title: Cerebrovascular involvement and clinical presentation of late-life depression, findings from the NESDO study.
abstract: The vascular depression hypothesis, which supposes a causal relation of vascular risk factors and vascular disease with depression, has not been definitively accepted. Inconsistent findings may be due to different clinical presentations of depression in older people with and without a clear history of stroke. We therefore aimed to investigate the association between vascular pathology, with and without previous stroke, and different symptom domains of depression.
  
  
  
  For our study, we used baseline data of 378 people aged 60 years and older with a current depression who participated in the Netherlands Study of Depression in Older persons (NESDO), an observational (multicentre) cohort study. Using all information on vascular pathology and risk factors, three classes were operationalized: a first class of depressed older people with previous stroke; a second class of depressed older people with cardiovascular and peripheral arterial diseases, but without stroke; and a third class of depressed older people with no vascular disease.
  
  
  
  The depressed older people with previous stroke were characterized by more 'motivational' symptoms, which distinguished them from other depressed older people. Inclusion in this stroke group was also associated with having increased prevalence of hypertension, smoking more cigarettes, and lower alcohol consumption.
  
  
  
  Our findings suggest that the 'vascular depression' connotation should be reserved for depressed (older) patients with vascular pathology and evident cerebral involvement.
authors.affiliation: a Department of Old-age Psychiatry, GGNet , Apeldoorn , The Netherlands.|b Department of Psychiatry , Radboud University Nijmegen Medical Centre , Radboud University Nijmegen , Nijmegen , The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Naarding
authors.affiliation: a Department of Old-age Psychiatry, GGNet , Apeldoorn , The Netherlands.
authors.forename: E O
authors.initials: EO
authors.lastname: Noorthoorn
authors.affiliation: a Department of Old-age Psychiatry, GGNet , Apeldoorn , The Netherlands.
authors.forename: T L A
authors.initials: TL
authors.lastname: Burm
authors.affiliation: c Department of Psychiatry , Leiden University Medical Centre, Leiden University , Leiden , The Netherlands.
authors.forename: R C
authors.initials: RC
authors.lastname: van der Mast
authors.affiliation: d Department of Psychiatry , VU University Medical Centre/GGZ InGeest , Amsterdam , The Netherlands.
authors.forename: A T F
authors.initials: AT
authors.lastname: Beekman
authors.affiliation: e Department of Psychiatry, EMGO Institute of Health and Care Research , VU University Medical Centre/GGZ InGeest , Amsterdam , The Netherlands.
authors.forename: H C
authors.initials: HC
authors.lastname: Comijs
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases; D002560:Cerebrovascular Circulation; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D015438:Health Behavior; D006801:Humans; D000067562:Late Onset Disorders; D008297:Male; D009426:Netherlands; D020521:Stroke
keywords: depression; older people; post-stroke depression; symptom profiles; vascular