Vascular and degenerative diseases of the central nervous system are one of the most common health problems in the elderly. Cognitive dysfunction, mood disorders and behavioural changes as well as psychotic symptoms constitute an invariable part of the clinical manifestation of these diseases. Psychopathological syndromes influence management decisions, commonly being a reason for patients' institutionalization; they are also a cause of suffering of patients and their caregivers and relatives. Relevant diagnosis of psychological symptoms is crucial in establishing adequate therapy, which improves quality of life of patients and their caregivers. The paper provides an overview of the psychopathological presentation of the most common central nervous system diseases in the elderly.