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Although estimates as to the incidence of personality disorder in the elderly remain controversial, it is well known that such a disorder is prevalently ego-syntonic and capable of interfering with the onset and treatment of other somatic and psychic pathologies, especially in later life, when individuals tend to be particularly vulnerable. Misdiagnosis or failure to treat these disorders may greatly diminish the quality of life of older adults and their families. The aim of this work is to define the chief psychopharmacological and psychotherapeutic guidelines for treating personality disorders in the elderly. Pharmacologically, patients require treatment with molecules designed to rebalance neurotransmitter system alterations, which underlie the symptomatological picture. As regards psychotherapeutic treatment, although there are only a few validation studies, we believe that dialectical behavior therapy and interpersonal psychotherapy may constitute valid therapeutic approaches that meet both the needs and the individual characteristics of patients affected by personality disorder and those of elderly patients.