18 Vascular risk factors for depression and apathy This model has given rise to new research questions. Is CSVD indeed a relevant causal risk-factor for apathy? Can CSVD be a sole cause of apathy and is CSVD-related apathy a recognizable and distinguishable clinical syndrome as using the term ‘vascular apathy’ suggests? These are all questions that lie at the heart of the research brought together in this doctoral thesis. Scope and objectives of the thesis Figure 3. Schematic representation of thesis outline The overall aim of the work presented here is to examine the associations between cerebrovascular disease with either depression or apathy in more depth. Figure 3 provides a schematic overview of the associations that are considered in the research documented in this thesis that consists of two parts. In the first part, we will be looking at the strength and nature of the relationships between cerebrovascular disease and depression and whether and how vascular risk and neuroticism interact in this relationship. In the studies presented in the second part, we investigate the strength and nature of the relationships between cerebrovascular disease, particularly CSVD, and apathy, where we evaluate the concept of vascular apathy as well as associations between CSVD and apathy in (remitted) depression. Part I In the study prescribed in Chapter 2 we asked ourselves: is depression associated with incident stroke and is this risk conditional upon the presence of cardiac disease? We sought to answer this question within the framework of the Longitudinal Aging Study Cardiovascular risk factors Cerebro- vascular accidents other vascular disease & Cerebral small vessel disease Chapter Depression Apathy Apathy in (remitted) depression Cardiac disease Neuroticism 2 4 3 5 7 6
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