The article by Onishi, J. et al. (2006). Behavioral, psychological and phsyical symptoms in group homes for older adults with dementia. International Psychogeriatrics, 18, [sUE ADD actual published page numbers here I do not know what they are because I am at home and do not have running order for March] contains an error at the foot of its first page. The article was received at the editorial office on 30 Sep 2004 (not 30 Sep 2005) and was returned for revision on 18 Nov 2004 (not 18 Nov 2005).

For almost two decades, O'Brien and colleagues have investigated virtually every facet of dementia with Lewy bodies (DLB), phenomenology, treatment, and neurobiology, ranging from genetics to post-mortem and in vivo imaging studies. The latest study from this group, reported here, describes differences in regional grey matter volumes using magnetic resonance (MR) imaging and an automated segmentation analysis method in a well-characterized sample of patients with Alzheimer disease (AD), DLB, and a healthy control group (Watson et al., 2015). The study incorporated detailed psychometric assessments of cognitive and motor functions for correlation with the grey matter volumes, and age, gender and dementia severity were included as covariates in the statistical analysis. The key observations are relatively greater hippocampal volumes and lower subcortical volumes in DLB compared to AD, but it is to be noted that most of these differences in subcortical volume were demonstrated indirectly through comparisons of the disease groups with age-matched healthy control subjects. Thus, replication in studies that make direct comparisons between DLB and AD subjects, perhaps in a larger sample size, is necessary. Still, these results highlight the potential for MR imaging to provide indicators of the extent of the neurodegenerative process in DLB. Furthermore, the results underscore the importance of correcting molecular imaging data for the effects of cerebral atrophy (partial volume correction) that may further enhance the ability of these methods to reveal pathophysiological processes.

The emergence of evidence-based medicine has challenged many conventional ideas about medical research. Instead of focusing just on individual studies, a science of systematic reviews has evolved. The Cochrane Collaboration, still only 15 years old, aims to collate systematically all randomized controlled trials through regularly updated systematic reviews to provide the best current evidence on different therapies. The most recent update has over 3000 reviews and over 1700 more protocols registered. Many expected that methodologically rigorous systematic reviews would bring clarity and agreement on the evidence for each therapy, so at first sight the disagreements between Kaduszkiewicz et al. and Birks seem surprising.

Background: Many countries have adopted new mental health legislation, with the detention of adults for treatment of mental disorders remaining an integral part of such policies. However, there are relatively few publications on the use of mental health legislation in the detention of older adults. This paper examines the civil detention of older adults in one Scottish region under successive mental health legislation.

Method: This prospective study collected data primarily by clinician-based interviews on all emergency detentions under the Mental Health (Scotland) Act 1984 of older adults in 1994 and compared these with all emergency and initial short-term detentions under the Mental Health (Care and Treatment) (Scotland) Act 2003 of older adults during 2008 in the same Scottish region.

Results: There were a total of 124 detentions, with an initial rate of 68 increasing to 141 detentions per 100,000 of the respective over-65 year age populations, a two-fold increase. Compared to the 1994 patient cohort, the 2008 cohort had higher rates of over 85-year-olds (18.4% v 5.4%) and organic mental disorders (74.7% v 56.8%) and were significantly more likely to be detained by consultant psychiatrists (73.6% v 18.9%) during working hours (87.4% v 48.6%) and proceed to six-month detention orders (31% v 10.8%).

Conclusion: The observed higher rates and longer periods of detention in the 2008 cohort may reflect changes in clinical attitudes and legal requirements from a previous reliance on the common law doctrine of necessity to the requirements of a more legalistic framework, and may signal future clinical requirements, given the aging population, pointing towards the need for earlier recognition and management of clinical issues in an attempt to minimize the “necessity” of clinico-legal intervention.

A generation ago, geriatric depression was regarded as either a natural reaction to the privations and multiple losses that accompany old age, or an irreversible consequence of cerebral degeneration heralding a dementia. Even if physicians overcame their expectation of the inevitability of depression in old age, an unhealthy nihilism concerning the effects of antidepressant treatment in this group held sway (Ford & Sbordone, 1980). Because Freud had taught that patients over the age of 45 years were resistant to change in psychoanalysis, even talking therapies were closed to this group. There is an inescapable irony in that Freud was himself in his 40s when he took this position—now regarded as not only ageist but essentially untrue (Jarvik & Small, 1989).

Corticobasal degeneration syndrome (CBDS) is a neurodegenerative disorder characterized by higher cortical dysfunctions associated with progressive asymmetric akinetic-rigid syndrome, and limb dystonia or focal myoclonus (Lang et al., 1994). One of the most typical and specific clinical features in CBDS is considered alien limb phenomenon, usually present in advanced disease stage (Doody and Jankovic, 1992).

We would like to congratulate Aprahamian et al. (2011) for their initiative to investigate the psychometric properties of the Cambridge Cognition Examination (CAMCOG) in assessing the cognitive status of the Brazilian elderly. This instrument is very frequently used in Brazil, but its measure characteristics have not yet been fully determined. Of course, cross-cultural adaptation and validation are rarely a simple procedure, often demanding a research program to completely adapt the tool to the specific language, culture, and selected population. In our opinion, the paper “Can the CAMCOG be a good cognitive test for patients with Alzheimer's disease with low levels of education?” (Aprahamian et al., 2011) is welcome as another trial by Brazilian scientists in this ongoing process. Notwithstanding, we believe that some comments about the methodological aspects of the paper are in order.

Background: At the request of the Editor of International Psychogeriatrics, a statistical audit of all papers published in the journal during 2003 was undertaken by the statistical advisor to International Psychogeriatrics.

Method: Only research papers using inferential statistical techniques were assessed and only the statistical elements of these papers were evaluated. The following issues were addressed: did the authors report a power calculation or address power issues? Did the authors report an appropriate effect size indicator? When multiple univariate statistical tests were used was a correction for type 1 error employed? Did authors demonstrate the adequacy of the data analyzed for the statistical tests employed? Were sufficient details reported to enable an evaluation of the statistical analyses and reported results?

Results: Twenty papers published during 2003 were suitable for analysis. None addressed power issues. About half reported an effect size indicator and about half adjusted the statistical analysis for the effects of multiple univariate statistical comparisons. Few demonstrated the adequacy of the data being analyzed and few provided sufficient detail to evaluate the statistical analyses and reported results. Most papers used the right statistic in the right way.

Conclusion: The statistical quality of articles published in International Psychogeriatrics could be improved by attention to a few relatively fundamental issues.

The image used to illustrate this editorial comes from a late medieval Book of Hours and shows some of the rituals related to death and burial at the time (Figure 1). For the Christian people of medieval Western Europe death was not only a common occurrence, but also one that was illustrated in many places in their lives. In their churches they would see sculptures of the Last Judgment above the front doors, a Dance of Death inside the back door, and along the walls funerary monuments. Above them were stained glass windows as well as altarpieces that might show the Death of the Virgin or other saints. At home there would be more panel paintings, as well as the illuminations of death-related rituals in the Office of the Dead in their books of hours, and the woodcuts of the Good Death in their Ars Moriendi books.