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Predictors of decline in IADL functioning among older survivors following the Great East Japan earthquake: A prospective study.

ABSTRACT: We described associations between the type of disaster experience and change in instrumental activities of daily living among older adult survivors before-after a terrible disaster.The study took advantage of a "natural experiment" afforded by the Japan Gerontological Evaluation Study (JAGES), a nationwide cohort study established in 2010, seven months prior to the earthquake and tsunami. A follow-up survey was conducted in 2013. This study was conducted in Iwanuma, which was directly struck by tsunami. Our sample comprised community-dwelling aged survivors in Iwanuma who responded to questions about personal circumstances and functional status both before and after the disaster (N = 3547). Personal experiences of earthquake and tsunami damage was used as an exposure variable. The outcome was changes in self-reported 13-item instrumental activities of daily living (IADL), which was assessed both before and after the disaster.Among the participants, 931 reported losing family member(s) to the disaster, while a further 549 reported losing friend(s). More than half of the participants reported any damage to their houses while approximately 1 in 8 lost their car(s). The multivariable OLS regression revealed that complete house loss and disruption of internal medicine were associated with significantly worse IADL: -0.67 points (95%CI: -0.99, -0.34) for entirely destroyed homes; -0.40 points (95% CI: -0.71, -0.092) for disruption of internal medicine. By contrast, loss of family/friends/pets/cars and disruption to the other medical service were not associated with decline in IADL.Complete house loss and disruption of access to internal medicine after a disaster were associated with significant adverse impact on decline in physical and cognitive functions 2.5 years after the disaster, while loss of family/friends was not.

SUBMITTER: Tsuboya T

PROVIDER: S-EPMC5373851 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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Predictors of decline in IADL functioning among older survivors following the Great East Japan earthquake: A prospective study.

Tsuboya Toru T Aida Jun J Hikichi Hiroyuki H Subramanian S V SV Kondo Katsunori K Osaka Ken K Kawachi Ichiro I

Social science & medicine (1982) 20170118

<h4>Introduction</h4>We described associations between the type of disaster experience and change in instrumental activities of daily living among older adult survivors before-after a terrible disaster.<h4>Methods</h4>The study took advantage of a "natural experiment" afforded by the Japan Gerontological Evaluation Study (JAGES), a nationwide cohort study established in 2010, seven months prior to the earthquake and tsunami. A follow-up survey was conducted in 2013. This study was conducted in I ...[more]

PMID: 28122269

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Project description:BackgroundChildren who are exposed to natural disasters are at greater risk of developing mental and behavior problems. Prior studies have suggested that positive parenting practices could prevent child mental and behavior problems among those who were exposed to natural disasters. Parent-child interaction increases oxytocin level in parents and infants; however, studies assessing the change in oxytocin level after positive parent-child interaction and its effect on child behavior problems among preadolescents who were exposed to natural disasters are lacking. This study investigated whether playful interaction stimulated oxytocin levels in 34 mother-child dyads who experienced the 2011 Great East Japan Earthquake in Kesennuma City in Miyagi Prefecture, Japan, and the effect of the maternal oxytocin changes on child behavior problems.MethodsParticipants were recruited in 2012 after the Great East Japan Earthquake. Annual surveys were conducted from 2012 to 2017. Salivary oxytocin level was assessed before and after the playful interaction in 2015. Behavior problems were evaluated by caregivers, using the Child Behavior Checklist (CBCL) in 2017. Fixed effect regression analyses were conducted to determine the effect of playful mother-child interaction on oxytocin level by comparing the change in the 10 min after the interaction with the change in the 10 min before the interaction. We also examined the effect of maternal oxytocin changes before and after the playful interaction on the onset of child behavior problems in 2017.ResultsA significant increase in maternal oxytocin level was detected following playful interaction, especially among mothers of first-born boys (2.63 pg/mg protein. 95% CI: 0.45, 4.81). Maternal psychological distress and trauma were also negatively associated with an increase of oxytocin levels. The increase in maternal oxytocin level was significantly associated with lower externalizing problem score of children 2 years later.ConclusionOur results might suggest a rational for potential preventive intervention for child behavior problems through playful mother-child interaction after natural disasters.

Project description:Importance:Depression and posttraumatic stress disorder (PTSD) represent 2 common mental health sequelae of natural disasters. However, to date, no studies have examined whether postdisaster depression and PTSD are associated with increased risk of mortality among community-dwelling survivors of natural disasters. Objective:To assess whether postdisaster depression and PTSD were associated with mortality in older disaster survivors. Design, Setting, and Participants:In this cohort study, prospective data were retrieved from older Japanese adults in Iwanuma City, Miyagi Prefecture, which was directly affected by the 2011 Great East Japan Earthquake and Tsunami. The baseline was established 7 months before the disaster (August 2010), and follow-up surveys were conducted approximately 2.5 years afterward (October 1, 2013, to January 31, 2014). Invitations were mailed to every citizen 65 years or older in Iwanuma City. Mortality data were obtained through March 4, 2017. Data analysis was performed from December 1, 2018, to June 30, 2019. Exposures:Postdisaster depression (Geriatric Depression Scale Short Form score ?5) and PTSD (Screening Questionnaire for Disaster Mental Health PTSD subscale score ?4) were measured in 2013. Main Outcomes and Measures:Mortality data were obtained by linkage to the national long-term care insurance database. Cox proportional hazards regression models were adjusted for predisaster sociodemographic characteristics, health behaviors, social cohesion, predisaster depression, and disaster experiences. Results:The response rate for the baseline survey was 59.0% (5058 of 8567 individuals), and the follow-up rate was 82.1% (3594 of 4380 eligible respondents). A total of 2965 individuals (mean [SD] age, 73.4 [6.2] years; 1621 [54.7%] female) participated in the study. The mean (SD) follow-up since the 2013 survey was 3.3 (0.5) years. Overall, 974 (32.8%) reported postdisaster depression and 747 (25.2%) reported PTSD. In adjusted models, depression was associated with more than double the risk of mortality (hazard ratio, 2.29; 95% CI, 1.54-3.42); PTSD was not associated with increased risk of mortality (hazard ratio, 1.10; 95% CI, 0.73-1.64). When evaluating the association of the 4-category comorbid depression and PTSD variable with mortality, survivors with depression only (HR, 2.24; 95% CI, 1.43-3.49) as well as those with comorbid depression and PTSD (HR, 2.54; 95% CI, 1.50-4.27) were at increased risk of death during the follow-up period compared with those with neither depression nor PTSD. Conclusions and Relevance:Depression, but not PTSD, was associated with mortality during 3.3 years of follow-up among older disaster survivors. These findings suggest that long-term mental health consequences of natural disasters may exist and that treating depression in older survivors of disasters may be beneficial.

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Predictors of decline in IADL functioning among older survivors following the Great East Japan earthquake: A prospective study.

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Predictors of decline in IADL functioning among older survivors following the Great East Japan earthquake: A prospective study.

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