[Perimenopausal and late life depression]

This article reviews recent evidence related to perimenopausal and late life depression. Transition to menopause and its changing hormonal milieu are associated with higher risk for mood disorders in some women. Several randomized placebo-controlled trials reveal the antidepressant efficacy of the hormone replacement therapy in depressed perimenopausal women but caution is still required for its use on perimenopausal depression due to the side effects. In the elderly populations, both major and minor depressions are frequent and their natural histories in the community are poor. From the public health perspective of Japan where aging is progressing most rapidly among the world, depression prevention may be imperative, but requires accurate assessment of not only depression but also vascular, Alzheimer dementia and suicide in the elderly.