Case: Zhang Da Ma is 65 years old, she used to be in good spirits, loves to exercise, loves to chat with family members, she has become inactive in the past 3 months, and her movements are slow, and it takes a long time to complete the usual chores, she also does not like to take the initiative to speak, every time she replies to her family’s questions with short and weak words, always says where her body is uncomfortable, her facial expressions change little, sometimes her eyes are dull, she is often indifferent to the things around her. Only when her late partner was mentioned did she get tears in her eyes and talk about many things she could not do, could not remember how to do, and her mind was blank. Her family took her to the hospital several times but could not diagnose any problem, and finally came to our hospital by chance to see if she had Alzheimer’s disease. Case Study: After the doctor’s diagnosis, Zhang’s depression was not dementia, but geriatric depression, which is easily masked by somatic symptoms and misdiagnosed as Parkinson’s disease due to the blockage of thinking and behavior, lack and slowing of random movements, and reduced somatic and physical activities. Many patients with geriatric depression complain of various physical complaints, such as headache, dizziness, decreased appetite, weight loss, chest tightness, fatigue and weakness, urinary urgency and frequency, etc. These symptoms can mislead doctors to conduct extensive internal examinations and can easily delay the condition. The following are 8 symptoms of geriatric depression to facilitate early identification and prevention of the disease by family members: ① Loss of interest in daily life and no sense of pleasure. ②Significant loss of energy and constant fatigue without any reason. ③Significantly slow movement, anxiety, and easy to lose temper. ④Low self-esteem, self-blame or guilt, serious feeling of having committed an unforgivable crime. ⑤ Delayed thinking or significant decrease in self-awareness of thinking ability. (6) Recurrent suicidal thoughts or behaviors. (7) Insomnia or excessive sleep. (8) Loss of appetite or weight loss. Doctors suggest that depression in old age is likely to be similar to Alzheimer’s disease due to the inhibition of thinking. For this type of patients, special attention should be paid to identify “false dementia and real depression” to avoid misdiagnosis, delaying treatment and affecting recovery. Depression in old age will become more and more serious if it is not treated. There are several types of antidepressants available to treat depression in the elderly. Antidepressant medications are effective only after two weeks of taking them, and after recovery, they need to be continued for six months to one year to prevent relapse. The dosage of antidepressants should not be changed at will without the knowledge of the doctor. Older people are not as stable as when they were younger, so treating depression in old age is more difficult than in younger people. The biggest headache for doctors is that many elderly patients often do not take their medication as prompted, so family members must supervise the patient to take the medication according to schedule and dosage, otherwise full recovery is difficult. All antidepressant medications have more or less side effects, and patients often fail to take them consistently, but most of the side effects actually go away with time. The newer drugs available today are very safe and can be taken for a long time. It is important to restore normal activities to older depressed patients. People with depression cannot be treated by taking medication alone; the most important thing is to get them back to normal activities. In this regard, encouragement and supervision from family members are very important. Usually, doctors will work with family members to arrange a daily schedule of activities for patients, such as playing tai chi in the morning, mahjong in the afternoon, chatting with friends over tea in the evening, etc. In short, they must be able to do something within their ability, mainly social activities. The patient’s worst mood is usually in the morning, so it is best to avoid going out during this time. Family and friends can take turns accompanying the patient on walks, such as shopping, playing sports or participating in other leisure activities. It is also important to understand that older people with depression are sometimes misunderstood as lazy and rambunctious, when in fact this is just a symptom of being sick. We emphasize that depression in the elderly is prone to recurrence, and thus the disappearance of symptoms does not mean the end of treatment. It is recommended that patients contact their doctors even after the clinical symptoms have completely disappeared. Make a medication regimen and treatment plan according to the specific situation, and insist on regular follow-up. In addition, participate in fitness and recreational activities, make more friends, try to make the life of the elderly rich and diverse, and learn to relieve worries, can also play a positive role in preventing relapse!