[Diagnosis and therapy of depression in advanced age]

Depressive symptoms and dementia are the most frequent psychiatric disorders in late life. Somatic diseases, social isolation, and functional disability, interfering with the activity of daily life and social participation are among the relevant risk factors. The elderly are particularly prone to subsyndromal depression because of their increased tendency to alexithymia and somatisation, which masks the depression. There is a strong association between comorbid physical illnesses and depressive symptoms for a number of common medical disorders. Antidepressive therapy is proven to be as effective as in younger age groups. Medical treatment should consider the special pharmacological features of old age and should be combined with psychotherapy. When the notion that depression in older people is "justified" is no longer common sense, then successful treatment will be more likely.