Almar Kok, assistant professor at Amsterdam UMC, has been awarded a €315.000 Starter grant from Amsterdam UMC for his project ‘Functional recovery after late-life depression: Searching for clues to turn disablement into resilience in population-based and clinical settings’
Sooner or later, most older adults will face functional decline in one or more areas, including mobility, self-care, and social interaction. Although the popular “disability paradox” suggests that older adults typically retain high levels of wellbeing despite functional decline, recent scientific evidence including from our group shows that this is not true for large parts of the older population. In contrast, functional decline is one of the causes of depression. And vice versa, depression may accelerate functional decline5. In fact, estimates of full functional recovery after late-life depression go as low as 20%. At the same time, for patients themselves, regaining adequate levels of daily functioning is often their main priority and more important than symptomatic recovery per se. Currently, the fact that depression often leaves long-lasting scars on daily functioning is a problem that appears hard to solve for older adults and their caregivers.
Therefore, Almar Kok‘s Starter Grant project aims to generate scientifically and clinically relevant knowledge that can help older adults respond in a more resilient way to functional and mental health challenges.
Using data from the Longitudinal Aging Study Amsterdam (LASA), the Netherlands Study of Depression in Older persons (NESDO) and the USA-based Precipitating Events Study (PEP), the project will focus on within-person changes in depressive symptoms and various domains of daily functioning to:
- identify subgroups of depressed older adults that differ in change across different functional domains, and investigate how these subgroups differ in clinical, psychosocial and lifestyle factors
- the extent to which good functioning in specific domains despite depression (e.g. cognitive function) can help to recover function in other domains (e.g. social interaction)
- examine whether psychological characteristics (e.g. perceived control over life and self-efficacy), instrumental and emotional social support, and lifestyle factors (e.g. physical activity and not smoking) can help to reduce the impact of depressive symptoms on functional decline
The data includes different intensity of measurement waves and periods: from LASA we use up to 35 daily self-reports of functioning from a calendar substudy, from NESDO we use thirteen 6-monthly measures of the WHO-DAS and psychiatric symptoms, and from the PEP-study we use up to 240 monthly measurements of functioning, and up to 10 measurements of depressive symptoms collected across 18 years in the same individuals.
The project will hire a PhD student who will be employed at the department of Epidemiology & Data Science of Amsterdam UMC.
The Amsterdam UMC Starter Grant is a new instrument set out in the national ‘Policy letter for higher education and science’ and corresponding administrative agreement. The aim is to improve continuity of research lines and thereby also reducing the application pressure to the Talent Scheme (NWO). The grant’s budget is to be spent over a period of 6 years!