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Health Forum Online    The Psychologist's Source for C.E. Credits Online

A Culturally Sensitive Approach to Differential Diagnosis of Mental Health Problems in the Elderly: Depression, Dementia, & Delirium

by Julia Weinberg, JD, PhD 4 CE Credits

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) 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.


This online course is approved for APA CE credit, NBCC CE clock hours, ASWB CE clock hours (Diagnosis & Tx of Mental Dx's), and NYSED CE credit.


Course Sections/Outline:

  • Overview
  • Introduction to Symptomatic Domains
  • Changes that Occur in Normal Aging
  • Symptomatic Profiles of Depression, Dementia, and Delirium
  • Cognitive Dysfunction Associated with Treatable Medical Conditions
  • Selecting Brief Screening Instruments
  • Flaws in Diagnostic Decision-making
  • Cultural and Ethnic Factors That Influence Assessment
  • Reducing Flaws in Diagnostic Reasoning
  • Summary
  • References

Learning Objectives:

After completing this course, health professionals will be able to:
  • Review six symptomatic domains most salient in making a differential diagnosis of dementia, depression, and delirium.
  • Use these six domains to comparatively evaluate symptomatic profiles of depression, dementia, and delirium  in the context of normal aging.
  • Recognize the cognitive dysfunction associated with at least 3 treatable medical conditions among the elderly that might influence diagnosis.
  • Identify at least 14 brief cognitive screening measures to assist in the differential diagnosis of depression, dementia, and delirium. 
  • Summarize at least 5 important factors that can contribute to misdiagnoses and under-diagnoses in this population, along with guidelines to enhance diagnostic accuracy.