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Association between health risks and frailty in relation to the degree of housing damage among elderly survivors of the great East Japan earthquake.

ABSTRACT: BACKGROUND:Many survivors of the Great East Japan Earthquake that occurred in 2011 were at risk of deteriorating health, especially elderly people living in disaster-stricken areas. The objectives of this prospective study were: a) to clarify the different lifestyle and psychosocial factors associated with frailty by sex among the non-disabled elderly survivors, and b) to describe the differences in characteristics stratified by the degree of disaster-related housing damage. METHODS:We followed 2261 Japanese survivors aged ?65 years (45.3% male; mean age, 71.7 years) without disability or frailty who completed a self-administered questionnaire at baseline. All participants completed a baseline questionnaire in 2011 and at least one identical follow-up questionnaire between 2012 and 2015 regarding lifestyle (smoking status, alcohol intake, physical activity, sedentary lifestyle, and dietary intake) and psychosocial factors (self-rated health, standard of living, psychological distress, and social networks). Frailty was defined as a score of ?5 on the Kihon Checklist, which is used by the Japanese government to certify the need for long-term care insurance. Adjusted odds ratios and 95% confidence intervals with frailty as the dichotomous dependent variable and health factors as the independent variables were calculated using a multilevel model for repeated measures by sex, followed by stratification analyses by the degree of housing damage. RESULTS:Over the 4-year study period, 510 participants (22.6%) developed frailty. In the post-disaster setting, many of the psychosocial factors remained more prevalent 4 years later among survivors with extensive housing damage. The presence of risk factors regarding the development of frailty differed by the degree of housing damage. Among men, psychological distress, in parallel with a poor social network, was related to frailty among only the participants with extensive housing damage and those living in temporary housing, whereas among women, worsening psychological distress was associated only with no damage and no displaced survivors. Among women with extensive damage and displacement, health outcomes such as overweight and diabetes and poor social networks were strongly related to frailty. CONCLUSIONS:Lifestyle and psychosocial factors associated with the risk of frailty differ by sex and the degree of housing damage.

SUBMITTER: Tsubota-Utsugi M

PROVIDER: S-EPMC6001143 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Association between health risks and frailty in relation to the degree of housing damage among elderly survivors of the great East Japan earthquake.

Tsubota-Utsugi M M Yonekura Y Y Tanno K K Nozue M M Shimoda H H Nishi N N Sakata K K Kobayashi S S

BMC geriatrics 20180604 1

<h4>Background</h4>Many survivors of the Great East Japan Earthquake that occurred in 2011 were at risk of deteriorating health, especially elderly people living in disaster-stricken areas. The objectives of this prospective study were: a) to clarify the different lifestyle and psychosocial factors associated with frailty by sex among the non-disabled elderly survivors, and b) to describe the differences in characteristics stratified by the degree of disaster-related housing damage.<h4>Methods</ ...[more]

PMID: 29898680

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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:OBJECTIVES:Previous studies have reported that displacement from one's own home after a natural disaster is associated with a higher degree of psychological distress. The present study investigated the longitudinal association between the period of residence in prefabricated temporary housing and psychological distress after the Great East Japan Earthquake. DESIGN, SETTING AND PARTICIPANTS:We conducted a longitudinal observation of 284 adults (aged ?18 years) who had lived in prefabricated temporary housing in Miyagi, Northeastern Japan. The period of residence in prefabricated temporary housing was classified into three categories: <3, 3-4 and >4 years (ie, still living in prefabricated temporary housing). OUTCOMES:The Kessler 6-item Psychological Distress Scale (K6) was assessed in both a baseline survey (2011) and a follow-up survey (2016). Higher psychological distress was defined by a K6 score of ?5. We used Firth's penalised likelihood method in the multivariate logistic regression model to estimate the adjusted ORs and 95% CIs. RESULTS:Among the total participants, the proportion of individuals with higher psychological distress at the follow-up survey was significantly higher in the >4 years category (multivariate OR=4.00, 95% CI 1.67 to 10.16) than in the <3 years category. Among participants who had a lower degree of psychological distress at the baseline, the proportion of those whose psychological distress deteriorated was significantly higher in the >4 years category (multivariate OR=4.87, 95% CI 1.26 to 20.28) than in the <3 years category. On the other hand, among the participants who had a higher degree of psychological distress at the baseline, the proportion of those whose psychological distress ameliorated was significantly lower in the >4 years category (multivariate OR=0.26, 95% CI 0.06 to 0.85) than in the <3 years category. CONCLUSIONS:The proportion of individuals with more severe psychological distress was higher among participants who had lived in prefabricated temporary housing for a long period.

Project description:ObjectivesAfter the Great East Japan Earthquake (GEJE) of 2011, many survivors have been forced to live in prefabricated temporary housing, which is uncomfortable and insufficiently durable for permanent living. Public reconstruction housing has been built to improve their living conditions; however, those moving have to rebuild personal relationships and adapt to a new environment. This study examined whether survivors moving to public reconstruction housing became more socially isolated than those remaining in prefabricated temporary housing.Design, setting and participantsSelf-report questionnaire data collected in 2015 (4 years after the GEJE) were used as the baseline for follow-up surveys in 2016 and 2017, as many survivors moved from prefabricated temporary housing to public reconstruction housing from 2015. We analysed longitudinal data from 393 survivors, distinguishing those who moved to public reconstruction housing during the 5th year after the disaster from those who remained in prefabricated temporary housing. Participants were assessed using the Lubben Social Network Scale-6 (LSNS-6) in all three surveys, with social isolation defined by a score of <12/30. To reduce the effect of selection bias, propensity score analysis was performed (178 of 393 participants were retained). We used a generalised estimated equation to evaluate the association between moving from prefabricated temporary housing to public reconstruction housing and changes in social isolation over 2 years.ResultsLSNS-6 scores of the reconstruction housing group were worse than those of the prefabricated housing group between 4 and 6 years after the GEJE (P=0.006). Over the same period, social isolation worsened in the reconstruction housing group but improved in the prefabricated housing group (P=0.002).ConclusionsSocial isolation should be monitored while supporting survivors who moved to public reconstruction housing, and further longitudinal research is needed to clarify the risk of social isolation.

Dataset Information

Association between health risks and frailty in relation to the degree of housing damage among elderly survivors of the great East Japan earthquake.

Publications

Association between health risks and frailty in relation to the degree of housing damage among elderly survivors of the great East Japan earthquake.

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