title: Delirium and depression: inter-relationship and clinical overlap in elderly people.
abstract: Delirium and depression are complex neuropsychiatric syndromes common in the elderly and are associated with poor health-care outcomes. Accurate diagnosis is essential to the provision of optimum health care for individuals with these conditions but is complicated by substantial clinical overlap in symptoms and comorbidities. A careful assessment of the patient's symptoms, including their context and time course, is needed for accurate diagnosis. Previous depression is common in patients with delirium and depressive illness is a recognised sequelae of delirium. The two syndromes seem to be caused by similar pathophysiological mechanisms, involving disturbances in stress and inflammatory responses, monoaminergic and melatonergic signalling, which point to new avenues for therapeutic intervention. Improved methods to assess delirium and depression in populations at high risk by virtue of their age, diminished cognitive reserve and physical frailty is a key target to achieve improved health-care outcomes in elderly individuals.
authors.affiliation: Department of Adult Psychiatry, University Hospital Limerick and University of Limerick Medical School, and Cognitive Impairment Research Group, 4i institute, Limerick, Ireland.
authors.forename: Roisin
authors.initials: R
authors.lastname: O'Sullivan
authors.affiliation: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife and Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Inouye
authors.affiliation: Department of Adult Psychiatry, University Hospital Limerick and University of Limerick Medical School, and Cognitive Impairment Research Group, 4i institute, Limerick, Ireland. Electronic address: david.meagher@ul.ie.
authors.forename: David
authors.initials: D
authors.lastname: Meagher