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Depression is one of the commonest psychiatric disorders among the elderly patients attending the outpatient department of the tertiary care hospital. The consequence of unrecognized and untreated depression in the elderly population may include excessive use of health care services, decreased treatment compliance and increased morbidity and mortality related to underlying medical illness and from suicide. The aim of the study is to estimate the prevalence of depression according to Geriatric Depression Scale (GDS) and to find out the association of GDS with ICD-10 Diagnostic Criteria for Research (ICD-10 DCR) among older adults in the Nepalese population. A study group of 100 elderly patients aged 65 years and above were randomly selected from the psychiatry, medicine and general practice outpatient departments of Tribhuvan University Teaching Hospital, Nepal. MMSE scale is administered and the patients scoring more then 24 were administered the GDS and clinical diagnosis was made according to ICD-10 DCR. 53.2% of the samples were found to experience depressive illness according to GDS which includes 34.2% of mild and 19% of severe depression. 83.3% of the patients diagnose with probable depression with GDS were also diagnose clinically with ICD-10 DCR (p<0.001). This study concludes that significant number of elderly patients attending OPD of tertiary care hospital suffers from depression and GDS is a reliable tool to screen depression in the Nepalese patients.