To the Editor.
—In the very aged, psychiatric diagnosis often poses substantial challenges because symptoms such as confusion, agitation, disorientation, somatization, and dysphoric mood can result from various disorders either functional (eg, depression) or organic (eg, dementia).1,2 Response to psychopharmacotherapy can give clues to diagnosis, but, as illustrated herein, it may also be deceiving.
Report of a Case.
—On admission to Maimonides Hospital, a chronic care facility, a 95-year-old woman was found to be alert. Myopia and mild hearing loss were her only physical problems, and she took no medication. When she was 99 years old, her fourth son died. With support from her only remaining child, a fifth son, she grieved appropriately and gradually resumed her daily activities. At 100 years of age, she derived satisfaction from congratulatory notes sent by the nation's leaders.In her 102nd year of life, her last son died of carcinoma. Her intense
Kushnir SL. Diagnosis and Treatment of Depression in a 102-Year-Old Woman. JAMA. 1988;259(17):2547. doi:10.1001/jama.1988.03720170023025