Heterogeneity in cognitive disability after a major disaster: A natural experiment study.
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ABSTRACT:
SUBMITTER: Shiba K
PROVIDER: S-EPMC8480922 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:We examined prospectively whether social capital mitigates the adverse effects of natural disaster on cognitive decline.The baseline for our study was established seven months before the 2011 Great East Japan Earthquake and Tsunami in a survey of older community-dwelling adults who lived 80 kilometers west of the epicenter (59.0% response rate). Approximately two and a half years after the disaster, the follow-up survey gathered information about personal experiences of disaster as well as incidence of cognitive disability (82.1% follow-up rate). Our primary outcome was cognitive disability (measured on an 8-level scale) assessed by in-home assessment.The experience of housing damage was associated with risk of cognitive impairment (coefficient = 0.04, 95% confidence interval: 0.02 to 0.06). Factor analysis of our analytic sample (n = 3,566) established two sub-scales of social capital: a cognitive dimension (perceptions of community social cohesion) and a structural dimension (informal socializing and social participation). Fixed effects regression showed that informal socializing and social participation buffered the risk of cognitive decline resulting from housing damage.Informal socializing and social participation may prevent cognitive impairment following natural disaster.National Institutes of Health (R01AG042463-04), the Japan Society for the Promotion of Science, the Japanese Ministry of Health, Labour and Welfare and the Japanese Ministry of Education, Culture, Sports, Science and Technology.
| S-EPMC5801543 | biostudies-literature
Project description:Natural disasters are often associated with forced residential relocation, thereby affected people experience a change of food environment that results in the increased body mass index. However, there are a few studies that examined whether a change in food environment caused risk of obesity after a natural disaster. To address this question, we leveraged a natural experiment of residential relocation in the aftermath of the 2011 Japan Earthquake and Tsunami. Our baseline data came from a nationwide cohort study of older community-dwelling adults conducted 7 months prior to the disaster. By chance, one of the field sites (Iwanuma City, Miyagi Prefecture) was directly in the line of the tsunami. Approximately 2.5 years after the disaster, we ascertained the residential addresses and health status of 3,594 survivors aged 65 years or older (82.1% follow-up rate). Fixed effects multinomial logistic regression showed that shortened distances to food outlets/bars increased the risks of transitioning from BMI in the normal range (18.5-22.9) to obesity (?25.0) (Odds ratios: 1.46 for supermarkets; 1.43 for bars; 1.44 times for fast food outlets). Radically changed food access after a natural disaster may raise the risk of obesity among older survivors.
| S-EPMC6344590 | biostudies-literature
Project description:Background and objectivesMany cross-sectional studies have confirmed a link between gait speed and cognitive function. However, it is unknown whether cognitive function plays a role in the onset of major mobility disability (MMD) and if the effects are independent of physical function. This study examined cognitive and physical function as predictors of MMD across an average of 2.6 years of follow-up in community-dwelling older adults with compromised mobility.Research design and methodData were collected from 1,635 participants in the Lifestyle Interventions and Independence for Elders (LIFE) study ages 70-89 years free of MMD at baseline. MMD was assessed every 6 months and defined as the inability to walk 400 m in ≤15 min without assistance or sitting. Cognitive function was assessed at baseline, 18 months, and 24 months using a cognitive battery categorized into four domains: global cognitive function, processing speed, verbal memory, and executive function.ResultsAcross the study duration of 2.6 years, 536 participants (32.8%) developed MMD. Cox Proportional Hazard models indicated a protective relationship for higher baseline processing speed (Hazard Ratio [HR] per standard deviation: 0.86, p = .006), executive function (HR: 0.86, p = .002), and global cognition (HR: 0.85, p = .001) on incidence of MMD adjusted for demographics, intervention, and comorbidities. Results were not significant after adjustment for gait speed. In adjusted longitudinal models, a positive change in processing speed was significantly associated with reduced risk of MMD (HR: 0.52, p < .001) while other domains were not.Discussion and implicationsIn the LIFE study, processing speed at baseline and follow-up was a significant predictor of subsequent MMD although the observed association may be explained by physical function as reflected in gait speed. More studies are needed to understand how cognitive function, alone and in combination with physical function, influences risk of MMD.
| S-EPMC6499408 | biostudies-literature
Project description:The underlying mechanism for deterioration in cardiometabolic health after major natural disasters is unknown. We leveraged natural experiment data stemming from the 2011 Great East Japan Earthquake and Tsunami (n = 1165) to examine whether specific types of post-disaster accommodations explain the association between disaster-related property damage and objectively measured cardiometabolic profiles of older disaster survivors. Causal mediation analysis showed that relocation to trailer-style temporary shelters largely mediated the associations between home loss and unhealthy changes in anthropometric measures (72.6% of 0.65 kg/m2 for body mass index and 62.3% of 3.89 cm for waist circumference), but it did not mediate the associations with serum lipid measures. This study demonstrates that there are outcome-specific pathways linking disaster damage and health of survivors.
| S-EPMC7686264 | biostudies-literature
Project description:Study Objectives:To examine prospectively the associations of disaster experiences and social support with sleep problems in older adults. Methods:Data came from a natural experiment caused by the 2011 Great East Japan earthquake and tsunami. Participants in an ongoing prospective cohort (3547 Japanese individuals aged 65 years or older) were inadvertently exposed to the disaster due to their residential location (Iwanuma city) after the 2010 baseline survey. We conducted a follow-up survey in 2013 to inquire about disaster-related experiences and short sleep duration, sleep insufficiency, poor sleep quality, insomnia symptoms, and sleep medication use. Poisson regression models adjusted for baseline socio-demographic and lifestyle covariates. Results:Financial hardship predicted increased risks of short sleep duration (relative risk [RR] = 1.40; 95% confidence interval [CI] [1.03, 1.90]), sleep insufficiency (RR = 1.29; 95% CI [1.01, 1.66]), poor sleep quality (RR = 1.47; 95% CI [1.26, 1.70]), and insomnia symptoms (RR = 1.13; 95% CI [1.01, 1.28]). Home destruction predicted sleep medication use while health care disruption predicted poor sleep quality. Loss of close relatives or friends did not predict any sustained sleep problems. Additionally, having instrumental support reduced risks of all sleep problems while having emotional support reduced risk of poor sleep quality. Conclusions:Approximately 2.5 years after the disaster, older survivors' sleep problems were more durably linked to material aspects of disaster damage than to loss of loved ones. Findings could inform targeted recovery efforts for groups with greatest need to promote older survivors' sleep health and overall well-being.
| S-EPMC6047443 | biostudies-literature
Project description:We investigated the association between disaster experience and the cardiometabolic risk of survivors 2.5 years after disaster onset, adjusting for health information predating the disaster, using natural experiment data stemming from the 2011 Great East Japan Earthquake and Tsunami. We used data from a cohort of adults aged 65 years or older in Iwanuma City, Japan, located 80 km (128 miles) west of the earthquake epicenter. The baseline survey was completed 7 months before the disaster, and the follow-up survey was performed among survivors approximately 2.5 years after the disaster. The survey data were linked to medical records with information on objectively measured cardiometabolic risk factors (n = 1,195). The exposure of interest was traumatic disaster experiences (i.e., housing damage and loss of loved ones). Fixed-effects regression showed that complete housing destruction was significantly associated with a 0.81-unit greater change in body mass index (weight (kg)/height (m)2; 95% confidence interval (CI): 0.24, 1.38), a 4.26-cm greater change in waist circumference (95% CI: 1.12, 7.41), and a 4.77-mg/dL lower change in high-density lipoprotein cholesterol level (95% CI: -7.96, -1.58) as compared with no housing damage. We also observed a significant association between major housing damage and decreased systolic blood pressure. Continued health checkups and supports for victims who lost homes should be considered to maintain their cardiometabolic health.
| S-EPMC7301774 | biostudies-literature
Project description:We encounter many natural disasters in Japan and various infectious diseases could occur during and after natural disasters. Two recent major natural disasters, the Great East Japan Earthquake and the Kumamoto Earthquake in 2011 and 2016, respectively, killed tremendous numbers of people and many were affected with infectious diseases in evacuation centers as well as shelters for long period. Infection control teams of medical facilities inside or outside of affected areas were dispatched, supported evacuees, and made great contributions to: (i) control epidemic infectious diseases such as influenza and norovirus infection, (ii) educate and encourage people, (iii) improve environments. According to the experiences and evidence accumulated from these two disasters, it is apparent that infection control activities will definitely reduce infection during and after disasters. However, unlike the Disaster Medical Assistance Team and Japan Medical Association Team, there is no organization specialized for infection control in disaster-affected areas. A disaster infection control team should be established by leads of either of government and/or societies related to infectious diseases and infection control.
| S-EPMC6328906 | biostudies-other
Project description:Earthquakes are a common and deadly natural disaster, with roughly one-quarter of survivors subsequently developing posttraumatic stress disorder (PTSD). Despite progress identifying risk factors, limited research has examined how to combine variables into an optimized post-earthquake PTSD prediction tool that could be used to triage survivors to mental health services. The current study developed a post-earthquake PTSD risk score using machine learning methods designed to optimize prediction. The data were from a two-wave survey of Chileans exposed to the 8.8 magnitude earthquake that occurred in February 2010. Respondents (n = 23,907) were interviewed roughly three months prior to and again three months after the earthquake. Probable post-earthquake PTSD was assessed using the Davidson Trauma Scale. We applied super learning, an ensembling machine learning method, to develop the PTSD risk score from 67 risk factors that could be assessed within one week of earthquake occurrence. The super learner algorithm had better cross-validated performance than the 39 individual algorithms from which it was developed, including conventional logistic regression. The super learner also had a better area under the receiver operating characteristic curve (0.79) than existing post-disaster PTSD risk tools. Individuals in the top 5%, 10%, and 20% of the predicted risk distribution accounted for 17.5%, 32.2%, and 51.4% of all probable cases of PTSD, respectively. In addition to developing a risk score that could be implemented in the near future, these results more broadly support the utility of super learning to develop optimized prediction functions for mental health outcomes.
| S-EPMC5726547 | biostudies-literature
Project description:Exposure to extreme events has been hypothesized to affect subsequent mortality because of mortality selection and scarring effects of the event itself. We examine survival at and in the five years after the 2004 Indian Ocean earthquake and tsunami for a population-representative sample of residents of Aceh, Indonesia who were differentially exposed to the disaster. For this population, the dynamics of selection and scarring are a complex function of the degree of tsunami impact in the community, the nature of individual exposures, age at exposure, and gender. Among individuals from tsunami-affected communities we find evidence for positive mortality selection among older individuals, with stronger effects for males than for females, and that this selection dominates any scarring impact of stressful exposures that elevate mortality. Among individuals from other communities, where mortality selection does not play a role, there is evidence of scarring with property loss associated with elevated mortality risks in the five years after the disaster among adults age 50 or older at the time of the disaster.
| S-EPMC5929150 | biostudies-literature
Project description:Prenatal maternal stress (PNMS) can impact a variety of outcomes in the offspring throughout childhood and persisting into adulthood as shown in human and animal studies. Many of the effects of PNMS on offspring outcomes likely reflect the effects of epigenetic changes, such as DNA methylation, to the fetal genome. However, no animal or human research can determine the extent to which the effects of PNMS on DNA methylation in human offspring is the result of the objective severity of the stressor to the pregnant mother, or her negative appraisal of the stressor or her resulting degree of negative stress. We examined the genome-wide DNA methylation profile in T cells from 34 adolescents whose mothers had rated the 1998 Québec ice storm's consequences as positive or negative (that is, cognitive appraisal). The methylation levels of 2872 CGs differed significantly between adolescents in the positive and negative maternal cognitive appraisal groups. These CGs are affiliated with 1564 different genes and with 408 different biological pathways, which are prominently featured in immune function. Importantly, there was a significant overlap in the differentially methylated CGs or genes and biological pathways that are associated with cognitive appraisal and those associated with objective PNMS as we reported previously. Our study suggests that pregnant women's cognitive appraisals of an independent stressor may have widespread effects on DNA methylation across the entire genome of their unborn children, detectable during adolescence. Therefore, cognitive appraisals could be an important predictor variable to explore in PNMS research.
| S-EPMC4445750 | biostudies-literature