The Department of Psychological Medicine at Changi General Hospital came together to produce this book. Although the focus was on the common conditions seen in geriatric psychiatry, the contributors include geriatrician, social worker, occupational therapist and psychologist. This book was written because psychiatric problems in the elderly present to a wide variety of medical professionals and we believe greater awareness of the psychological aspects of aging will result in better management and improved outcomes for this growing group of patients.

Old age can bring many stressors such as illness, bereavement and disability and we need to understand the elderly person's normal adjustment to these losses. Doctors also need to identify pathologic reactions such as depressive disorders and anxiety disorder. Untreated, these contribute to the high rate of elderly suicide in Singapore - 2006, it was 17 per 100 000, twice the rate of the general population. The chapters "Grief", "Coping with Physical Illness", "Depression" and "Anxiety Disorders" also suggest interventions that can be considered by general practitioners in similar circumstances.

The risk of dementing illnesses increases sharply with age. Many times, memory loss is dismissed as a normal part of aging. However, when there is increasing loss of executive function and behavioural disturbances, the elderly are more prone to injury and disability. This also causes high rates of caregiver stress and institutionalisation. This book provides an overview of the assessment and treatment of common problems seen in dementia.

In the elderly, there is a two-way link between physical and psychological illness. The elderly often present their psychological complaints as physical symptoms, and acute medical problems are often associated with psychiatric symptoms. The chapters "Delirium" gives an account of the management of an elderly lady who presents with abrupt onset of psychosis after sustaining a fracture. Delirium is always an important consideration when treating medically unstable elderly persons and should not be mistaken for schizophrenia and related conditions, which are elaborated upon in the chapter, "Late-Onset Psychoses".

Doctors often need to assess the elderly for mental ability to consent to medical procedures and to make important decisions such as the writing of a will. The chapter on competence outlines the factors to take into consideration and the steps needed to ensure an adequate assessment.

Using case vignettes to illustrate clinical points and advising on the usual first-line treatment, the authors hope to share their experiences with the wider medical community. Working with the elderly is a joy and truly doctors will find that "we can lead them and learn from them through this final phase of life".