Late-Life Depression addresses mood symptoms in older adults where vascular change, pain, sleep disruption, isolation, bereavement, and cognitive shifts often intertwine. This page turns complexity into clear steps. Begin with a medical and functional differential: thyroid, B12, anemia, sleep apnea, heart/renal disease, medications (anticholinergics, steroids, beta-blockers), pain syndromes, and neurocognitive disorders. Screen for suicidality with attention to hopelessness and perceived burdensomeness; map daily routines (sleep, meals, light, activity) and social participation. If you’re exploring an older adult psychiatry conference, you’ll find algorithms that pair problem-solving therapy, behavioral activation, and grief work with careful pharmacology (start low, go slow; monitor orthostasis, sodium, falls, QTc). We emphasize circadian repair (consistent wake time, morning light, evening wind-down) as a force multiplier for therapy and meds, and we incorporate pain, mobility, and sensory fixes (hearing/vision) that unlock engagement. Care coordination with primary care, cardiology, and neurology avoids ping-ponging and catches interactions early.

Treatment succeeds when the plan fits home life. We coach caregivers without undermining autonomy, use step-counters and simple logs to reinforce activation, and embed sleep and nutrition anchors patients can follow even on low-energy days. Tele/phone visits help when transport is hard; home-based services and community partnerships (senior centers, faith groups, meal programs) rebuild connection. For cognitive concerns, we outline screening, reversible contributors (hearing loss, meds), and pathways for MCI or dementia, including safety and driving. Deprescribing matters: simplify sedatives, anticholinergics, and duplicative agents that worsen mood and cognition. Equity features—interpreters, large-print materials, cost navigation—make care usable. Dashboards track function, falls, ER use, sleep, and participation, not just scores; transitions (hospitalizations, bereavements) trigger proactive follow-ups. For device-based options, see TMS/ECT for Depression; for polypharmacy alignment, pair with Precision Psychopharmacology.