Diagnosis, course, and consequences

Both major depression and dysthymia are common disorders in late life. However, making an accurate diagnosis may be more challenging than diagnosing depression in younger persons both because of comorbid general medical conditions and because of the illnesses, cognitive disturbances, and myriad adverse life experiences the elderly face. Often, dysphoria is sloughed off as an understandable response to adversity, and the diagnosis of depression is missed. Thus, elderly persons with major depression and dysthymia may be exposed to unnecessary prolonged suffering and to the disruptions of family life, impairment of functioning, worsening of comorbid general medical illness, and premature death that are the hallmarks of untreated depression.