Psychiatry does not have the concept of geriatric paranoia. The emergence of delusional symptoms in the elderly may be due to environmental factors, physiological factors, disease factors, etc., and the causes should be clarified and then adjusted in a timely manner. 1. Environmental factors: prolonged exposure to adverse life events will affect the mood of the elderly, often tense and uneasy, coupled with the presence of physical discomfort, may produce hypochondriacal delusions. Changes in the family environment or work environment may induce delusions of victimization in the elderly. 2. Physiological factors: excessive alcohol intake for a long time, withdrawn personality and other reasons, may lead to delusions in the elderly, especially after drinking too much alcohol resulting in chronic alcoholism, which can cause mental retardation and symptoms of jealousy and delusion, and withdrawn personality often leads to suspicion and delusions may also occur. 3. Disease factors: many physical diseases and metabolic toxicity can appear delusion, delirium and dementia patients can also appear delusion. Mental illnesses such as schizophrenia, mood disorders, etc. also often appear delusions. The elderly long-term presence of delusion symptoms, serious impact on daily life, should go to the regular hospital in time for diagnosis and treatment, comply with the doctor’s prescription medication, and actively cooperate with the doctor’s treatment to prevent the condition from worsening.