It is well established that depression is common in late life and associated with a range of consequences for the individual and those close to them. These consequences include higher use of health services and declines in functional ability (Luppa et al., 2007), not to mention negative subjective experiences, such as reduced engagement with, and enjoyment of day-to-day activities. Depression in late life is a heterogeneous condition made more complex by the links between depression, cognitive decline and dementia. The “Vascular Depression Hypothesis” suggests that a subset of late life depressive disorders are caused by cerebrovascular disease (Taylor, 2014), but questions about the relationships between depression and cognitive decline remain unanswered. The paper chosen as the paper of the month in this issue of International Psychogeriatrics addresses one of these questions, namely, whether we can identify clinical signs and symptoms that predict cognitive decline in individuals diagnosed with depression. This question is of great clinical relevance, as not all patients and clinicians will have access to the neuroimaging or detailed neuropsychological assessment that could cast light on risk for cognitive deterioration.