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

Abstract

Introduction 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. Methods 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=3,547). 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. Results 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. Conclusion 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.

Long-Term Associations Between Disaster Experiences and Cardiometabolic Risk: A Natural Experiment From the 2011 Great East Japan Earthquake and Tsunami

“…Regarding the first explanation, we did not find an association between loss of loved ones and changes in cardiometabolic risk. This lack of long-term associations with health for loss of loved ones is consistent with the existing evidence (24). Moreover, there was no association between changes in Geriatric Depression Scale score and cardiometabolic risk.…”

“…Older adults are also vulnerable to health problems in the aftermath of disasters. For instance, we have previously reported that older survivors of the 2011 Great East Japan Earthquake experienced increased risks of functional disability, cognitive decline, and depression (18,24,25).…”

A Bibliometric Profile of Disaster Medicine Research from 2008 to 2017: A Scientometric Analysis

“…These papers focus on post-disaster effects on the physiology and mental health of survivors, including their daily behaviors, physiological indicators, and mental states. [69][70]63 (2) "Public health preparedness." These papers focus on the establishment, evaluation, and management of medical rescue systems.…”

Worsening Health Status among Evacuees: Analysis of Medical Expenditures after the 2011 Great East Japan Earthquake and Nuclear Disaster in Fukushima

“…As of October 2015, 44,094 people (approximately 2% of the total population in Fukushima Prefecture) were evacuated from Fukushima Prefecture to other prefectures (Fukushima Prefecture 2019). The coastal area of Miyagi Prefecture, located north of Fukushima, was disproportionally affected by the tsunami that struck after the Great East Japan Earthquake, with loss of housing, disruption of access to internal medicine, and adverse effects on daily activities of living (Tsuboya et al 2017). According to previous research, community-level social capital (i.e., bonds of trust between community members, as well as norms of mutual assistance) mitigated the impact of housing damage on cognitive decline (Hikichi et al 2018).…”