The diagnosis and treatment of depression in dementia.

Abstract

For many years, the problem of accurate diagnosis of depression among elderly patients with cognitive impairment has focused on patients with major depression who are misdiagnosed as having dementia—cases of so-called depressive pseudodementia. Yet the more common, and possibly more difficult, predicament for the clinician is making the diagnosis of depression for the patient with established dementia. This difficulty is often exacerbated when a diagnosis is needed for an institutionalized patient with severe dementia, yet reliable information about subjective affective symptoms is lacking due to the patient’s cognitive status. This paper discusses ways to improve diagnostic accuracy in treating patients with depression and dementia and reviews treatment options for these patients. Diagnostic issues