Peculiarities of Vascular Depressive Disorder at the Stages of Development of Subcortical Vascular Dementia in Old Age and Senility

O.A. Levada, I.Ya. Pinchuk


The prevalence and clinical structure of vascular depressive disorders (VDD) have been studied in elderly patients at the stages of development of subcortical vascular dementia (SVD), its pathogenetic correlation with clinical manifestations of cognitive deficit, as well as impact of VDD on the daily functioning. There were examined 49 old and senile patients without cognitive impairments (WCI), 63 patients with subcortical vascular mild cognitive impairment (SVMCI) and 60 patients with SVD. VDD was a key psychopathological disorder at the stages of SVD development. Its prevalence increases with the deterioration of the cognitive status, and was 22.4 % in those WCI, 53.38 % — in patients with SVMCI and 70 % in patients with SVD. The special features of clinical structure of VDD in SVMCI and SVD were: moderate depression, greater cognitive component (attention disorders) and asthenic spectrum disorders, absence of suicidal symptoms, high comorbidity with apathy and impaired night and motor behavior. The combination of depressed apathetic and executive disorders suggests the formation of a specific syndromes of depressive-apathetic-executive dysfunction, progressing with the development stages of SVD. This group of symptoms affects the daily activities of patients. Severity of VDD in SVMCI and SVD depends primarily on the degree of leukoaraiosis and atrophic process of the frontal-subcortical parts of the brain according to MRI/CT data.


vascular depressive disorder; subcortical vascular dementia; subcortical mild cognitive impairments


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