[The differential diagnosis of late onset psychiatric symptoms: current and future possibilities!]

Diagnosis of late onset neuropsychiatric symptoms can be very challenging. Age-related variability in the clinical presentation of highly prevalent psychiatric conditions may be linked with cognitive and somatic disease or psychosocial adjustments.

To discuss traditional and innovative diagnostic tools such as novel biomarkers, and to describe future developments that might improve the diagnostic accuracy benefitting also the treatment of late onset neuropsychiatric symptoms.

We conducted a literature search and combined this with a critical reflection on current practice inspired by the clinical experience of the authors.

We describe a step-by-step approach to the differential diagnosis of late-onset psychiatric disorders versus neurodegenerative disorders. We also describe a three-step diagnostic process that illustrates how biomarkers can be efficiently used in the diagnosis of neurocognitive disorders.

Recent research has improved the early diagnosis of neurocognitive disorders in patients presenting with late onset psychiatric symptoms. Concurrently, recent studies on the curative treatment of neurodegeneration offer promising preliminary findings.