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Depression is more common in old age than dementia, yet is underdiagnosed and undertreated. The reasons for this may relate to the overlap of presenting symptoms with ‘normal’ distress, which can make a diagnosis difficult, or to a lack of recognition of the importance of the condition by clinicians, patients and their families. Regardless of age, depression can present with low mood in addition to other biological changes e.g. in sleep and appetite, and psychological changes e.g. low self-esteem and guilt, see table 1. However, it is important to recognise that patients may not always present in such a typical way. Other presenting features that may indicate depression include anxiety, a preoccupation with somatic symptoms, and a change in function, with reduced interest in previously enjoyed activities. Changes in cognitive performance, particularly reduced executive function, e.g. planning activities, and poor attention and memory may be prominent, and this can lead to difficulty distinguishing depression from dementia.


Journal article


The Practitioner

Publication Date





19 - 22

Total pages