you was big
enough to claw your way up onto a horse and on some occasions
you’ve exercised such fair average judgment in looking after my
affairs that I’ve wondered why on all occasions you was such a poor
hand to look after your own.”
“I’ve been so taken up with your business that I’ve sort of let my own
interests drift along,” Carver explained.

“You’re right handy at doing things for me,” Hinman resumed. “But
when it comes to doing anything for yourself you’re somewhat the
most tinkering, trifling specimen I’ve come acrost. You really ought to
settle on some one job and stick at it.”
“That’s my one favorite motto,” Carver confessed. “Stick to your bush
—and be exhibited among the vegetables.”
He turned his eye upon a tumbleweed that raced madly past before
the wind. The dried skeleton was of the general size and shape of a
pumpkin. Two more of these discontented wraiths of the prairies
hurtled past.
“Now there goes a vegetable with ambitions,” said Carver. “Every
winter the tumbleweed tribe stages a protest against being mere
plants rooted forever to one spot.” He chanted a few of the
numberless verses of a prairie song:

“Our size and shape is similar,”

Said the tumbleweed to the pumpkin.
“I’ll run you a race from here to there
And all the way back again.

“I’m a wild free blade of the open,

The spirit of all unrest.
I may end up in some worse place
But I’m going to make the test.”

“And I’m the soul of solid content,”

Said the pumpkin to the weed.
“Rather than take any chance at all
I’ll stay here and go to seed.”

But I’d rather be a traveling weed

Than a stationary squash.

“I know,” Hinman said. “You’re a pure-bred tumbleweed and no

mistake. But most folks follow one business, and let the rest alone.”
“And it’s my observation that most folks are dissatisfied with what
they’re working at but keep on doing it the rest of their natural lives
just to try and vindicate their judgment,” Carver said. “Now if I don’t
settle on one pursuit there’ll never be any reason for me to be
discontented with my choice.”
The old man considered this bit of philosophy.
“If you ever decide to risk a mistake I’ll maybe help you out to a mild
extent,” he said, “provided you come through with this present little
errand I’m sending you on.”
Carver thanked him, pocketed the bills which constituted the
advance upon his venture, and headed his horse off to the east. As
he rode he reviewed all possible motives underlying Hinman’s
proposal. Tax-dodging on a smaller scale was no unusual thing
along the line, but he was morally certain that this motive, though the
purported object of the trip, was entirely secondary in Hinman’s
considerations.
“The taxes won’t amount to half the expenses of the trip,” Carver
reflected. “Now just what is he aiming at?”
He had reached no satisfactory solution when, an hour later, the
squat buildings of Caldwell loomed before him. He dismissed the
problem temporarily. As he rode down the wide main thoroughfare it
seemed that the hand of time had been turned back two decades to
the days of Abilene, Hayes and Dodge, when each of those spots in
turn had come into its brief day of glory as the railroad’s end and the
enviable reputation of being the toughest camp on earth. In their day
all those towns had eclipsed the wildest heights of wickedness
attained by mushroom mining camps of lurid fame, then had passed
on into the quiet routine of permanent respectability as the trading
centers of prosperous agricultural communities. But little Caldwell
stood unique, as if she were a throwback to an earlier day, nestling
in the edge of a state where prohibition and anti-gambling
regulations had long prevailed, yet her saloons stood invitingly open
by day and night and the clatter of chips and the smooth purr of the
ivory ball were never silent in the halls of chance; for just beyond lay
No Man’s Land, the stamping ground of all those restless spirits who
chafed against restrictive laws that were not of their own making,
and wide-open Caldwell reaped the harvest of their free-flung
dollars.
Groups of tall-hatted, chap-clad men hailed Carver from the sidewalk
as he rode down the wide main street. Scores of saddled horses
drowsed at the hitch rails and ranchers’ families rattled past in
buckboards drawn by half-wild ponies. The street was thronged with
blanketed Indians, for the Government beef issue was parcelled out
semi-monthly on the little hill south of Caldwell and every two weeks
the whole Cherokee nation made the pilgrimage to receive the
largess of the Great White Father. As if to complete the illusion that
he had been transported back to the days of Dodge and Abilene,
Carver could make out the low-hanging pall of dust which marked
the slow progress of a trail herd moving up from the south along the
old Chisholm Trail, a thoroughfare now paralleled by the railroad that
pierced the Cherokee Strip, but which was still available to those
who would save freight charges and elected instead to follow the old-
time method of pastoral transportation in marketing their droves.
Carver left his horse in a lean-to shed in rear of a two-room frame
house in the outskirts of town. The plot of ground on which it stood,
consisting of three corner lots, had come into his possession the
preceding winter through the medium of a poker hand. Instead of
disposing of the tract for ten dollars—the amount of chips which he
had risked against it—it had pleased him to retain it and construct
thereon the little board house, performing the work himself during
leisure hours.
He headed for the swinging doors of the Silver Dollar, hopeful of
finding congenial companionship even though this was the wrong
time of day for any considerable activity within doors. A group of men
sat along the rear wall and conversed in listless tones. Here were
those upon whom fortune had failed to smile the preceding night,
waiting for some kindred spirit who, more favored than themselves,
might express a willingness to relieve their temporary distress.
“It’s high noon and I’ll wager not a man present has even had his
breakfast,” Carver greeted. “But the rescue squad is here to provide
nourishment for the losers.”
He tendered a crisp bill to Alf Wellman.
“Fill the boys with food,” he invited. “And in the meantime, while
they’re deciding what to order—” and he motioned toward the
polished bar.
Wellman jerked a casual thumb in the direction of the three men in
the group who were unknown to Carver.
“These are the Lassiter boys,” he announced by way of introduction.
“Not bad after you get to knowing ’em.”
The three Lassiters were an oddly assorted crew; Milt, the eldest, a
gaunt, dark man who spoke but seldom; Noll, a sandy, self-assertive
and unprepossessing individual; while Bart, by several years their
junior, was a big blond youngster whose genial grin cemented
Carver’s instant friendship.
Noll Lassiter hitched from his chair, his eyes resting on the bank note
in Wellman’s hand, and as he attained his feet a slight lurch testified
to the fact that even if he had not found food during the morning
hours he had at least found drink. Being thus fortified his desire for
food was now uppermost.
“Let’s eat,” he said.
“Restrain yourself,” the younger brother admonished. “The
gentleman’s giving a party. Besides it’s downright harmful to eat
breakfast on an empty stomach—and mine is absolutely vacant.”
“Worst thing you could do,” Wellman seconded. “It will show up on a
man if he keeps at it.”
“I expect there have been folks tried it and went right on living till
they got kicked by a horse or died some other sort of a natural
death,” said Carver. “But what’s the use of taking chances?”
Noll restrained his urge for food while the host paid for two rounds,
then reverted to his original contention.
“And now,” said he, “let’s eat.”
“Not until I’ve purchased a return round for our old friend Carver,”
Bart dissented.
“How’re you going to manage it without a dime in your pockets?” Noll
demanded.
“You ought to be familiar with the state of my pockets,” the blond
youth returned, “having conducted a thorough search of them and
purloined therefrom my last ten spot before I was awake. Why didn’t
you reserve two bits for breakfast before you tossed it off on the
wheel if you’re so damn near starved?”
He remained with Carver while the others followed Wellman through
the swinging side door that led into the adjoining restaurant.
“And now, since Pete here,” said Bart, indicating the barkeeper,
“steadfastly refuses to open a charge account, I’ll have to do some
financing. Lend me a couple of quarts of your very worst,” he
wheedled. “Not charge, you understand, but just lend ’em to me for a
period of three minutes. Something round a dollar a quart.”
The bartender selected a brace of black bottles and shoved them
across to Lassiter who moved with them to a rear door that opened
on an alley. Several blanketed figures prowled this rear thoroughfare
and the copper-hued wards of the Government converged upon the
man in the doorway. He exchanged the two quarts for two five-dollar
bills, thereby becoming eligible for a protracted stay within the walls
of the penitentiary.
“Now we can start even,” he announced, paying Pete for the initial
stock and retaining the surplus. “Quick turns and small profits is my
rule of life.”
“One day you’ll acquire a new rule—long years and no profits,”
predicted the white-aproned philosopher behind the bar. “Unless you
learn to transact that sort of business by the dark of the moon.”
“Necessity,” Lassiter advanced in extenuation of his lack of caution.
“Suppose you set us out a sample of something a few shades more
palatable than what we just peddled to the old chief.”
The two pooled their resources and pursued their casual carefree
way, all sense of responsibility discarded for the moment, as one
might shed an uncomfortable garment with the idea of donning it
again at some future time. The youthful Lassiter, who deplored all
things serious while at play, found in Carver a delightful companion
who seemed sufficiently light-minded and irresponsible to satisfy the
most exacting. The wheel in the Silver Dollar, the faro bank in the
Senate and the crap layout in the Gilded Eagle, each contributed