Editor’s Note
Call for Specialty Abstracts
Member Survey

Editor’s Note
William Burke ● United States

Greetings to all! I am delighted to assume the role of Editor-in-Chief of the IPA Bulletin and many thanks to our immediate past-editor, Dr David Folks, who has done such a fine job these last eight years.

The change in editors is but one of several major changes that will be obvious to our readers. First, you have noticed that you are no longer holding a paper copy of the Bulletin in your hand. We are excited to join the 21st century and move to an all-electronic publishing platform for the IPA Bulletin. There are many reasons we chose to do so but the primary reason was that we wanted to have a fiscally responsible way to reach you, our members, in a more frequent fashion thereby allowing us to provide more timely information. We of course are also excited by other opportunities that electronic publishing provides including our ability to integrate with our wonderful association web page, edited by Jay Luxenberg, and our flagship IPA journal, International Psychogeriatrics, edited by Nicola Lautenshlager.

The content of the Bulletin, at least for now, will look familiar to past readers. Most of the prior sections of the “old” Bulletin can be found in the links below. I want to draw your attention and give my special thanks for Brian Draper, who in this issue, is wrapping up his ongoing column “On the Web.” Thank you Brian for another fine contribution and for all of your columns dating back to 2001. Brian has assured me that he will continue to make ongoing occasional contributions. 

While we have some ideas about new content areas for future issues of the Bulletin we are also very interested in your ideas about what would be most interesting and useful to include. Therefore, expect to receive a brief survey in the not too distant future to help us plan our future content.

Lastly, I would like once again to thank all of the prior assistant and deputy editors who have worked on earlier versions of the Bulletin. With the change in editors and format I have had the opportunity to assemble a new group of deputy editors. I am extremely pleased to introduce this wonderful group of energetic, devoted clinicians and researchers from around the world who will play a major role in the new Bulletin. Please see below very brief descriptions of this fine group who you will be hearing more from in future issues. That’s all from me for this issue and will bring you more updates in the next Bulletin.

Olusegun Baiyewu (Ibadan, Nigeria)

Dr. Baiyewu is a Professor of Psychiatry at the University of Ibadan and an Honorary Consultant Psychiatrist to the University College Hospital Ibadan, Nigeria. His research interest is in dementia and depression in the elderly especially behavioral disorders in dementia and mild cognitive impairment. He is currently the Director of Project for Ibadan, in the Indianapolis-Ibadan Research Project. This is a collaborative project between Indiana University School of Medicine, Indianapolis, United States and the University of Ibadan Nigeria, which started in 1992. He is a current member of the IPA Board of Directors.

Sonia Maria Dozzi Brucki (São Paulo, Brazil)

Dr. Brucki is a neurologist at the University of São Paulo in the Cognitive and Behavioral Neurology Group, Department of Neurology. She is also the Secretary of Neurology for the Brazilian Association of Geriatric Neuropsychiatry.

Her clinical and research interests include the development and validation/adaptation of cognitive tests to the Brazilian population. She is also interested in the effects of illiteracy and low educational level on cognitive performance of healthy elderly subjects, mild cognitive impairment and dementia patients. Other interests include prospective memory in mild cognitive impairment and the effects of exercise on cognition in mild cognitive impairment.

Naaheed Mukadam (London, UK)

Dr. Mukadam is currently working as a registrar (ST6) in Barnet, Enfield and Haringey NHS trust. She is interested in ethnic minorities and their access to dementia services. She has spent the past two years researching this topic and has recently published a systematic review and qualitative study in this area. She aims to continue this work, hopefully by developing interventions to improve access to dementia services for ethnic minority groups.

Kenichi Meguro (Sendai, Japan)

Dr. Meguro is Professor in the Department of Geriatric Behavioral Neurology at Tohoku University Graduate School of Medicine, Sendai, Japan. Kenichi also is the head of the Office against Dementia, the Osaki-Tajiri SKIP Center, Osaki, Japan.

He has numerous academic interests including neuroepidemiology, neuropsychology, and neuroimaging of Alzheimer disease and vascular dementia. He is also interested in psychosocial intervention for dementia patients.

Anand Ramakrishnan (Nottingham, UK)

Dr. Ramakrishnan considers himself primarily as a clinician and works as a Consultant Old Age Psychiatrist who is clinically responsible for a functional in-patient ward for older people and providing full community services (including a memory clinic) for 18,000 older people in the Ashfield district. He has teaching responsibility for undergraduate and post-graduate students at the University of Nottingham.

Dr. Ramakrishnan was a co-organiser of IPA-RCPsych international meeting held in Dublin in 2008 and has been active in the IPA as well by chairing symposia, presenting at IPA conferences and assisting as an abstract reviewer. 

Huali Wang (Peking, PR China)

Dr. Wang is also a current member of the IPA Board of Directors and is an Associate Professor of Geriatric Psychiatry at the Peking University Institute of Mental Health. She leads several research projects on dementia and cognitive impairment and has been closely collaborating with international research teams. Since 2009, she has led the Alzheimer's Disease Care and Research Network within China (ADCRN), aiming to build a cadre of experienced investigators and improve the research capacity for multi-site AD studies. In addition, Dr. Wang has great expertise in neuropsychological assessment of the elderly and has contributed great effort to public health education on brain health among the elderly.

Call for Specialty Abstracts Open until 10 June 2011

If you have late-breaking, up-to-the-minute research, this is the place to present it for the first time. Take advantage of this great opportunity to share your research with your peers and get feedback from international experts in the field.

Specialty Abstracts include:

• Education (Posters)

• Hot Topics (Posters)

• Colloquium on Long-Term Care: Perspectives from
  the Community and the Nursing Home
  (Symposia, Free Communication, and Posters)
  Pre-meeting taking place on 6 September.

You may submit your unique abstract through the IPA website at http://abstracts123.com/ipa2/.

Member Survey

IPA is committed to providing you with membership that is of value to you – whether helping you learn about the newest research, improving your clinical care, connecting with colleagues who stimulate your thinking or support you in your practice but most of all working toward our collective mission of improving mental health around the world. In order to learn your current and future needs in the field, we will be conducting an electronic survey which will be distributed to all members in the near future. Our researcher has already contacted some of you in an initial member group discussion to fine tune the questions. Please be sure to watch for the survey in your e-mail. It should only take 10 to 12 minutes to complete. We want everyone’s input!

Masatoshi Takeda ● Japan

A massive 9.0 Magnitude earthquake occurred inthe Pacific Ocean nearby Northeastern Japan, Friday March 11, 2011 at 14:46 (JST), destroying almost all Tohoku and Kanto Areas. Tohoku area is the northern part of Japan including Fukushima, Miyagi, Iwate, Aomori, Akita and Yamagata Prefectures. Kanto Area is the governmental and commercial center of Japan where Tokyo and Yokohama are located including seven Prefectures. The Tohoku-Kanto Great Earthquake caused serious damage to buildings and life lines in cities along the east coast of Tohoku Area, such as Iwaki, Minamisohma, Sohma, Iwanuma, Natori, Sendai, Higashiatsushima, Ishinomaki, Kesennuma, Rikuzentakada, Ofunato, Kamaishi, Miyako, Kuze, and Hachinohe. Even in Tokyo, some modern buildings had cracks in walls, and skyscrapers trembled for several minutes, terrifying people working and living in this area. It was only a prelude of the merciless natural disaster.

The earthquake occurred in the 200 km x 500 km wide area along the Pacific coast of Tohoku Kanto Area, and the massive TSUNAMI was the next part of the disaster. Soon after the earthquake, the tsunami was forecasted and a tsunami warning was issued by the authority giving an order of evacuation. The power of this natural disaster was, however, beyond our imagination. The massive tides of 7-10 m height wiped out houses, bridges, buildings and everything in its path. The tsunami water went 2 km inside the mainland destroying all infrastructures for anyone living there.

Japan has experienced frequent earthquakes because it is located over the intersection of four earth plates. Due to its history of many earthquakes, Japan has developed advanced technology for earthquake forecasting and has amassed much knowledge about earthquakes and tsunami. TSUNAMI has become a global term originating from the Japanese language. The natural power of tsunami caused by the Tohoku-Kanto Great Earthquake killed thousands of people and wiped away all houses, paralyzing the infrastructure of those living in Tohoku Area.

People in the Tohoku and Kanto areas have suffered from many aftershocks several times a day over the next few days with some of great magnitude over the following weeks. Aftershocks with over M5.0 were recorded 247 times in six days by March 17, 12:00, which is the largest number on record. Though the magnitude of each aftershock is smaller than the main quake, they are high enough to cause survivors to feel frightened and terrified in blackouts and the cold winter weather.

The Tohoku Kanto earthquake is the fourth largest earthquake recorded in the world since 1900, after Temuco-Valdivia, Chile earthquake (22 May 1960; M9.5, 1,655 deaths), Prince William Sound, Alaska earthquake (28 March 1964; M9.2, 131 deaths) and Off West Coast of Northern Sumatra, Indonesia (26 December 2004; M9.1, 227,898 deaths).　The number of deaths and those lost have been increasing day by day.

Damage to Nuclear Plant as of 18 March 2011
The Tohoku Kanto Earthquake and the following tsunami hit the Fukushima Daiichi nuclear power station with unbridled ferocity.

When the earthquake occurred, reactors Nos. 1, 2, and 3 were in operation, and Nos. 4, 5, and 6 were at rest for regular maintenance. Immediately after the huge tremor, the control rods were automatically deployed and the reactors were stopped as scheduled. However, fuel rods continue to give off extreme heat for a long time, even after reactors have ceased operating, which might cause the coolant water inside the reactor to boil, leading to the risk of the reactor boiling dry. The emergency core cooling system (ECCS) is designed and implemented to prevent this from occurring. The system circulates water inside the reactor using electric power from sources other than the nuclear power plant itself, and also features a doughnut-shaped structure called a suppression pool, to cool high-pressure steam into water. Spent fuel rods removed from reactors need to be kept permanently cooled with circulating water. However, in the Fukushima Daiichi plant, power generators for operating the ECCS system broke down. Although the generators were designed to keep operating even after very strong tremors, the tsunami was of a scale beyond anticipation, and might have thrown seawater on the generators.

The temperature began to rise rapidly inside the reactor, which had lost its coolant functions. As a result, the metal tubes containing the fuel rods began melting down. In addition, the melted alloy caused a chemical reaction with the water, leading to a discharge of hydrogen, which caused the explosions of the No. 1 reactor building walls on Saturday, March 12, 15:36. The hydrogen explosion also occurred with No. 3 reactor on Monday, March 14, 11:01. In the damaged reactors, the temperature continued to rise and a huge quantity of coolant water evaporated, leading to the risk that the exposed parts of the fuel rods above the water may melt. Although Tokyo Electric Power Co. workers poured seawater into the reactors using pump vehicles, the operation did not go smoothly due to the fear of contamination from radioactive material.

Tuesday morning, March 15, 6:00, there was an accident at the No. 2 reactor in which the pressure-control room appeared to have been damaged. It is feared that exposure of the fuel rods to the air sparked a fire that lent to leakage of the radioactive material contained therein. Meanwhile, water used to cool spent fuel rods in the No. 4 reactor could no longer be circulated due to the loss of power, and fire occurred with No. 4 reactor on Tuesday, March 15, 6:00.

To avoid exposure to radioactive material, the government issued an evacuation order to the people within the radius of 20 km from Fukushima Daiichi Nuclear plant and to stay indoors to the people 20-30 km radius from the nuclear plant. Fears about health risks rose dramatically.

As of the end of March, the death toll is now 5,692 and will inevitably climb higher as the recovery of bodies in tsunami-hit coastal areas becomes possible after the waters there remain stable and tsunami warnings are lifted. About 10,000 are missing and about 530,000 people are staying in more than 2,600 shelters as of March 17, 18:00, six days after the killer quake.

Recognizing Tohoku-Kanto Great Earthquake as one of the greatest disasters, 115 countries and regions in the world have offered help to the affected area. Rescue and medical teams have started their actions.

On behalf of my colleagues in Japan, thank you to all of you for your expressions of concern and offers of assistance.  It is during times like this that one truly appreciates the tremendous camaraderie of the circle of the IPA community.

Officer Announcement
IPA 2011 Board of Directors Election
Annual Members Business Meeting

2011 - 2013 IPA Officers

It is with pleasure that IPA announces our newest officers who will assume their positions at the conclusion of the 2011 Congress in The Hague in September.  Congratulations to:

Jacobo Mintzer, President
Henry Brodaty, President-elect
Horácio Firmino, Treasurer
Jay Luxenberg, Treasurer-elect
Raimundo Mateos, Secretary    
Masatoshi Takeda, Immediate Past President

IPA 2011 Board of Directors Election – Ballots are due 30 June

Help determine the future of IPA by participating in the IPA Board of Directors Election. 

All of the candidate background information as well as ballots are available in the Members Area of the IPA Website. See the Election box on the Members Area home page and follow the directions to obtain candidate information. You will be able to submit your ballot immediately.

IPA Annual Members Business Meeting

Wednesday, 7 September 2011 at 18:00 The Hague, The Netherlands

Each year, IPA conducts a business meeting for our members to hear updates on IPA and our activities.

All current members are invited and encouraged to attend. This is an excellent opportunity to hear about your association!

MEETING AGENDA
Call to Order - Masatoshi Takeda, IPA President
Establishment of Quorum - Daniel O'Connor, IPA Secretary
President's Remarks - Masatoshi Takeda, IPA President
• 2010 - 2011 IPA Annual Report
Treasurer's Report - HorácioFirmino, IPA Treasurer-elect
Secretariat's Report - Susan Oster, Executive Director
Installation of New Board Members - Masatoshi Takeda, IPA President
• 2011 - 2013 Officers
• 2011 - 2015 Board of Directors
2011-2013 President's Remarks - JacoboMintzer, President-elect
Member Open Forum
Adjournment

We hope to see you at the Congress and at the Business Meeting.

Member Recognition

Member Recognition
Barry Reisberg

The American Association for Geriatric Psychiatry (AAGP) has named Barry Reisberg, MD, of the NYU Langone Medical Center, as its 2011 Distinguished Scientist for his pioneering research on Alzheimer’s disease and his mentorship of rising leaders in the field. Dr. Reisberg, United States, is a former President of the International Psychogeriatric Association (IPA) serving from 1997 through 1999. He has also served as an officer and member of the Board of Directors since 1985.

Over his 30-year career, Dr. Reisberg has conducted ground-breaking research on the course of Alzheimer’s disease and its accompanying neuropsychiatric symptoms, and has contributed directly and indirectly to the development of several cognitive enhancers and the use of antipsychotic agents for behavioral disturbances.
   
At the NYU Langone Medical Center, Dr. Reisberg is a professor in the Department of Psychiatry, director of the Fisher Alzheimer’s Disease Program, and director, Clinical Core, NYU Alzheimer’s Disease Center. He served as the research training director for the Geriatric Psychiatry Fellowship Program at NYU for 20 years, and directed the Clinical Research Fellowship Program for more than 25 years. As a longtime mentor, he has influenced the careers of leading investigators from around the world.

2011 IPA Congress
Webinar

Save the dates - 6-9 September 2011 - 15th International Congress - Register Today!

Be a part of the Congress – participate in this truly international meeting. Here is the most recent confirmed program update. IPA has developed a stimulating scientific program with the theme, Reinventing Aging Through Innovation.

Pre-Meeting Programs
Monday, 5 September 2011

Neuroimaging in Dementia Workshop
This one-day, popular, highly interactive workshop incorporates an audience voting system to help reinforce and apply imaging techniques and diagnosis. It is recommended for geriatric psychiatrists, old age psychiatrists, neurologists, geriatricians, primary care physicians with an interest in the elderly and other dementia, specialists, as well as trainees in these areas.
Limited to 75 participants, register early.
Co-Chairs: John O’Brien (United Kingdom)
Philip Scheltens (Netherlands)

Presenters:
Jan Booij (Netherlands)         
Klaus Ebmeier (United Kingdom)
Karl Herholz (United Kingdom)  
Giorgos Karas (Netherlands)
Ian McKeith (United Kingdom)
Leonardo Pantoni (Italy)

INTERDEM Workshop: 'Raising the standard: better evaluations of psychosocial interventions in dementia care through improved methodology.'

INTERDEM is a pan-European network of researchers focusing on early detection and psycho-social interventions in dementia. The network is committed to raising the quality of the evidence-base on psychosocial interventions, through the use, for example, of innovative methodologies and approaches to outcome evaluation. This workshop aims to encourage researchers in the field to consider carefully methodologies and outcome measures appropriate to the intervention being evaluated. A range of topics will be covered, including the use of qualitative methodologies, appropriate use of randomised controlled trials, mixed methods approaches and the development of more sensitive and relevant outcome measures.

Confirmed speakers include:

Professor Jill Manthorpe, Kings College London, UK
Professor Myrra Vernooij-Dassen, Nijmegen, Netherlands
Professor Esme Moniz-Cook, Hull, UK
Professor Bob Woods, Bangor, UK


Site Visits
Congress delegates will have an opportunity to visit local long-term healthcare facilities through pre-arranged tours with IPA colleagues. Check the Congress website for sign-up information.

Tuesday, 6 September 2011
Colloquium on Long-Term Care                                                                                                 
Perspectives from the Community to the Long-Term Care Home
Co-Chairs:
David Conn (Canada)              
Petra Borsje (Netherlands)
Raymond Koopmans (Netherlands)
Wendy Moyle (Australia)

Building on the success of the Long-Term Care Symposium in Spain, this one-day forum includes two tracks and will offer the following: 

• Review issues related to the assessment of nursing home residents.

• Discuss some of the challenges of caring for residents in long-term care homes.

• Review the utilization of clinical guidelines in long-term care homes and the potential benefits.

Discuss the need for their further development and utilization along with the challenges of implementation. 

A multi-disciplinary, geographically diverse committee of 13 experts has developed a leading-edge program combined with the practical tools you can immediately put to use when you return to your workplace. This is the international perspective on mental health issues in long-term care that you won't want to miss!

Dutch Society of Geropsychologists (SPO)
The morning program will present recent and clinically relevant developments regarding people with dementia and their informal caregivers. In the afternoon, a variety of workshops will illustrate the specific role of geropsychologists in psychogeriatric care in the Netherlands.

Caring for Carers: A Hands-On Training Workshop for Interdisciplinary Professionals
Chair: Joel Sadavoy (Canada)
Ken Laidlaw (United Kingdom)    
Anne Margriet Pot (Netherlands)   
Tuula Saarela (Finland)

This half-day workshop will be offered twice – in the morning and again in the afternoon. An innovative program designed for geriatric interdisciplinary practitioners wishing to improve their knowledge and skills for dealing with family carers managing behavioral problems of family members with dementia at home. 

Opening Session
Tuesday, 6 September 2011
The Opening Panel Discussion will launch the congress with a thought-provoking dialogue.
Geriatric Mental Health – Today and Tomorrow – reinventing aging through innovation                                                                                                                  
Edmond Chiu (Australia)
Jacobo Mintzer (United States)
Desmond O’Neill (Ireland)
Marcel Olde Rikkert (Netherlands)
Panel Facilitator: Kenneth Rockwood (Canada)

Symposia  Wednesday – Friday
7- 9 September 2011
Reconceptualization of Late-Life Schizophrenia and Psychosis and Its Implications for Treatment
Chair: Dilip Jeste (United States)
Sebastian Köhler (Netherlands)  
Paul David Meesters (Netherlands)
Ipsit Vahia (United States)

This session will include four presentations aimed at providing a comprehensive overview of current research and concepts in aging and psychosis. The session will first provide a novel conceptual overview of the impact of aging on schizophrenia along with directions for a future research and clinical agenda.The subsequent presentations will focus on determinants of clinical outcome in aging with psychosis, identify pressing clinical needs in this population and highlight the role of successful aging in schizophrenia.

New Developments in Psychological Therapy for Older Adults
Chair: Bob Woods (United Kingdom)
Ken Laidlaw (United Kingdom)
Mark Kunik (United States)
Andreas Maercker (Switzerland)
Anne Margriet Pot (Netherlands)

This symposium aims to highlight new developments in psychological therapy with older people, including presentations on applications of cognitive behavior therapy to broader populations of older people experiencing psychological problems than has previously been the case.

New Developments in Fronto-Temporal Dementia
Chair: Philip Scheltens (Netherlands)
Bruce Miller (United States)      
Yolande Pijnenburg (Netherlands)
Rik VandenBerghe (Belgium)

In this symposium, new developments within the field of fronto-temporal dementia (FTD) will be highlighted by outstanding speakers well-known for their contributions to this field.

Depression in Dementia
Chair: Chip Reynolds (United States)
Sube Banerjee (United Kingdom)
Craig Nelson (United States)     
Paul Rosenberg (United States)    
Alan Thomas (United Kingdom)

This symposium will address present new data on three interrelated topics:

• Treatment of depression in persons with dementing illness

• Neurobiological bases of treatment response/failure to pharmacotherapy of depression in dementia

• Pathways from depression to mild cognitive impairment and dementia

How Much Evidence is Necessary for Nonpharmacological Interventions?
Chair: Ken Rockwood (Canada)      
Clive Ballard (United Kingdom) 
Nicola Lautenschlager (Australia)
Leonardo Pantoni (Italy)

The rationale for asking this question is that according to commonly promulgated rules for grading evidence, preventive or therapeutic interventions can most confidently be implemented only following meta-analyses of controlled clinical trials. This symposium will consider whether we should ever deviate from this as the highest standard, or whether it might under some circumstances be valid to act on epidemiological data.

New Criteria for Alzheimer’s Disease, Opportunities and Potential Pitfalls
Chair: Serge Gauthier (Canada)      
Henry Brodaty (Australia)           
Helen Fung-kum Chiu (Hong Kong)
Bruno Dubois (France)

This stimulating debate will focus on the positive and negative considerations about the use of the early diagnostic test. Revised criteria for the diagnosis of AD have been proposed by three workgroups of the US Alzheimer Association, defining pre-clinical, mild cognitive impairment (MCI) and dementia stages. Ethical and societal perspectives will be explored. This is a “must-attend” program.

Register Today!

Neuroimaging in Dementia Webinar Series - Registration Now Open!

Now our most popular workshop is available as an interactive webinar — you can attend the workshop without leaving your office! This outstanding member benefit comes to you at no additional charge! Register Today!

The webinar will focus on imaging techniques that have real clinical utility and will present how best to implement the main neuroimaging techniques in your practice. Many clinical guidelines for dementia now emphasize the need for informed and appropriate application of different imaging modalities in varying care situations.

Live presentations with interactive teaching and real life examples:

• 12 April 2011 Session One: Structural Imaging

• 10 May 2011 Session Two: Perfusion SPECT and PET

• 24 May 2011 Session Three: Dopaminergic Imaging and Guidelines

Presenters:
John O'Brien (United Kingdom) Co-Chair
Philip Scheltens (Netherlands) Co-Chair
Jan Booij (Netherlands)
Klaus Ebmeier (United Kingdom)
Karl Herholz (United Kingdom)
Giorgos Karas (Netherlands)
Ian McKeith (United Kingdom)

Register Today!

Current Status of Psychogeriatrics in China
Huali Wang, Xin Yu
Peking University Institute of Mental Health, Beijing 100191, CHINA

As the population ages in China, mental health problems have become an inevitable social phenomena and a great challenge in China. The estimate of population aged over 60 was nearly 160 million. There is a huge demand for mental health service for the elderly. For example, it is estimated that there were around 6 million people with dementia in China, accounting for nearly 1/5 of the total dementia cases worldwide [1]. The prevalence of depression in the aged population was approximately 1.78% [2]. However, the social service system is yet to be ready to provide adequate support in line with the acceleration of aging. Mental health service for the elderly should continue to be one of the priorities in the national mental health service system in China.

With the first set-up of a psychogeriatric ward in Shanghai in 1982, the team of geriatric psychiatry has gradually grown. Psychiatric hospitals in Beijing, Nanjing and Guangzhou adopted the proposal to initiate inpatient care for the elderly with mental disorders. According to a survey based on response to a questionnaire on the mental health service resources in 2004, there was a great shortage of resources and facilities available for the elderly [3]. The estimate of beds for the elderly with mental disorders ranged from 0.06 to 2.2 per 10,000 elderly persons. Among 136 facilities responding to the survey, 66 had set up the department of geriatric psychiatry, and 27 had the intention to set up a department of geriatric psychiatry. Only a few had the capacity to provide inpatient and outpatient services simultaneously. Led by Prof. Xin Yu, a former member of IPA Board of Directors, the Psychogeriatric Interest Group of Chinese Society for Psychiatry (C-PIG) was formulated in 2005 and became an affiliation organization of the International Psychogeriatric Association (IPA) in 2006.

The International Training Certificate Program on Organizational and Clinical Practice of Mental Health of The Old Age (briefly named as the Arie Course) jointly run by University of Melbourne and Beijing Medical University in 1998 and 1999 was the first professional training on geriatric psychiatry. With the establishment of C-PIG, annual CME programs were organized to improve the clinical and research capacity for mental health service in the old age, especially for people with depression and dementia. Now more than 500 participants (including psychiatrists, neurologists, and geriatricians) have been enrolled in the program. In particular, the national Alzheimer’s Disease Care and Research Network (ADCRN) led by the Peking University Institute of Mental Health was formed in 2009 and training on providing standard care for people with dementia has been provided. The ADCRN sites have been encouraged to adopt an integrative model for dementia care, including clinical service jointly provided by a team of a geriatric psychiatrist, neurologist, and radiologist, continuum case management (e.g., memory clinic and inpatient care), and sustainable caregiver support system. It is anticipated that, with the infrastructure development in provincial hospitals and institutions around China, the national collaborations would be developed and capable for providing standard care for people with dementia. In China, the practice of geriatric psychiatry does not need credentials. The training on geriatric psychiatry has not been included in the curriculum of national residency (Step I) training program on psychiatry. In some hospitals, approximately 3-6-months training on geriatric psychiatry has been proposed to be included in the advanced residency training program. In 2008, the first textbook Geriatric Psychiatry (editor: Xin Yu) was published following the publication of Neurology & Psychiatry in the Old Age (2005) and the Practice Guideline of Dementia Care (2007). These books, together with CME training materials, have become valuable resources for professional training on geriatric psychiatry.

Psychogeriatrics in China remains challenged by a shortage of professional service providers, a lack of disciplinary integration among geriatrics, neurology and geriatric psychiatry, mal-capability of community mental health service, inequitable distribution and inefficient utilization of resources, and absence of national mental health service strategy for the elderly. Therefore, C-PIG now strives to tackle these challenges by proposing a series of potential strategies and solutions, e.g., promoting curriculum development and sub-specialty training, enhancing multidisciplinary collaborations, accumulating evidences of mental health service for the elderly through collaborative studies at national, regional and international levels, strengthening community outreach programs, and trying every effort for health policy advocacy. It is optimistic that psychogeriatrics would have a rapid development in the coming decade in China.

References:
[1] Zhang ZX, Zahner GEP, Roman GC, et al. Dementia subtypes in China: prevalence in Beijing, Chengdu, Shanghai, and Xian.  Arch Neurol, 2005, 62: 447-453.
[2] Shen YC, eds. Psychiatry. Beijing: People’s Health Publishing House, 2001.
[3] Xue HB, Yu X, Xiao SF, Zhang MY. [Evaluation of present status of psychiatric services in elderly in China]. J Clin Psychol Med 2006;16(1):11-13.

Wendy Moyle ● Australia
Mark Rapoport ● Canada

Nursing Research and Practice
Wendy Moyle

Psychosocial Interventions
A recent US study aimed to explore culture change specifically related to staff decision-making around interventions for BPSD. Focus groups with 35 staff from 6 long-term care facilities explored staff perceptions of resident behaviours, the approaches used to address these behaviours and the rationale for selecting specific interventions. Data were analysed using both content and thematic analysis. Findings revealed the many challenges faced by staff to implementing non-pharmacological strategies including staff feeling a lack of control over the environment, resident co-morbidities and high acuity levels. While staff may be aware of interventions that modify state of person and environment, their limited work time posed a significant barrier to using non-pharmacological interventions. This cumulated in staff’s perceptions of pharmacological intervention as an efficient and reliable intervention to control behaviours and promote a quiet environment. Staff attention was on ‘challenging residents’ whereas passivity was not seen as an indication for intervention. Furthermore, staff were concerned with managing behaviours for the good of the organisation rather than understanding of the behaviours for the good of the individual. Nurses and care staff developed their repertoire of strategies through trial and error, rather than learning from research-based evidence.  Recommendations include: implementation of staffing patterns and roles that allow staff time and skills to make a difference; development of education programs that focus on understanding rather than the need to control; and further research framed around theoretical frameworks that consider time and its influence on intervention selection.

Kolanowsi et al.  It’s about time: Use of nonpharmacological interventions in the nursing home.  J Nrs Scholarship 2010, 42 (2), 214-222.

An Australian randomised controlled trial investigated the effect of live music on quality of life and depression in 47 people with dementia using the QOL-AD and GDS. A live active music group (30 minutes of musician-led familiar song singing and 10 minutes of pre-recorded instrumental music for active listening) and an interactive reading group run for 40 minutes, three mornings a week for 8 weeks. Participants then crossed over into the opposite arm and the protocol was repeated for another 8 weeks. There was a five-week washout period between crossover to reduce the likelihood of carry over effects. The main significant finding was a significant difference in the mid-point QOL belonging scores between music and reading groups (F(1,45)=6,672, p<.05). Those participants who experienced the reading control group first reported higher feelings of belonging (3.61) than those who experienced the music first (3.17). Means showed that when the first reading group crossed over into the music group their scores decreased (3.61 to 3.46), whereas when the first music group crossed over into the reading group their scores increased (3.17 to 3.57). The authors conclude it may be that music does not have a stronger therapeutic effect than other group activities. They recommend introducing a third group of usual care into the research design.

Cooke et al. A randomised controlled trial exploring the effect of music on quality of life and depression in older people with dementia. J Hlth Psych, 2010, 15 (5), 765-776.

Staff Attitudes and management
A UK study aimed to explore the views of nursing staff in relation to aggressive behaviours in people with dementia and strategies used in practice. A survey of 36 staff (out of a possible 52) in 6 dementia care units using the Management of Aggression in People with Dementia Attitude Questionnaire was conducted alongside a 3-month observation audit using the Staff Observation Aggression Scale. Staff viewed aggressive behaviour by people with dementia as deriving from an interaction with the environment or with others. Staff responded to aggressive behaviours by using interpersonal interventions and a moderate use of medications. Over the 3-month observational period a total of 79 incidences of aggression were recorded in relation to residents whose family members consented and involved 31 residents. The results from the audit substantiated the views reported by staff. The authors acknowledge the study limitations including the small number of care homes and staff, and all facilities owned by the one owner may not be representative of other settings. In future research the authors suggest an audit of medication use would also be informative.

Pulsford et al. A survey of staff attitudes and response to people with dementia who are aggressive in residential care settings. J Psych & Mental Hlth Nrs, 2011, 18, 97-104.

An Australian study aimed to explore management of people with dementia in the acute care setting. A descriptive qualitative approach was used with semi-structured interviews with a cross section of 13 multi-disciplinary staff. Five subthemes were revealed with the over arching theme being paradoxical care, in that an inconsistent approach to care emphasised safety at the expense of well-being and dignity. Subthemes included: defining confusion, whereby in spite of decisions of how patients should be managed staff displayed limited understanding of the difference between acute and chronic confusion. Everyday challenges referred to the blame being centred on the patient rather than the management strategies or environment. Cultural barriers referred to the competing activities within the acute environment reducing the opportunity for the person with dementia to be appropriately cared for. The most common form of care management was ‘specialling’ whereby the most junior staff member with limited education was assigned to observe the patient. The need to maintain patient safety and a limited understanding of appropriate interventions encouraged specialling. There was an underlying sense of dissatisfaction with the care management and staff raised the need for greater optimal care practices. However, this environment created a risk management approach rather than one that incorporated injury prevention as one facet of an overall strategy. Furthermore, limited understanding of the difference between chronic and acute confusion resulted in superficial and general care management whereby staff assumed the strategies that were in use were suitable for any older person with confusion, whether it was chronic or acute. The authors emphasise the need for staff education and in particular, integration of an academic environment into the clinical setting to encourage incorporation of evidence-based practice.

Moyle et al. Acute care management of older people with dementia: a qualitative perspective. J Clin Nrs 2010, 20, 420-428.

Wandering
A US study aimed to explore the extent of and factors associated with a change of wandering status of male residents in nursing home care. Residents admitted to 134 Veterans Administration (VA) Nursing Homes over a 4-year period were examined using repeated assessments with the Minimum Data Set (MDS). This resulted in 6673 residents being included in the data set. The majority (86%) were classified as non-wanderers at time of admission and 94% of these remained with this status until discharge, or at the end of the study. 51% of those classified as wanderers changed status to non-wanderers. A number of factors were identified as influencing change in status to wanderers. Residents with severe cognitive impairment and who exhibited socially inappropriate behavior, or who required assistance with personal hygiene at admission were less likely to change from wandering to non-wandering.  However, residents who were dependent for mobilisation were more likely to change status to a non-wanderer. The authors argue for more studies that delineate safe from unsafe wandering.

King-Kallimanis et al. Longitudinal investigation of wandering behaviour in department of veteran affairs nursing home care units. Int J Geriatric Psych 2010, 25, 166- 174.

Research and Practice
Mark Rapoport
February 15, 2011

ECT

Two recent European studies examined different aspects of electroconvulsive therapy (ECT).  The first used MRI measures as predictors of ECT response and the second was an open trial assessing the impact of ECT among patients with mild cognitive impairment (MCI) or dementia.

A naturalistic study of 81 older adults with major depression who were undergoing ECT was conducted in the Netherlands. Each subject underwent an MRI and the researchers found that the presence of moderate or severe medial temporal lobe atrophy was associated with a 3-fold decreased likelihood of remission of depression with the ECT course. Neither cortical atrophy nor white matter hyperintensity burden were associated with response.

Oudega et al. White matter hyperintensity burden, medial temporal lobe atrophy, cortical atrophy, and response to ECT in severely depressed patients.  J Clin Psychiatry 2011, 72(1), 104-112.

A small case series of ECT was conducted in Germany, in which 13 patients with no cognitive impairment (NCI), 19 with MCI and 12 patients with dementia underwent ECT for the treatment of major depression.  An MMSE was conducted prior to each treatment, after the 6th ECT, and again 6 weeks and 6 months after treatment. The MMSE of the NCI and MCI groups improved significantly over 6 months, and there was a numerical but not statistical improvement in the MMSE of the dementia group. The improvement in the dementia group was significantly greater for those on anti-dementia drugs such as cholinesterase inhibitors.

Hausner et al.  Efficacy and cognitive side effects of ECT in depressed elderly inpatients with coexisting mild cognitive impairment or dementia.  J Clin Psychiatry, 72(1), 91-7.

Benzodiazepines.
Despite guidelines suggesting reduction or elimination of benzodiazepine use among older adults, recent evidence suggests they are robustly more common among older than younger adults, and that their discontinuation may reduce the attendant risks of cognitive impairment and dementia.

A longitudinal Canadian study was conducted from 1994 to 2006 with interviews every two years, and benzodiazepine/sedative-hypnotic use was recorded from a list of all medications taken in the 2 days preceding each interview. There was a 48.5% attrition rate in the study, largely from non-response. The frequency of use of benzodiazepines/sedative-hypnotics increased with age, with 0.6% of those aged 12-45 years, 2.1% for those aged 46-65 years, and 3.4% for those aged 66 and older. Age 66 and over was associated with a 5-fold increase in initiation of benzodiazepine/sedative hypnotic over time. The authors report that major depression had less of a relationship to benzodiazepine/sedative hypnotic initiation in older adults than in the younger group.

Patten, S.B. et al Pharmacoepidemiology of benzodiazepine and sedative-hypnotic use in a Canadian general population cohort during 12 years of followup.  Can J Psychiatry 2010; 55(12): 792-799.

Researchers from Taiwan conducted a nested case-control study of dementia to determine the risks associated with benzodiazepines. The authors found that dementia was associated with almost a 3-fold increased likelihood of current benzodiazepine exposure. Interestingly, the risk reduced according to the length of time in which benzodiazepines had been discontinued with the risk being no longer significant by 3 years after discontinuation, except for heavy users. 

Wu CS et al, Effect of benzodiazepine discontinuation on dementia risk.  Am J Ger Psychiatry 2011, 19(2):151-159.

An eight week open-label study of benzodiazepine discontinuation was conducted in 30 nursing home residents in Japan. The average age of the subjects was 79.1 (SD 8.9), and they had various diagnoses. The mean daily flurazepam equivalent dose was 19.5mg (SD 10.9), and the benzodiazepine was tapered over 3 weeks. The subjects underwent testing of postural stability, sleep ratings, and subtests of the Repeateable Battery for the Assessment of Neuropsychological Status (RBANS) at baseline 12 hours post-dose, and again after 8 weeks. There were 26 completers, and among this group, measures of trunk motion, immediate and delayed memory, language, attention, and constructional ability robustly improved, without a decrement in sleep ratings. The absence of a control group is an important limitation, yet this study suggests that a controlled study would be warranted.

Tsunoda, K. Effects of discontinuing benzodiazepine-derivative hypnotics on postural sway and cognitive functions in the elderly.  Int J. Ger Psychiatry, 2010; 25: 1259–1265.

Imaging

Two recent cross-sectional studies using different imaging techniques shed important insights into mechanisms in dementia. The first used the Brain Derived Neurotrophic Factor (BDNF) Val66Met polymorphism to predict cognition, cortical thickness, and white matter integrity in a group of healthy adults across the lifespan, and the second used FDG-PET imaging to look at regional brain metabolism associated with executive dysfunction in dementia.

A group of 69 healthy adults ranging in age from 19 to 82 were examined in a cross-sectional study assessing the relationship of the BDNF-Val66Met polymorphism to measures of memory and cognition in Toronto, Canada. The authors used a measure of episodic memory from the Repeatable Battery for the assessment of Neuropsychological Status (RBANS), an MRI measure of T1 cortical thickness, as well as fractional anisotropy of the white matter tracts using diffusion tensor imaging. An intriguing age x genotype interaction was found, such that lower measures of cognition, cortical thickness (especially in the medial temporal areas) and white matter integrity (especially in temporal-parietal and temporal-frontal areas) were found for the carriers of the Met allele in younger adulthood, and in Val/Val individuals in later life. 

Voineskos, A.M. et al. The Brain-Derived Neurotrophic Factor Val66Met
Polymorphism and Prediction of Neural Risk for Alzheimer Disease. Arch Gen Psych 2011;68(2):198-206

A PET study was conducted in California of 41 patients with Alzheimer’s disease in order to examine the correlation between cerebral metabolism and executive functioning in this population. Each subject was administered 5 tests of executive functioning and underwent FDG PET scanning. The authors reported that reduced activity in the right middle and inferior frontal gyrus, as well as the left middle frontal gyrus and both angular gyri was associated with lower scores on several executive measures. Other areas of lower metabolism correlating with executive measures were reported in the left temporal lobe and both parietal lobes, although the parietal lobe correlations were not significant once controlling for MMSE score. The study confirmed the recognized relationship between frontal lobe dysfunction and executive dysfunction in AD, but also raises the notion that posterior cortical metabolism contributes to performance on executive functioning tasks.

Woo B.K.P. et al Executive deficits and regional brain metabolism in Alzheimer’s disease.  Int J Ger Psychiatry 25: 1150-1158.

Psychiatric Disorders in Long-Term Care

Researchers from Toronto, Canada and Manchester, UK conducted a systematic review of the prevalence of psychiatric disorders in long-term care. They limited their search for those using validated measures for symptoms or establishing diagnoses. They also determined the prevalence of disorders in the US long-term care population in 2004’s National Nursing Home Survey (NNHS). They found a median prevalence of 58% for dementia in the reviewed studies, and 52% in the NNHS. Of those with dementia, the median prevalence of BPSD was 78% in the reviewed studies, and about 37% in the NNHS.  Major depression had a prevalence of 10% in the reviewed studies and only 1.33% in the NNHS. Most other psychiatric disorders had insufficient data to estimate prevalence. The authors commented on the small sample sizes and the few LTCs incorporated in the study samples, as well as the differing populations and measures in the different studies, making comparison difficult.  They argued for more studies in countries outside of Europe and North America, as well as collaboration with standard measures across centres.

Seitz, D. et al.  Prevalence of psychiatric disorders among adults in long-term care homes:  A systematic review.  Int Psychogeriatrics 2010; 22(7), 1025-39.

Psychotherapy

Researchers in San Francisco conducted a randomized controlled trial in which 221 older adults with major depression who had low scores in two executive function tests were randomized to either problem-solving therapy (PST) or supportive therapy for 12 weeks. There was little attrition in this study, with only 9% dropping out of treatment. At 12 weeks, response, defined as a 50% or greater reduction of HAMD score, common in the PST group (56.7%) than the supportive therapy group (34%). Remission, defined as a HAMD of less than 10 for 2 consecutive weeks, was also more common in the PST group than the supportive therapy group (45.6% vs 27.8%). The results of this study are similar to the demonstrated effectiveness of PST for cognitively intact depressed older patients, and the fact that the group differences were only apparent at 12 weeks (not at 6 weeks) suggests that adequate time was required for the development of problem-solving skills in this group. 

Arean, P.A., et al Problem solving therapy and supportive therapy in older adults with major depression and executive dysfunction.  Am J Psychiatry  2010, 167: 1391-1398.

Brian Draper ● Australia

Reflections and Farewell

In 2001 it occurred to me that there was scope for a website review column in the IPA Bulletin that would have the aim of informing the IPA membership about interesting websites relevant to our work with a focus on providing an assessment of quality. I contacted David Ames, who at that time was the editor of the Bulletin, and he quickly replied that he thought it was a good idea and would be very pleased if I were to take it on. Now ten years later it is time for me to step down due to the demands of other commitments.

A lot has happened on the Internet during the past decade. In 2001, Internet search engines were in their infancy and so to find information about psychogeriatrics, dementia or other aspects of old age mental health required a certain level of competency in the web user – a competency that a decade later still eludes the average web user but is compensated for by modern search engines. There were also many concerns about the quality of information available and often there was a paradox that what seemed to be the most informative websites were not necessarily the ones developed by the most credible organizations with the best quality content. For a while, many well established organizations had at best a perfunctory web presence and took a while to cotton on to the fact that the Internet was the future of information dissemination. So there was a need to bridge this gap.

Since 2001, over 100 websites have been reviewed in ‘On the Web’ by 94 reviewers from 32 countries on six continents. It was always critically important to me that the column should be truly international in its focus and hopefully that has been achieved. I would like to thank all of you who have contributed to the column because without you there would have been little content. Indeed, the introduction to this last column is perhaps as much as I have needed to write in the whole period!  

As Bill Burke takes over the reins as the new editor of the IPA Bulletin we have already discussed future directions that the column could take but I’ll leave that in Bill’s capable hands. For this last column in the current format I thank my willing and able contributors Elaine Greene from Ireland, Huali Wang from China and Ali Javadpour from Iran for their reviews.

Dementia Gateway
http:// www.scie.org.uk/dementia

Dementia Gateway was launched in 2009 by The Social Care Institute for Excellence (SCIE), an independent charity funded by the UK Department of Health, whose remit is to promote best practice in social care. Dementia Gateway aims to provide up-to-date online resources to support people with dementia, their carers and staff working in dementia services.

This is a well presented website. The Homepage loads quickly, is clearly laid out and user friendly. Pages load readily and links are easily navigable. The website is accessible to the visually impaired and provides speech enabled text (using a web tool called Browsealoud). The content is practical and presented in sections which address many common issues encountered by carers of individuals with dementia. Topics range from "Getting to know a person with dementia" to "'Tackling' difficult situations."  

Each section comprises a number of web pages. The information provided is up to date, well summarised and the terminology is accessible to lay users. Additionally, each issue addressed is supplemented by an ‘over to you’ self-assessment section where the website user can review their understanding of the topic. The ‘over to you’ section is downloadable and also includes downloadable ‘trainers notes’ in PDF format. All sections also include links to ‘extra reading’ and other relevant web resources where users can access more in-depth information about the topic. Some sections also include links to short videos developed by SCIE ‘Social Care TV’ which address a number of different topics relevant to dementia.

An impressive number of UK dementia experts have been involved in writing and editing the sections presented. The authorship of each section is clear and short bios are provided for all authors. Experts are drawn from a number of different disciplines and include dementia sufferers, providing a comprehensive perspective on care. Many of the interactive features presented on the website relate to general social care issues and are linked back to the SCIE website within which ‘Dementia Gateway’ is embedded. While not all of these interactive features are relevant, there are a number of downloadable resources available within Dementia Gateway which could prove useful in clinical practice.

This useful website provides simple, up to date, practical information and advice and is an excellent resource for families and carers of persons with dementia.

Reviewer: Elaine Greene, St James’s Hospital, Dublin, Ireland

International Association of Gerontology and Geriatrics
http://www.iagg.info/

The International Association of Gerontology and Geriatrics website is mainly focused on elderly people. The website covers various topics in geriatrics in a clear and simple way which is most useful for international users. Its collaboration with WHO is a strong point. The website presents information about education and research on the web.

The weakness of the site is the home page. It is a bit confusing in appearance, utilizing various font types. It would better to include some Icons for main topics. Meanwhile the headlines located in the upper part of the front page are clear. I found this to be a good website for geropsychiatry.

Reviewer: Ali Javadpour, Iran.

Alzheimer’s Disease Chinese (ADC) website
http://www.adc.org.cn

Alzheimer’s Disease Chinese (ADC) is a member organization of Alzheimer’s Disease International (ADI). The mission of ADC is to raise the public awareness about Alzheimer's disease and all other causes of dementia, to improve the quality of care for people with dementia, and to ultimately improve the quality of life of people with dementia and their families. The website was launched in 2005, and has recently been renovated to be more inclusive and user-friendly.

The overall performance is good with quick load of the pages and quick access to the hotlinks. Generally the ADC website is logical and easy to follow. The homepage of the website provides an overview of the domains covered by the network, and allows easy navigation through different topics: organization and executive committee, recent news, information about caring for people with dementia, and member space. The right column of the welcome page provides information of toll-free service phone number, and links to the downloadable documents and materials, e.g., ADC membership application form, early signs of Alzheimer’s disease, caregivers’ manual, etc. Most of the online resources were prepared by the neurologists and geriatric psychiatrists in the executive committee.

ADC also updates international connection on the website, and shares the information of ADI events, including World Alzheimer’s Day, ADI congress and regional conference. In addition, ADC shares the national campaigns to promote the public awareness of dementia in China. The information for access to services (nursing home, support groups, memory clinic) was not provided—fortunately it is imminent. The links with other important web sites, e.g. Alzheimer’s Disease International, the Ministry of Health of China, are underway. Unfortunately, the website does not provide an English version.

Summary: The Alzheimer’s Association Chinese website provides clear information regarding the structure and national and international events of the association, and conveys the message on dementia care in a relatively logical flow and clear navigation. We are looking forward to more information on accessible services that are appropriate for elderly in China.

Reviewer: Huali Wang, Peking University Institute of Mental Health, Beijing, CHINA

China Alzheimer’s Project
http://www.memory360.org
China Alzheimer’s Project (CAP, named in Chinese as Memory360 Project) was launched on September 21, 2009, the World Alzheimer’s Day by China Contemporary TCM Institute, a non-profit organization subordinated to the State Administration of Traditional Chinese Medicine. The mission of CAP is to improve the quality of life for patients and families affected by dementia; and to enhance the capability for public to prevent and cope with dementia. The overall performance of the website is very good and straightforward.

In addition to the organization structure of CAP and information on dementia care, I find the website more impressive in three major aspects. First, the website provides a flash brain tour, navigating the brain and Alzheimer’s disease. Users may find it more interesting and illustrative relative to reading materials. Second, the website provides hyperlinks to international organizations and corporate partners. More important, the CAP website provides search links to hospitals potentially serving for dementia, although the quality and capacity for dementia care in the facilities could not be easily reviewed and accredited. Last, but not of the least importance, the website provides a forum where volunteers could share their personal experiences and stories when working with people with dementia. The moving stories could inspire more attention and support to the dementia care community. In conclusion, the CAP website is an appealing and well-functioning website, which is full of innovation and creativity.

Reviewer: Huali Wang, Peking University Institute of Mental Health, Beijing, CHINA

As an IPA member, you receive all of the IPA member benefits (see below) plus some new innovative or enhanced IPA programs and services such as our Neuroimaging in Dementia Webinar Series included with your membership at No Additional Charge. Register Today!

In addition, IPA has launched a membership database that will enable you to easily renew your membership, update your member information, provide your input to the IPA Board of Directors, and access new programs and services—at any time and any place because it is available on the IPA website and IPA Members Area.

You have access to some of the latest research, best care practices, and a professional community of colleagues from all over the world and all disciplines in the geriatric mental health field.  Specifically, your membership benefits include:

• International Psychogeriatrics– In 2011, the Journal increased from 8 issues to 10 times per year (electronic access is available through the IPA Members Area)

• IPA Bulletin – In 2011, the IPA Bulletin is now produced electronically and instead of 4 issues will be brought to you 6 times per year (visit the IPA website - Members Area for the current and archived issues) – they will now be “searchable.”

• Discount registration for IPA meetings - Upcoming IPA Meetings:&nbsp; 6-9 September 2011 - The Hague, The Netherlands

• Exclusive access to IPA Members Area. (Welcome Members!) on the IPA website, including interacting with IPA colleagues through the online member directory, and special IPA publications and other resources such as the newly revised, electronic Complete Guide to Behavioral and Psychological Symptoms of Dementia (BPSD).  Future plans include updating the Nurses Guide and Primary Care Physician Guide as well as creating a new volume for long-term care.

• Task Forces, Shared Interest Groups, and Regional Initiatives – all of these professional forums are working on projects to help in individual settings and advance the field – learn more about them in the Members Area of the IPA website.

If you are not an IPA member, consider joining IPA. IPA is unique in its commitment to making its programs relevant and accessible to all of the disciplines working in all areas of geriatric mental health and wherever they live. This commitment is most evident in our membership benefits and dues structure – we want to provide the best quality information, resources and education as well as ensure that our colleagues, whether in a developed country or a developing country, can all afford to participate. Visit our web site for more information.

4-6 May 2011 / Auckland, New Zealand
Australian & New Zealand Society for Geriatric Medicine
Website: http://www.anzsgm.org

11-14 May 2011 / National Harbor, Maryland USA
American Geriatrics Society
Website: http://www.americangeriatrics.org

14-19 May 2011 / Honolulu, Hawaii, United States
American Psychiatric Association
164th Annual Meeting of the APA
Website: http://www.psych.org/

24-27 May 2011 / Hamburg, Germany
European Stroke Conference
Website: http://www.eurostroke.org

29 May–3 June 2011 / Prague, Czech Republic
World Congress of Biological Psychiatry
Website: http://www.wfsbp-congress.org

16-21 July 2011 / Paris, France
Alzheimer’s Association
Website: http://www.alz.org/icad

24-27 July 2011 / Harrogate, UK
British Association of Psychopharmacology
Website: http://www.bap.org.uk

6-9 September 2011 – The Hague, Netherlands
International Psychogeriatric Association
15th International Congress
Email: info@ipa-online.org
Website: http://www.ipa-online.org

10–13 September 2011 / Budapest, Hungary
European Federation of Neurological Societies
Website: http://www.efns.org

20–23 October 2011 / Riga, Latvia
Congress on Vascular Dementia
Website: http://www2.kenes.com/vascular/Pages/Home.aspx