Pseudodementia or depression? Unresolved issue. Cognitive alterations in a population of geriatric patients.

Approximately 5-10 % of people over 65 share a neurocognitive disorder, with an exponential increase up to the age of 90-95 years. Neurocognitive disorders may also be inferred by psychic and behavioural symptoms that make it difficult for the clinician to differentiate between late onset psychiatric disorders, early onset psychiatric disorders or overlapping neurological and psychiatric disorders. Psychiatric disorders in old age show some typical patterns compared with those in young adulthood. In this regard, depression tends to be present with somatic symptoms, insomnia, lack of appetite, cognitive deficits, hypopexy and a tendency to deny the actual depressive symptoms such as despondency, melancholy and despair. Anxiety disorders are usually less severe than in the juvenile age and mostly expressed as concern the fear of losing one's autonomy and of being subjected to delinquent acts, while psychotic disorders consist mainly of well-structured and poor persecution delusions, with fewer negative symptoms and formal thought disorders. In the diagnosis of the neurological sequelae of psychiatric illnesses and of the relative psychopharmacological treatments, a careful personal history sometimes accompanied by neuroimaging investigations, is certainly an useful diagnostic tool hat can be diriment even in the evaluation of the psychiatric symptoms occurring in the course of neurological illnesses. Given the controversies in this field, the present study aimed to explore the presence of neurological alterations, as evaluated through psychometric tests, in subjects older than 65 years of age suffering from depression, in order to possibly detect the presence of a cognitive deterioration, pose an early diagnosis, and propose targeted therapeutic interventions aimed to improve both cognitive performance and mood symptoms