Vascular risk factors for depression and apathy

Abstract

The first part of this thesis explores and describes associations between cerebrovascular disease and late-life depression. The results point out that cerebrovascular disease is a risk-factor for depression, and vice versa. Also, when more risk-factors for depression are present, such as the personality trait of neuroticism and vascular disease as well, the contribution of each risk-factor may become hard to distinguish, because of ceilingeffects. The second part of this thesis is dedicated to the vascular apathy hypothesis, a theory that states that cerebral small vessel disease can cause apathy. The evidence for a causal relation between cerebral small vessel disease and apathy is convincing. However, since we cannot differentiate between etiologically different apathy syndromes as yet, and since using the term 'vascular apathy' would suggest a distinct clinical syndrome, at present we advise against the use of this term