There has been longstanding interest in the relationship of depression to vascular disease and this has received renewed interest since the publication of the “vascular depression” hypothesis by Alexopoulos and colleagues (Alexopoulos et al., 1997). They proposed that cerebrovascular disease (CVD) predisposed, precipitated or perpetuated late-life depression by its impact on frontal-subcortical circuits (FSC). However, whilst several lines of research strongly support this proposal, we still have no useful working criteria for vascular depression, assuming such a nosological entity exists.