This month's theme of the Mental Health Clinician is geropsychiatry. The number of people in the U.S. over the age of 65 years is expected to double and those over the age of 85 years is expected to increase five-fold.1,2 The majority of older adults suffer from at least one chronic disease and 90% take at least one chronic medication daily.3 The average community older adult takes at least 3 medications on average. Residents in long-term care settings have even higher medication use rates. It is also reported that adherence with medication regimens is poor, and this is often due to adverse events. The impact that pharmacists can have on assuring rational pharmacotherapy, improving adherence, and reducing adverse events in the elderly is immense.

In this issue Chris Thomas, PharmD, CGP, BCPS, BCPP reviews the data on the care of patients with neuropsychiatric symptoms associated with Alzheimer's Disease (AD). In addition, Eric Kutscher, PharmD, BCPP and Megan Leloux, PharmD review the evaluation of elderly patients and general pharmacotherapy principles in older adults. There is an original research report from Jonathan Leung, PharmD, BCPS, BCPP on the dosing of valproate in elderly patients with dementia and also one from Ryan Carnahan, PharmD, BCPP on the “Improving Antipsychotic Appropriateness in Dementia Patients (IA-ADAPT)” Clinical Tools and Training Program. This issue features a case report on the use of ginkgo biloba and vitamin E in people with cognitive deficits. Finally, Clayton English, PharmD, BCPP discusses the controversial use of high dose donepezil.

The role of pharmacists in the care of elderly patients is an important one and is an area where many CPNP members have unique practices. In this issue, two pharmacists provide us an overview of their practice sites and the impact they have on the care of the elderly. Cindy Thomas, RPh, CGP describes her role as a consultant pharmacist in Ohio. Mark Dewey, PharmD from North Dakota State University offers insight into his role as a consultant pharmacist and academician.

Projections of the population by selected age groups and sex for the United States: 2008 to 2050. Source: Population Division, US Census Bureau
Release Date: August 14, 2008. Available at: Accessed September 30, 2009
Percent distribution of the projected population by selected age groups and sex for the United States: 2008 to 2050. Source: Population Division, US Census Bureau
Agreement between drugs-to-avoid criteria and expert assessments of problematic prescribing--invited commentary
Arch Intern Med