We are grateful to Nancy Miller, Zbigniew Lipowski, and Barry Lebowitz for their outstanding work as guest editors of this issue of International Psychogeriatrics. These papers were stimulated by a special meeting of the National Institute of Mental Health (NIMH). They are authored by Americans and Canadians and are followed by discussions and critiques from experts in Europe, Australia, and Asia. This format is a novel one, but one which presents many exciting possibilities.