Vascular depression in Black Americans: A systematic review of the construct and its cognitive, functional, and psychosocial correlates

Late-life depressive symptoms and white matter structural integrity within older Black adults

“…Indeed, vascular depression is clinically defined by the presence of cognitive impairment, psychomotor retardation, depressive symptoms, and MRI-evidence of vascular disease ( Krishnan et al, 1997 ; Alexopoulos, 2019 ), and Black adults may thus be predisposed to this diagnosis ( Reinlieb et al, 2014 ), especially in late-life when age and common vascular risk factors such as hypertension and diabetes increase risk of WMHs ( Gottesman et al, 2010 ; Nyquist et al, 2014 ; Whitlow et al, 2015 ; Hughes et al, 2018 ; Waldron-Perrine et al, 2018 ). However, little remains known about the construct of vascular depression and its correlates in older Black adults due to a stark paucity of research ( Bogoian and Dotson, 2022 ). To validate the construct of vascular depression within Black adults, and to understand its correlates to the extent that race-relevant interventions could potentially be developed, will require more studies that include neuroimaging with behavioral measures and employ large epidemiologic all-Black samples.…”

Association of white matter hyperintensities and clinical vascular burden with depressive symptoms in Black older adults

“…29 To address this important gap, the current study used data from the Health, Aging, and Body Composition (Health ABC) study and Healthy Brain Project sub-study 30 to examine the relationships between vascular health, WMH, and subthreshold depressive symptoms in a Black sample followed for 4 years. Based on the VaDep literature in primarily NHW samples and the findings of a recent review, 14 we hypothesized that participants with greater clinical vascular burden and higher WMH severity would have more depressive symptoms at baseline and over 4 years of follow-up. We also evaluated whether significant relationships found in the primary analysis in Black participants differed between Black and NHW adults.…”

“…However, there is limited research on the VaDep construct among Black older adults. A recent systematic review by Bogoian and Dotson 14 found just 30 studies that examined the impact of vascular conditions on depression in late middle-aged to older (mean age ≥ 50) samples comprising at least 75% Black adults, and only 11 of those studies incorporated a discussion of the VaDep framework in their study design or interpretation of findings. [15][16][17][18][19][20][21][22][23][24][25] Despite study heterogeneity, within these studies there was converging evidence in primarily Black samples for the validity of the VaDep hypothesis, suggesting that late-life depression can be caused by, or exacerbated by, cerebrovascular disease or other vascular factors.…”

Can we promote cognitive resilience in late-life depression?

“…The highest-performing group also had fewer vascular risk factors than the group with the worst executive, attention/working memory, and processing speed performance, supporting vascular health as an important contributor to cognitive resilience. The large body of literature on vascular depression shows that the combination of depressive illness and vascular burden results in disproportionate cognitive impairment, particularly in executive functioning, as well as greater functional decline compared to nonvascular depression (Alexopoulos, 2019). Thus, vascular risk is another modifiable factor that could be included in treatments to promote cognitive resilience in LLD.…”

“…As summarized in a recent systematic review (Bogoian and Dotson, 2022), the very limited literature in Black older adults with comorbid depression and vascular disease suggests possible racial disparities in vascular depression prevalence (e.g. Reinlieb et al, 2014) and associated functional disability (e.g.…”