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The neurobiology of late‐life depression: Impact of silent cerebrovascular disease
Author(s) -
Lawlor Brian A.,
Anderson Mary C.
Publication year - 1995
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.470101005
Subject(s) - depression (economics) , dementia , medicine , cardiology , disease , cerebral infarction , hyperintensity , stroke (engine) , persistence (discontinuity) , psychology , ischemia , magnetic resonance imaging , mechanical engineering , radiology , engineering , economics , macroeconomics , geotechnical engineering
Depression in the elderly is associated with increased mortality, persistence of symptoms and progression to dementia in a substantial number of cases. Minor cerebrovascular lesions such as deep white matter changes, lacunar infarcts and silent cerebral infarction can be demonstrated in some late‐onset depressives and may be relevant to the development of depression, or associated with the persistence of symptoms and the emergence of treatment resistance. Increased morbidity and mortality may occur through subsequent cerebrovascular events, and progression to dementia might result from multiple cerebral infarcts. Treatment strategies that address underlying vascular risk factors could decrease the likelihood of fatal strokes or stepwise progression to (multi‐infarct) dementia, thereby improving the long‐term prognosis for a subgroup of late‐onset depressives.