Loss of brain tissue becomes notable to cerebral magnetic resonance imaging (MRI) at age 30 years, and progresses more rapidly from mid 60s. The incidence of dementia increases exponentially with age, and is all too frequent in the oldest old (≥ 90 years of age), the fastest growing age group in many countries. However, brain pathology and cognitive decline are not inevitable, even at extremely old age (den Dunnen et al., 2008).

We have arrived at an exciting juncture in dementia research: the second major pathological hallmark of Alzheimer's disease (AD)–tau–can now be seen for the first time in the living human brain. The major proteinopathies in AD include amyloid-β plaques and neurofibrillary tangles (NFTs) made of hyperphosphorylated paired helical filament (PHF) tau. Since its advent more than a decade ago, amyloid PET imaging has revolutionized the field of dementia research, enabling more confident diagnosis of the likely pathology in patients with a variety of clinical dementia syndromes, paving the way for the identification of people with preclinical or prodromal AD pathology, and serving as a minimally invasive molecular readout in clinical trials of putative disease-modifying interventions. Now that we are on the brink of a second revolution in molecular imaging in dementia, it is worth considering the likely potential impact of this development on the field.

This article touches primarily on the influence that the socioeconomic and cultural conditions in Poland have on the family structure and individual needs of the elderly. Based on several studies in the past 20 years in Poland, I will show the main direction the changes are taking in the patterns of family support (i.e., intergenerational help) for elderly people.

I have chosen the 30 years, 1969–1999, for this article, because this represents my psychiatric career from entry into the training scheme at the Maudsley Hospital to being current head of the old-age group at the Institute of Psychiatry. What becomes apparent, on looking back, is that the developments at this campus, which contains a psychiatric teaching hospital and a postgraduate research institute, reflect those in the UK over that time. In many areas, the lead has come from here. These activities will be reviewed and some challenges for the next decade proposed. The latter will be personal, from a researcher with an epidemiological/public health perspective.

Assessment of progress in geriatric psychiatry in Canada is a difficult task. There are no good and easily accessible measures; the process of assessment is influenced by personal values and emotions; to a large extent, progress in geriatric psychiatry defies national and even subspecialty boundaries. Difficulties notwithstanding, I have attempted a brief, dispassionate assessment that focuses on training, personnel, services, professional organizations, and research activity.

Mental disorders and illnesses in old age are not an inescapable fate, particularly if physicians can look beyond the medical aspects of an illness to the potential interpersonal, familial, and social influences. Indeed, the different factors involved in the genesis of mental disorder intertwine to form an intricate network, from which it is very difficult to isolate single components. Moreover, the importance of the components that trigger an acute mental disorder and shape the course and diversity of the symptomatology can continue to change. The interweaving of different pathogenic factors contributes further to the diversity and ambiguity of the clinical symptomatology.

Marin et al. (2003) have suggested that apathy may be independent of executive functions in older-aged patients with major depression, although the correlation between apathy and the “controlled oral word association test,” a test of executive measures, approached significance. However, Feil et al. (2003), using the same definition and measure of apathy, observed a strong correlation between apathy and both verbal and non-verbal executive cognitive measures. The question thus arises as to whether apathy contributes to executive cognitive dysfunction in non-demented patients with late-life depression. We therefore re-examined this issue, looking particularly at whether apathy distinctly affects executive control functions. Our hypothesis was that apathy would contribute to cognitive impairment in depressed elderly patients independently of the severity of depression.

Our top and middle management initially received thorough training in group theory and group management techniques for organizational reasons. In daily shift meetings, nurse aides (NAs) learn some of the techniques and approaches, translating part of them to work with patients. From the moment we started to focus on the day-care center patients as a group to be managed every minute, we found that disturbances decreased significantly (based on empiric assessment by staff).

It is both an honor and a privilege to introduce the winners of the sixth biennial IPA Research Awards in Psychogeriatrics, sponsored by Bayer AG. On behalf of IPA and the entire psychogeriatric community, I want to thank Bayer for their very generous support of these awards since their inception in 1989.