Helen Lavretsky, MD, MS

The aging of the world’s populations represents one of the most remarkable success stories in medicine and of humankind, but it is also a source of various challenges.

Depression complicates medical illnesses and their management, and it increases health care use, disability, and mortality. This article focuses on the recent research data on diagnosis, etiopathogenesis, treatment, and prevention in unipolar, bipolar, psychotic, and subsyndromal depression.

More women than men are diagnosed with depression. Yet, men who are troubled by depression are also more likely to die, even when suicide is removed from the factors of consideration. Vascular depression, hyperintensities within the brain, physiological changes and late-life onset provide both insight and more questions into the nature of depression and this enigmatic paradox.