Late-life depression

This chapter discusses the specific factors that play a role in depression in older people, including the large heterogeneity of the concept, its clinical presentations, diagnostic procedures and identification of risk factors, consequences, and treatment of depression in late life. However, compared to the Diagnostic and Statistical Manual (DSM), 4th ed, Text Revision, a number of changes have been made to the DSM-5, with a putative impact on the classification of depression in late life. The concept of 'vascular depression', which has established the aetiological connection between cerebral vascular damage and depression, was described by Post in the 1960s. The differential diagnosis of depression and apathy syndrome in the presence of a developing neurodegenerative disorder, Parkinson's disease, or dementia is often extremely difficult. The majority of older adults, who attempt suicide or die, suffer from depression. Psychotherapy should be considered in older people with depression on the same grounds as in younger adults.