Cerebrovascular Disease, Aging, and Depression: Clinical Features, Pathophysiology, and Treatment

doi:10.1017/9781108552684.037

32 - Cerebrovascular Disease, Aging, and Depression: Clinical Features, Pathophysiology, and Treatment

from Part V - Later Life and Interventions

Published online by Cambridge University Press: 28 May 2020

Faith Gunning and

Abhishek Jaywant

Edited by

Ayanna K. Thomas and

Angela Gutchess

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Ayanna K. Thomas: Affiliation:
Tufts University, Massachusetts
Angela Gutchess: Affiliation:
Brandeis University, Massachusetts

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Summary

This chapter reviews both seminal and recent work on late-life depression (LLD), with an emphasis on the vascular depression subtype of LLD. We first describe the clinical features and symptom presentation of LLD, highlighting executive functioning deficits that are a core feature of the “depression with executive dysfunction” syndrome. We discuss both vascular and nonvascular etiological pathways to depression with executive dysfunction in older adults. We highlight recent findings on the association between vascular disease, altered structural and functional brain network connectivity, and clinical symptoms in LLD. Vascular depression is associated with nonresponse to standard pharmacologic treatment. As such, behavioral interventions offer promising avenues for treatment. Novel behavioral approaches encompass psychotherapy, noninvasive brain stimulation, and cognitive remediation that are targeted toward the specific neural circuitry dysfunctions that underlie both affective and cognitive symptoms in older adults. We review these approaches, as well as psychosocial, exercise, and lifestyle interventions.

Type: Chapter
Information: The Cambridge Handbook of Cognitive Aging
A Life Course Perspective
, pp. 593 - 611

DOI: https://doi.org/10.1017/9781108552684.037 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2020

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32 - Cerebrovascular Disease, Aging, and Depression: Clinical Features, Pathophysiology, and Treatment

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