A study of 161 consecutively admitted elderly major depressives with a mean age of 71.7 +/- 6.6 revealed that 72 patients (45%) were delusional. Delusional depressives were significantly older than nondelusionals at onset (62.4 +/- 15.5 + 17.2), but were of comparable age at admission. Utilizing the median age of onset (60) as a cut-off, a sex difference was identified: an association between lateness of onset and delusions was only apparent in women. The presence of a concurrent medical or neurologic disorder or hearing deficit did not increase the association. The importance of investigating samples of elderly patients to identify age effects that only occur in late-life is emphasized.