La depressione nell'anziano fragile istituzionalizzato Depression is one of the leading disorders affecting mental health among nursing home elderly residents. Its higher prevalence among institutionalized subjects is due to its complex and interactive relationship with comorbidity, disability and cognitive impairement, while the role of transition to the nursing home as a risk factor is uncertain. Depression decreases the quality of life and is related to worse functional, health and cognitive outcomes. It is often under-recognized due to its somatic presentation and to the presence of dementia. Although several antidepressant drugs have been demonstrated to be effective and well tolerated in the frail elderly patients, the management of depression should include non pharmacological interventions and a greater attention by nursing home staff to the overall quality of care.