What is vascular depression?

Vascular depression is a late-life form of depression that usually only affects people ages 60 or older. Blood vessels may harden over time, reducing or blocking normal blood flow to the brain. This reduced or blocked blood flow can lead to vascular depression. People with vascular depression may also be at risk for heart disease or stroke.⁶

Although there are no highly effective treatments for vascular depression, scientists are making progress in understanding and treating this condition. Researchers are studying the specific brain changes linked to blood vessel problems. In older people with depression, higher blood pressure is linked with abnormal changes in white matter, the tracts of nerve fibers that connect and allow communication between different parts of the brain.⁷ Some of these abnormal changes were linked with specific problems in the frontal lobe, an area of the brain involved in thought processes such as planning, problem solving, and judgment. These abnormal changes may also affect a person’s response to treatment with antidepressant medications.

One recent study showed that vascular depression can be effectively treated with repetitive transcranial magnetic stimulation (rTMS).⁸ The U.S. Food and Drug Administration has approved rTMS to treat major depression. Study participants had not responded to standard depression treatments. After 2 weeks, those who received rTMS were more likely to have achieved remission (no longer had any symptoms of depression) compared with those who did not receive rTMS. Further studies aim to find the lowest possible dose of rTMS that can be used to most effectively treat people with vascular depression.

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