Current Diagnostic Challenges in Late-Life Depression and Neurocognitive Disorders

The comorbidity between late-life depression and neurocognitive disorders (NCDs) in the elderly is a subject of increasing interest within the scientific and medical community. We conducted a narrative review of clinical studies focused on depression and NCDs, primarily covering articles published over the past 25 years. Compared with younger adults, depression in the elderly is often characterized by difficulties in expressing sadness, more pronounced somatic, anxiety, and psychotic symptoms, as well as a heightened risk of suicide and cognitive impairment. Depressive symptoms in the elderly may mimic NCDs, act as prodromal signs of future NCDs, or represent a clinical dimension of dementia. NCDs and late-life depression share specific clinical similarities, particularly at illness onset, emphasizing the importance of early differential diagnosis to guide the development of precise, integrated, and tailored interventions.