Diagnoses of mental health conditions in the elderly can be extremely challenging. In fact, a large proportion of elderly patients present with cognitive, emotional, and behavioral signs and symptoms that do not even fit cleanly into well-defined (DSM-IVTR) diagnostic categories. This course discusses evidence-based approaches to assessing symptoms of cognitive impairment, mood, and psychosis that must be considered in differentiating diagnoses of depression, dementia, and delirium in the elderly. The discussion covers factors that contribute to under-diagnosis and misdiagnosis, including cultural differences and the clinical setting. Specifically, evidence-based instruments for brief cognitive screening are described. Further, an overview of common medical conditions that may underlie the presenting psychological symptoms are provided to facilitate appropriate referrals and/or follow-up for additional assessment and treatment.

• Discuss empirical evidence regarding normal aging and comparatively evaluate symptoms of depression and cognitive impairment.
• Identify common medical conditions associated with these psychological symptoms to facilitate decisions pertaining to referrals or provisional medical and/or neuropsychological assessments.
• Select methods for brief cognitive screening to assist in the differential diagnosis of depression, dementia, and delirium.
• Identify important factors that can contribute to misdiagnoses and under-diagnoses in this population.