Objective. To study apathetic depression first diagnosed at late age and identify its relation to cognitive and social dysfunction as well as to morphological and functional changes in the brain. Material and methods. Thirty-two patients at the age above 60 years with newly diagnosed depressive episode and 15 healthy age-matched volunteers were included in the study. All patients were divided into two groups by the score on the Apathy scale (AS): >14 — depression with apathy (n=21), <14 — depression without apathy (n=11). Patients were examined using psychometric methods (HAMD, GDS, AS, SHAPS, SF-36, MoCA-test), neuroimaging (MRI scanner with a magnetic field strength of 1.5 Tesla — EXCEL ART Vantage Atlas-X, Toshiba, Japan) and statistical data analysis. Results and conclusion. Apathy component in clinical depression reflects a tendency towards the increase in depression severity and cognitive deterioration that results in the substantial lowering of quality of life and correlates with cerebrovascular changes, decrease in gray and white matter volume and mean cortical thickness of large hemispheres.