The Validity of Vascular Depression as a Diagnostic Construct

  • Lauren Taylor
  • Adith Mohan
  • Perminder S. SachdevEmail author


The ‘vascular depression’ (VaD) construct initially proposed a relationship between late-life depression (LLD) and vascular disease and stimulated significant investigation into this nature of this relationship. The construct became synonymous with an aetiological proposition that vascular disease or risk factors are central in the pathogenesis of LLD. Validity of the VaD construct warrants consideration. This chapter reviews strategies that have been used to demonstrate an aetiological relationship between vascular disease and depression and considers the evidence for this association from various perspectives including (i) clinical features and the specificity of a VaD clinical phenotype, (ii) neuroimaging findings, (iii) proposed mechanisms for the aetiological role of vascular disease in depression, (iv) prognostic implications with a focus on treatment response and (v) shared pathomechanisms underlying both depression and vascular pathology. Our review suggests that the evidence in support of a causal relationship between depression and vascular disease, and thus the validity of the VaD construct, is not consistent. Whilst strong associations exist, the agnostic ascription of vascular disease as causative in LLD is potentially misleading, particularly in light of emerging evidence for diverse and interrelated pathomechanisms.


White Matter Hyperintensities Small Vessel Disease Uncinate Fasciculus Diffusion Tensor Imaging Study Cerebral Small Vessel Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Lauren Taylor
    • 1
    • 2
  • Adith Mohan
    • 3
    • 1
    • 2
  • Perminder S. Sachdev
    • 3
    • 1
    • 2
    Email author
  1. 1.School of PsychiatryUniversity of New South Wales MedicineRandwickAustralia
  2. 2.Neuropsychiatric Institute (NPI), Euroa Centre Prince of Wales HospitalSydneyAustralia
  3. 3.Centre for Healthy Brain Ageing (CHeBA)RandwickAustralia

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