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

Abstract

BackgroundMany 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.MethodsWe 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.ResultsOver 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.ConclusionsLifestyle and psychosocial factors associated with the risk of frailty differ by sex and the degree of housing damage.Electronic supplementary materialThe online version of this article (10.1186/s12877-018-0828-x) contains supplementary material, which is available to authorized users.

Changes in smoking behavior among victims after the great East Japan earthquake and tsunami

“…According to a report from Fukushima, few people started smoking after the disaster; the smoking rate was not high among victims in 2012 compared with smoking rate among the general population, and smoking rate decreased after the disaster [11]. A longitudinal study of elderly people in Iwate Prefecture from 2012 to 2015 found that smoking prevalence was higher among people with complete destroyed houses and that continued decreasing from 2011 through 2014 and increased in 2015 [22].…”

Association between continued residence in temporary prefabricated housing and musculoskeletal pain in survivors of the Great East Japan Earthquake: a longitudinal study

“…In our previous study, about 70% (561/792) of the participants who lived in PHs at 2 years after the GEJE continued residence in a PH at 4 years after the disaster. Possible reasons for the high rate of continued residence in a PH are economic poverty,5 lack of public housing or loss of motivation to move out 7…”

“…A previous study reported that prolonged PH stays were associated with physical dysfunction and psychological distress 6 7 26. Ishii et al indicated that most PHs were built in areas that were separated from the local communities in which survivors previously lived, and did not include commercial areas; therefore, refugees tended to confine themselves to their own PHs, leading to physical inactivity,26 which is considered to be related to MSK pain 27.…”

“…In a previous study, the rate of psychological distress among evacuees increased with longer duration of residing in a PH 6. Most PHs are smaller than the former homes of evacuees, have poor isolation, thin internal walls and lower soundproof effect, which leads to health problems 7. PHs are not suitable for long-term living; long-term residence in them could have negative effects.…”

Did the Number of Older People Requiring Long-Term Care and Expenditure Increase after the 2011 Great East Japan Earthquake? Analysis of Changes over Six Years

“…A systematic review revealed psychological burdens such as a deterioration in mental health [21] and an increase in prevalence of post-traumatic stress disorder (PTSD) [22], as well as deterioration in health due to living in an evacuation center or a worse living environment [23], an increase in frailty risk [24], spread of pneumonia [25], and an increase in the number of people with subjective symptoms such as gastrointestinal and/or musculoskeletal symptoms [26].…”