La dépression vasculaire : évolution des malades et du concept

Late life depression differs from early life depression by no history of mood disorders, and by presence of vascular risk factors, cognitive decline and hyperintensities on MRI. A sub-type of depression is the vascular depression. We present a 6.2 years follow-up of five vascular depressed patients. The severity of depression was high with suicide attempt in three cases. Apathy and pharmacological resistance were reported. Non pharmacological management was more efficacious. Vascular dementia was the final diagnosis for three patients whose two had neuropathological diagnosis. It would be necessary to ameliorate the delimitation of the definition of vascular depression to distinguish them from mild cognitive impairment and from vascular dementia. The specificity of the treatment and the characteristics of the follow-up are arguments to realize a MRI when a patient has a late life depression.