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A knowledge of cultural factors is essential to an understanding of aging and mental health. This paper surveys cultural aspects and folk theories of aging, attitudes to the elderly, death, disengagement and role theory. The cultural aspects of psychopathology are then reviewed and the evidence for differing prevalences of depression and dementia considered, concluding with a comment on the provision of care for this group. It is argued that an understanding of systems of prestige and esteem gained from anthropology is important in understanding how culture influences the development of mental illness, but clearly also patterns of urbanization and industrialization worldwide influence the position of the aged. The importance of studying attitudes to the elderly is that the elderly come to perceive themselves in the same way. The prevalence of depression and dementia in Japan may be lower than in the West, which implies this culture may exert a protective influence. The position in China is less clear. Differences in family structures, attitudes, integration in the community and fulfilment of roles may account for these findings.