In their article proposing a "鈥榁ascular Depression' Hypothesis," Alexopoulos et al1 distinguish a very significant group of patients with features of depression, related to underlying vascular disease and neurological lesions. Though they acknowledge that their concept is broad and encompasses many pathogenetic processes, I would contend that many of the patients they consider as having vascular depression may be more appropriately classified as having an apathy syndrome instead.2