Depression is a common cause of distress in old people when it tends to be a chronic condition with a high rate of recurrence.1 Diagnosis may be difficult - symptoms of depression may be less prominent, or attributed to normal ageing or co-existent physical disease. It may be difficult to decide whether sadness is a realistic response to unfortunate circumstances such as social isolation, or a pathological condition. Correctable, if uncommon, causes of depression such as hypothyroidism should be excluded.
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