[Loss of motivation in the elderly]

The loss of motivation is frequent in aged person and sometimes is difficult to assess. It is associated with depression but not exclusively. It overlaps with frontal brain aging consequences. Moreover, somatic problems can interfere with a loss of motivation; loss of motivation is frequent with exhausting chronic diseases, cognitive impairment and it facilitates the social withdrawal. In elderly, loss of motivation blunts the intensity of moral pain. Depressions with conative disorders can move in a dysexecutive syndrome. Even if, owing to the treatment, the cognitive disorders disappear, several years after, an authentic dementia can be diagnosed. With aging process, elderly must cope with losses, less or more balanced: affective, physical and financial losses, triggering the reject of any personal commitment. Aging process also concerns brain amines, especially dopamine, exposing old persons to depression. It alters by a similar way others brain neuro-mediator, such acetylcholine, involved in dementia. Both loss motivation and executive disorders have to be systematically assessed. An antidepressant therapeutic is necessary in case of doubt, improving patients thymic status, quality of life of patients and their family, and sometime of frontal dysfunctions.