Nerve growth factor (NGF), a trophic factor involved in the development, maintenance, and survival of the peripheral nervous system and the cholinergic neurons of the central nervous system, is significantly reduced in Alzheimer's Disease (AD) patients (Aloe et al., 2012). Particularly basal forebrain complex (BFC) neurons are highly affected in AD patients. NGF protects BFC neurons in experimental trauma models and in age-associated cholinergic decline. Therefore, administration of NGF is investigated as a therapeutic option for AD patients (Aloe et al., 2012). NGF therapy is limited by hyperalgesia, limited bioavailability, and use of invasive methods including intracranial injection of adeno-associated virus-based gene delivery vector, which constitutively expresses human NGF. In this context, non-pharmacological modes of treatment such as meditation and Yoga have been considered as alternative approaches to treat neurological disorders. Yogic breathing (YB, also called Pranayama) is a collection of techniques to regulate breathing voluntarily. YB induces a strong relaxation response via vagal and parasympathetic stimulation (Jerath et al., 2006). Such responses are causally linked to rapid changes in gene expression, particularly to those genes controlling stress, inflammation, and metabolism. Saliva is a known source of NGF, and incidentally, Yoga and relaxation stimulate salivation. Saliva (0.75–1.5 L/day in humans) contains numerous biologically active molecules to be potentially useful as diagnostic markers and as therapeutic clues. Salivary secretion regulates the digestive, nervous, immune, and respiratory systems. We conducted a pilot study to investigate whether YB could potentially stimulate salivary expression of NGF in cognitively normal healthy volunteers. This could serve as a model for future studies in AD patients.

Electroconvulsive Therapy (ECT) has been demonstrated to be a safe and effective treatment for geriatric depression, although its application might be challenging when medical comorbidities exist. The present case reports a 78-year-old man diagnosed with recurrent unipolar major depressive disorder (MDD), who presented with a severe depressive episode with psychotic features (DSM IV). He successfully received a course of bitemporal (BT) ECT with a hip-aztreonam-spacer due to a hip fracture that occurred during hospitalization. This was followed by maintenance ECT (M-ECT) with a recent prosthesis collocation. This particular case illustrates the importance of a multidisciplinary approach in geriatric patients with somatic complications receiving ECT.

I read with great interest Cheng's guest editorial “Defining successful aging: the need to distinguish pathways from outcomes.” The landscape of successful aging literature is littered with pathway – and outcome-oriented conceptualizations, making this differentiation an important issue to address. Further to the notion highlighted by Cheng is the usage (and confounding) of items surrounding successful aging. A recent review of the operational definitions of successful aging highlights the continued heterogeneity of successful aging operationalizations, identifying over 100 unique definitions of successful aging (Cosco et al., 2014). Perhaps as a by-product of this pervasive definitional heterogeneity, there is an equally pervasive conceptual overlap of the constituent components of successful aging. Depending on the definition of successful aging used (and possibly the availability of variables in a dataset and theoretical background of the researcher), the same item may be used as a predictor, component, or outcome of successful aging. While Cheng (rightfully) advocates for the inclusion of psychosocial components into definitions of successful aging, these items are particularly prone to this conceptual confusion. Take, for example, an item specifically identified by Cheng: life satisfaction. Successful aging was originally posited as inextricably linked to life satisfaction; however, subsequently, life satisfaction has been identified as a predictor (Roos and Havens, 1991), indicator (Leonard, 1981), and component (Pruchno et al., 2010) of successful aging. Further, several qualitative studies have been conducted with laypersons specifically differentiating between successful aging and life satisfaction, e.g. Fisher (1995). As Cheng illuminates and these examples highlight, the language of successful aging is rife with conceptual confusion – an inhibitive force in the advancement of the field – that must be addressed.

The authors would like to apologise for a typographical error in the abstract of the above mentioned article.

In the results section of the abstract on the first page of the article, the first odds ratio that refers to ‘aged care facilities’ should be (OR 5.44; 95% CI 4.43–6.67) and the second odds ratio that refers to health service facilities should be (OR 4.56; 95%CI 4.06–5.13).

In Ireland, the population aged 65 years and over is projected to increase by 20,000 annually with the proportion of the population aged over 65 years doubling over the next 30 years. It is estimated that up to 60% of older people in hospital have or can develop a mental disorder during their admission (Royal College of Psychiatrists, 2005). The needs of older adults are distinct in many ways and a previous systematic review found that old age psychiatry services for hospitalized older adults are effective (Draper and Low, 2005). With regard to models of service provision, there is evidence that a liaison type service is superior to consultation only. The latter service is limited and reactive whereas a dedicated liaison service is proactive and is more likely to succeed in having good mental healthcare adopted as the standard of care within a hospital (Royal College of Psychiatrists, 2005). Consultation–Liaison (CL) services have been associated with decreased psychiatric morbidity, improved function, reduced length of stay, fewer readmissions, and increased cost-effectiveness compared with usual care (Royal College of Psychiatrists, 2005, Parsonage and Fossey, 2011). In Ireland, specialist community services for older adults have developed steadily, while CL services have remained relatively neglected with no specific recommendations regarding CL services for older adults in national guidelines (Department of Health, 2006). This is not necessarily out of step with international trends where in spite of increasing rates of referral to CL services for older adults in the United Kingdom and the United States there is a reported lack of emphasis upon this important area of service provision (Anderson et al., 2011). Consequently, little is known about age-specific CL services for older adults in Ireland, and service development has proceeded in an unstructured way. In particular, it is not known whether such a service is available within each area and if so, what the nature and extent of the services provided are.

The use of antipsychotics for the management of behavioral and psychiatric symptoms of dementia (BPSD) remains highly controversial. These drugs are well known to be associated with increased mortality from cerebrovascular events, as well as with falls, cognitive impairment, and other serious side effects. In 2009, a UK target was set to reduce their use in dementia patients by two-thirds over a three-year period (Banerjee, 2009).

Memory complaints (MCs) are experienced by a large proportion of middle-aged and older adults and are often a source of distress and worry. Because of the perceived threat of Alzheimer's disease (AD), MCs are known to be associated with depression, anxiety, and poor quality of life (QoL). Generally, these MCs are part of a normal aging process but may also reflect mild cognitive impairment (MCI) or the onset of dementia. Although the literature is unclear about evolution of patients with MCs, there is growing evidence that suggests that MCs are associated with an increased risk of dementia. The potential importance of MCs is furthermore reflected in the new diagnostic criteria proposed for early AD (Dubois et al., 2007).