This chapter explores case history based on psychiatry in old age. The important thing to remember is that depression is not normal in old age and that treatment is extremely worthwhile. The main problems in the old age are painful arthritic joints, loneliness following bereavement, risk of hypothermia, insomnia, low mood with tearfulness and psychomotor retardation, and poor appetite and weight loss. Although elderly people generally enjoy relatively good health, the ageing brain is more susceptible to physical insults than the brain of a younger adult. Various pathological processes such as cerebrovascular disease and amyloid plaque formation may cause a global deterioration in brain function called dementia. The elderly with normal cognitive functions are susceptible to a range of mental disorders that affect younger adults too. Affected by bereavements, loneliness and failing health, some elderly people may begin to suffer with depressive illness.