There is strong evidence supporting the concept of vascular depression, a distinct subtype of late-life depression linked to cerebrovascular disease and characterized by apathy and psychomotor change.
Is there an association between cardiovascular or cerebrovascular disease and late-onset depression?
This review supports the concept of 'vascular depression', a distinct subtype of late-life depression associated with cerebrovascular and cardiovascular disease.
BACKGROUND: Growing evidence suggests that there may be a subtype of depression arising in later life that is characterised by a distinct clinical presentation and an association with cerebrovascular disease. This has been termed 'vascular depression'. AIMS: To review the evidence for associations between cardiovascular disease and depression and between cerebrovascular disease and depression, and to examine implications for clinical practice and research. METHOD: The authors reviewed the medical literature covering the past 5 years. RESULTS: There is strong evidence for an association between cardiovascular disease and depression, but this is not confined to older people. The causal pathway may be bi-directional. There is also a convergence of evidence suggesting a causal link between cerebrovascular disease and depression, especially that occurring later in life. The major focus has been on neuroradiological findings thought to be due to vascular disease, although the pathology may be heterogeneous. CONCLUSIONS: Although there are gaps in the evidence there is strong support for the concept of vascular depression, characterised by reduced depression ideation, subcortical neurological dysfunction, apathy and psychomotor change. This has implications for both treatment and prevention.
Baldwin et al. (2002) conducted a review in Late-onset depressive disorder (vascular depression). Cardiovascular and cerebrovascular disease was evaluated. There is strong evidence supporting the concept of vascular depression, a distinct subtype of late-life depression linked to cerebrovascular disease and characterized by apathy and psychomotor change.