Depressive syndromes and dementia are the most frequent psychiatric di
sorders in the elderly. Reactive depressive syndromes can be associate
d with the restriction of social competence due to increasing multi-mo
rbidity, loneliness, social isolation, the consequences of retirement,
interpersonal conflicts, and the loss of partners or close relatives.
Endogenous depressive syndromes in the elderly are frequently combine
d with diffuse and changing somatic complaints, psychomotor restlessne
ss and agitation. Furthermore, depressive syndromes can be caused by s
omatic illness, degenerative disorders, other organic diseases or cert
ain drugs. The presence of simultaneously occurring somatic illness, p
ositive family history, certain personality traits, and severity of di
sease could exert an adverse influence on clinical outcome. Medical tr
eatment should consider the special pharmacological features of old ag
e, and should be combined with psychotherapy as well as a close involv
ement of the relatives.