Psychological problems in the elderly.

Intellectual changes in healthy old people are slight and not of practical significance. When intellectual changes are suspected, patients should be examined very carefully in a relaxed situation so they do not feel they are being `tested'. The physician should be aware of the differential diagnosis of psychiatric disorders in the elderly and not simply label patients as `senile'. The elderly are subject to acute brain syndromes caused by physical illness or drug toxicity. When acute brain syndromes are excluded, the illness is as likely to be a functional one as a chronic organic brain syndrome. The most common functional illness in old age is depression. More accurate diagnosis of elderly, mentally ill patients will lead to more effective treatment and management.