Psychiatrists who work with older adults often encounter diagnostic and therapeutic problems that are more complex than those faced in treating younger persons. The psychiatric symptoms of most elders do not fit easily into the diagnostic categories ofDSM-Ill-R or DSM-IV, because elderly people experience multiple symptoms that affect both physical and mental functioning. Psychiatric disorders coupled with physical problems lead to syndromes of functional impairment that constitute the patient’s chief complaint. Once formulated by the clinician, these syndromes determine strategies to manage the symptom complex underlying the syndrome and to reverse the underlying disorder or disorders. Among the most common functional disabilities or syndromes encountered by psychiatrists in treating older adults are memory loss, anxiety, depression, sleep disturbances, and psychosis. In an era of emphasis on specific disorders in psychiatry, psychiatrists who work with older adults may benefit from an approach to treat-