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Assessing tearfulness in the elderly

Tearfulness after a stroke*

  • Usually inexplicable by patient
  • Not associated with sadness
  • "Emotional incontinence"
  • Typically associated with "pseudobulbar palsy"
  • May revert to uncontrollable laughter
Tearfulness in delirium
  • Emotionally labile
  • Tears not sustained
  • Can be distracted from sadness
Tearfulness in depression
  • Occurs in setting of sustained lowered mood
  • Associated with reported sadness and misery
  • Other features of depression are present
Tearfulness in adjustment reaction
  • Associated with recent upsetting experience
  • "Understandable sadness" or anger of recent onset

* Remember: patients who have had stroke are also at risk for depression, delirium and adjustment reactions.

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