Geriatric Psychiatry: Key Research Topics for Clinicians is loosely organized into seven sections: research problems and progress; origins of dementia; behavioural problems in dementia; depression; other psychiatric disorders; studies in long-term care; and coping and vulnerability in old age.
The first section provides a rationale for the volume and outlines the remaining chapters. The chapter on 'Funding research structures' is unique to the United States, but provides a fine model of research activities and research training, which, unfortunately, are in jeopardy due to budget cutting. The article by Jeste on geriatric psychiatric research demonstrates the growth of the field in the United States and the expanding interest in academic activities.
Berrios begins the section on origins of dementia with a fascinating history of Alzheimer's disease, with a focus on the fact that Alzheimer originally described the illness as including arteriosclerotic changes.
The article by Gurland focuses on reconciling conflicting cross-cultural findings. His review of scales highlights multiple conflicts, which can only be partially resolved through adjustments of the cutpoints. Yamasaki and colleagues discuss cholinergic activity and memory acquisition and retention in rats, and this article represents the sole basic science neurobiological contribution of this volume.
Behavioural problems in dementia include a chapter on wandering, and a second article reviews the use of non-neuroleptic medications in managing agitation in dementia (Schneider and Sobin).
Burgio describes innovative techniques in conducting a behavioural microanalysis comparing haloperidol and oxazepam in demented psychogeriatric patients. However, the conclusions do not seem justified based on extremely short treatment periods (3 weeks) and the unblinded nature of the evaluations. Mayer and Darby provide a creative piece on the use of mirrors to deter wandering in older demented people and utilize observational approaches on an inpatient unit.