CEREBROVASCULAR RISK-FACTORS AND LATER-LIFE MAJOR DEPRESSION - TESTING A SMALL VESSEL BRAIN DISEASE-MODEL

The topic of vascular depression has received increasing prominence as a putative etiology of depression in later life. The authors examined on aspect of this model by comparing the burden of systemic cerebrova scular risk factors (CVRFs) in 130 psychiatric inpatients with major d epression and 64 normal control (NC) subjects, all age greater than or equal to 50 years. Depressed subjects did not differ statistically fr om NCs on cumulative CVRF scores. Diabetes mellitus and atrial fibrill ation were both associated with depression, but only atrial fibrillati on retained an independent association after medical disability was st atistically controlled. Among the depressed subjects, CVRF scores were not significantly associated with overall symptom severity, psychiatr ic disability, age on onset of depression, melancholic subtype, or psy chotic depression. These data did not support the notion that a linear model of small-vessel disease might apply to the great majority of ol der inpatients with major depression.