Depression and dementia represent frequent clinical presentations in the elderly population. Both diseases are interlinked. Indeed, depression in the elderly may reflect an increased risk for the later development of dementia. Worldwide, about 47 million people are affected by dementia, which represents about 10% of the general population over 65 years of age. On the other hand, among elderly people, the prevalence of depressive symptoms and major depressive disorder (MDD) is 15% and 1–3%, respectively. Female gender, alcohol and substance or drug abuse, family history, and medical conditions are factors associated with depression in the elderly.
In the present chapter we specifically focus on discrimination between elderly MDD and major neurocognitive disorder. Concerning this point, two steps have to be performed: (1) observation of clinical response to antidepressants’ treatment, taking into consideration a possible longer latency of antidepressants’ efficacy in elderly/lower response to antidepressants in older age, and (2) cross-clinical assessments with neuropsychological evaluation, imaging, and laboratory tests.
Considering the background of the present literature, we pointed out the case of a woman, 72 years old, with a long history of MDD and a recent diagnosis of mild cognitive impairment (MCI). She was referred to our outpatient clinic for a relapsing depressive episode. In the present case presentation, we investigated the differential diagnostic process, observing clinical course, using neuropsychological evaluation, blood and urine laboratory exams, computed tomography, magnetic resonance imaging, positron emission tomography, cerebrospinal fluid analysis, and electroencephalogram.
Depression Dementia Pseudodementia Elderly
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