John O’Brien

It gives me great pleasure to introduce our first Bulletin of 2001, which the purists among you would say is the first of the real new millennium. It is, perhaps, appropriate then that we reflect on something of our
past. Among other items, this issue contains excellent historical accounts from
two distinguished figures whose research has had a tremendous and lasting influence on the development and practice of Old Age Psychiatry, both within the UK and globally, and who haveparticular connection with my own base
of Newcastle.

Sir Martin Roth, writing with his usual clarity and precision, describes the time of his arrival in
Newcastle as Professor of Psychiatry in 1956 and the circumstances which led to the formation of novel research ideas developed with Bernard Tomlinson, Gary Blessed, David Kay and others.

This group, of course, was involved with the seminal studies published in the late 1960s and early 1970s showing that the pathological substrate of dementia in later life (i.e. plaques and tangles) was exactly the same as that of “pre-senile” dementia. This work completely changed the perception of late life dementia from a natural part of aging to an illness. Furthermore, the work of this group, still widely quoted today, showed that tangles had a high correlation with cognitive impairment in Alzheimer’s disease, while the volume of infarction correlated
with cognitive impairment in those with vascular dementia.

Sir Bernard Tomlinson, a neuropathologist, provides a wonderful complementary account of the same period; both he and Sir Martin transmit something of the tremendous atmosphere of true discovery and enthusiasm that clearly existed at the time. Anyone who feels that research is impossible while under-taking heavy clinical commitments should take note (and heart!) from Sir Bernard’s article, in which he describes undertaking detailed neuropathological study of cases while being Head of Hospital Laboratories and, with only one colleague, responsible for all surgical histology and post mortems of a busy 1,000-bed, acute General Hospital undertaking
1,000 post mortems a year. 

The importance of their contribution went beyond the actual findings of their studies. Clinically, their work played an important role in raising the profile of psychiatric disorders in the elderly and emphasized the need for special management (and so, service development) of this group. Their studies also ably illustrated the power of the clinico-pathological study, which has subsequently proved so fruitful in our field in defining and classifying disorders, as well as establishing neurochemical deficits which have directly led to the recent introduction of effective cholinergic therapies for Alzheimer’s disease

Love it or hate it, the Internet is here to stay and IPA has established an excellent Web site, which is detailed in an article by Jay Luxenberg. However, the way to learn about a Web site is to visit it and if you have not yet (or not recently) visited, then log on now (well, at least when you have finished reading the Bulletin) to www.ipa-online.org. Be sure to bookmark the site for future
reference. The Web site contains a host of useful information about IPA, including tables of contents of the journal and some current and back articles of the Bulletin, as well as frequently changing news and a “cover story.” Important information is also provided about upcoming meetings. I have found the slide presentations that can be downloaded particularly useful for educational presentations. We are very grateful to Jay Luxenberg and Sture Eriksson for their input into developing and maintaining the Web site.

The use of the Internet as an important way of disseminating information is also highlighted by
Ales Kogoj’s article on the Alzheimer’s Disease and Related Disorders Association of Slovenia. Ales describes the impressively rapid development and progress of the Association, which was only established in 1997, as well as outlining the many challenges ahead.

We are pleased to congratulate David Resnikoff on his appointment as National Advisor for the
dementias in Mexico as well as our President, Ed Chiu, on his appointment as guest Professor at Peking University Health Science Center. We always like to hear news and information about honors and awards involving IPA members, which we can report in the Bulletin. Please keep us posted.

This issue will arrive with most members around, or shortly after, World Health Day, which is being held on 7 April this year. As outlined in the last issue, the focus of this day is on Mental Health and it is fitting that Alzheimer’s disease was chosen as one of six key health issues to address. It is, therefore, both an honor and appropriate that Alzheimer’s Disease International has been invited to deliver a statement on dementia at the official World Health Day launch. We hope to include further details of this in a subsequent issue.

Also in this issue, Philippe Robert updates us on the John O’Brien status of the next IPA Congress, to be held in Nice from 9-14 September. I recommend this meeting to you and personally look forward to the Congress, unbelievably IPA’s tenth, with great enthusiasm. The Scientific Program, which looks excellent, should be attraction enough to book now, but if not, the wonderful scenery and delights of Nice surely must be. Finally, when you have digested the contents of the Bulletin, you also might like to digest the recipe on page 23, a simple but delightful dish of baked bananas and liquorice, which, I can assure you, is equally delicious without the liquorice.

John O’Brien, Deputy Editor, is Professor of Old Age Psychiatry, Department of Psychiatry and the Institute for the Health of the Elderly, University of Newcastle upon Tyne, and Honorary Consultant in Old Age Psychiatry at Newcastle General Hospital. He can be contacted at j.t.o’brien@newcastle.ac.uk.

Reprinted from IPA Bulletin, Volume 18, Number 1