EDITORS' INTRODUCTION

As the number of people living longer increases around the world, the likelihood of developing conditions such as dementias also increases. The cultural concepts of dementia as normal ageing make it less likely that individuals or their carers will seek help from services. With longevity comes physical frailty and an associated increase in mental illness. Shah and Mackenzie have discussed epidemiological findings in an earlier chapter in this volume.

Cohen and Ahmed focus here on working with elderly people across cultures. They point out that there are a variety of ways in which ageing can be defined from the biological, psychological and social perspectives. Typically, however, ageing is identified with chronological age. In traditional societies, old age is seen as changes in social or economic role, chronology and changes in physical characteristics. The relationship of events and historical context affects individuals in different ways and the social roles are affected by a number of factors. As women over the age of menopause are becoming pregnant in the West, their experiences of ageing are going to be remarkably different from their cohort. There is a variety of ways in which culture may affect the development and course of psychiatric conditions in older persons – direct or indirect effects of the ecosystem and lifestyle patterns and unhealthy living. Social forces such as globalization and urbanization will affect physical and mental health. Lastly, Cohen and Ahmed indicate the fostering of certain personality patterns that may become dysfunctional in later life. Managing mental illness in the elderly involves issues of assessment which will be culturally influenced.