There is probably no single reason that scientific authors choose a particular journal for the publication of their research papers. Most of us will have a feeling for the importance or otherwise of our work as we prepare it for submission and will want it to appear in the most prestigious and authoritative journal that will take it. Alternatively, we might want to reach a particular specialist audience because sometimes it is highly satisfying to know that your work has at least been read—even if it hasn't been cited! But why should you send your manuscripts for publication in International Psychogeriatrics rather than in one of the large number of competitor journals that have sprung up in the field in recent years? Here are four good reasons.

In the 12 years of its existence, International Psychogeriatrics has never presented an editorial by its publisher. It seems fitting to write this editorial at this particular time because the year 2000 marks Springer's 50th anniversary in business. Bernhard Springer founded our publishing company in 1950, in New York. I became its owner and president after my husband's death in 1970.

The purpose of the study was to investigate the natural history of insomnia and its association with depression and mortality. In 1983, 1,870 randomly selected subjects aged 45–65 years answered a questionnaire on sleep and health. Of the 1,604 survivors in 1995, 1,244 (77.6%) answered a new questionnaire with almost identical questions. Mortality data were collected for the 266 subjects that had died during the follow-up period. Chronic insomnia was reported by 36.0% of women and 25.4% of men (χ2 = 9.7; p < .01). About 75% of subjects with insomnia at baseline continued to have insomnia at follow-up. Insomnia in women predicted subsequent depression (odds ratio [OR] = 4.1; 95% confidence interval [CI] 2.1–7.2) but was not related to mortality. In men, insomnia predicted mortality (OR = 1.7; 95% CI 1.2–2.3), but after adjustment for an array of possible risk factors, this association was no longer significant. Men with depression at baseline had an adjusted total death rate that was 1.9 times higher than in the nondepressed men (95% CI: 1.2–3.0).

Considerable burden is reported by informal caregivers of older individuals with cognitive impairment. Significant progress in the understanding of determinants of this burden has been achieved. However, further progress could be attained if we considered important methodological issues that may have limited our understanding of caregiver burden. These issues include subgroups of care recipients and caregivers, measurement issues, research design, and statistical techniques. Fifty-three studies published between 1980 and 1997 (inclusive) that focused on caregiver burden were abstracted to determine the extent to which the methodological issues discussed above were considered. Overall, we found considerable variability among the studies surveyed. Further understanding of the caregiving process and reductions in caregiver burden will depend on the attention to methodological issues and understanding of burden across the whole caregiving career.

The aim of this study was to identify factors associated with vocally disruptive behavior (VDB) in nursing home patients referred to aged care services for treatment, using a case-control methodology. Characteristics of the VDB, reasons for referral, perceived causal factors, and psychotropic use were noted. Twenty-five subjects and controls were examined with the Screaming Behavior Mapping Instrument, the Cornell Scale for Depression in Dementia, the Dementia Behavior Disturbance Scale, and measures of cognition, functional capacity, social activities, and emotional reactions of nursing staff. VDB was associated with other disturbed behaviors, depression, anxiety, severe dementia, functional impairment, communication difficulties, use of psychotropic medication, social isolation, and emotional distress in the nursing staff. Reasons for referral may relate more to the stress experienced by nursing home staff in managing VDB than to specific attributes of the VDB itself.

Personal space has been a research issue in both social psychology and nursing in the past 20 years. In the context of behavioral and psychological signs and symptoms in dementia (BPSSD), however, personal space and other basic paradigms of social psychology sparsely play a role. In order to assess personal space in demented (n = 10) and nondemented (n = 10) elderly participants, we replicated the original study addressing personal space by Felipe and Sommer (1966). The two groups differed in the overall number of participants showing a specific reaction, in the mean duration until specific reactions occurred, and in the percentage of participants within a group showing a specific reaction at a given point in time. The argument is being made that such findings might reflect situational as well as disease-specific changes in the perception of and reactions to invasions of personal space in demented patients. We suggest that further research in that field could bring about more information on the nature of dementia, and especially BPSSD. Implications for therapy and care of dementia patients are being discussed.

Background: The developments in the understanding of Alzheimer's disease (AD) have led to genetic testing, expansion of research centers, and emergence of novel treatment modalities. However, behavioral symptoms and disturbances remain the leading cause of distress to families and patients. The management of these disturbances is not fully elucidated and not without controversies. Aim: To review and integrate the two important approaches to management and treatment of depression in AD as published in the American Psychiatric Association's guidelines for the treatment of patients with AD versus the American Academy of Neurology's official publication on managing AD. Method: Both publications are analyzed focusing on the pharmacological treatment of depression. The analysis includes sources of data, generalization, and common and conflicting recommendations. Conclusion: Selective serotonin reuptake inhibitors are the drugs of choice for the treatment of depression in AD patients.

Objective: To investigate the nature of deficits in social cognition and real-life decision making in a group of patients with Alzheimer's disease (AD). Design: A comprehensive neuropsychological and psychiatric assessment, including the Moral Judgment Interview and the Bechara's Card Test, was carried out in 25 patients with AD and 20 age-comparable normal controls. Setting: Outpatients clinic. Results: AD patients had significantly lower scores in the Moral Judgment Interview and obtained significantly less earnings in the card test when compared to the normal control group. The Moral Judgment Interview score correlated significantly with Raven's Progressive Matrices and Block Design, whereas the card test correlated significantly with both the Benton Visual Retention Test and the Buschke Selective Reminding Test. No significant correlations were observed between the experimental tasks and the psychiatric variables. Conclusions: AD patients demonstrated significant deficits on tasks assessing social cognition and real-life decision making. These impairments correlated with deficits on specific neuropsychological tasks, but not with behavioral problems frequently found in AD patients.

Dementia is a relatively “new” disease in the medical field. Over the past few decades, neurologists, geriatricians, psychologists, and sociologists were keen to determine the causes of dementia. The prevalent picture of the scientific and theoretical causation of dementia, however, overshadows the lay perspective of dementia. To get a better understanding of the latter aspect, this study examined family carers' knowledge of dementia and how they made sense of the disease. Individual interviews were completed with 18 family carers. The interview data were analyzed based on grounded theory, which is characterized by a constant comparative method of analysis (Glaser & Strauss, 1967). This method of analysis is inductive in nature and allows the construction of a theory of the lay interpretation of dementia. The study revealed family carers' limited knowledge of dementia might be related to medical professionals' inadequate explanations of the multifaceted dimensions of dementia. Hence, the family carers tended to use external events and personal experiences to explain the occurrence of dementia. Findings suggested that the development of a lay understanding of dementia was a means for family carers to gain control of this abstruse disease and served as an adaptive strategy to cope with the loss experienced during the caring process. The study indicates a definite need for health care professionals to form partnerships with family carers in order to develop good dementia care.

We examined 510 subjects representing 83.2% of all citizens of a Finnish city aged 85 years or over. Mini-Mental State Examination (MMSE) scores, diagnosis of dementia by DSM-III-R criteria, and Apo-E genotype were determined. The prevalence of dementia was 38.6%. The odds ratio (OR) of the Apo-E ε4 carriers (with the reference population of people with the genotype ε3/ε3) for dementia was 2.36 (95% CI 1.58–3.58). There was a significant sex difference: The OR in women was 3.23 (95% CI 2.02–5.17) whereas among men it was insignificant. The mean MMSE score (± SD) among the Apo-E ε4 carriers (15.0 ± 10.0) and noncarriers (18.7 ± 8.6) (p < .001) differed among the whole population, but not within the demented or nondemented subjects analyzed separately. This study does not support the hypothesis that the Apo-E ε4 allele impairs cognitive functions of nondemented elderly, at least in those surviving to very old age.

Comprehensive Alzheimer's disease (AD) treatment should address caregiver well-being. We predicted that caregiver burden would be lower among caregivers of AD patients who received donepezil relative to caregivers of patients not treated with donepezil. A self-administered, nationwide survey of AD caregivers was used to match caregivers of patients treated with donepezil (n = 274) to caregivers of patients not treated with donepezil (n = 274). The Caregiver Burden Scale measured time demands and distress linked to commonly performed caregiving tasks. Respondents were three-quarters female, with an average age of 60 years. Results demonstrated that donepezil caregivers reported significantly lower scores on difficulty of caregiving. This difference remained when statistical controls for multiple patient and caregiver variables were imposed. However, selection factors must be recognized as a possible explanation for differences. The groups reported no difference on the time-demand subscale. In conclusion, better management of AD symptoms through donepezil treatment may reduce the burden of caregiving, providing physicians with a pharmacologic approach to improving quality of life for AD patients and their families.

The Clinician Interview-Based Impression of Change, plus carer interview (CIBIC-Plus), is widely used in antidementia drug trials. It comprises Likert scales for disease severity and changes, and written accounts summarizing semistructured interviews evaluating behavior, cognition, and function. Studies using the CIBIC-Plus have focused on the numeric scores to the exclusion of the textual data. Our study explored both sets of data to evaluate whether the CIBIC-Plus written data supported (a) the clinicians' global evaluation of patients' changes during treatment, and (b) the emergence of consistent treatment effects. The global (numeric) scales of change were inconsistently supported by the textual data provided in the CIBIC-Plus. No consistent treatment effects were noted. Methodological problems presently limit the retrospective use of the CIBIC-Plus textual data. Improved standardization of note-taking in the CIBIC-Plus textual data may allow for a better understanding of the typical profiles and clinical importance of changes seen in the course of dementia treatment.