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Elderly may face increased dementia risk after a disaster

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Published: Monday, 24 October 2016
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Elderly people who were uprooted from damaged or destroyed homes and who lost touch with their neighbors after the 2011 calamity in Japan were more likely to experience accrued symptoms of dementedness than those who were able to stay in their homes, according to a new study from Harvard T.H.

Chan School of Public Health. The study was the first to look at dementedness as a potential health risk in the aftermath of a disaster.

The study will appear online in an Early Edition of the Proceedings of the National Academy of Sciences journal (PNAS).

"In the aftermath of disasters, most people focus on mental health issues like PTSD," aforesaid Hiroyuki Hikichi, research fellow at Harvard Chan School and lead author of the study. "But our study suggests that psychological feature decline is besides an important issue. It appears that relocation to a temporary shelter after a disaster may have the accidental effect of separating people not just from their homes but from their neighbors - and some may speed up psychological feature decline among vulnerable people."

The Harvard Chan researchers, working with colleagues in Japan, were able to conduct a "natural experiment" among a group of elderly residents of the coastal city of Iwanuma, placed about 80 kilometers west of the earthquake epicentre, where nearly half the land area was afloat by the calamity. Seven months before the disaster, elderly residents of Iwanuma had been surveyed about their health as part of an on-going study of aging called the Japan geriatric Evaluation Study (JAGES). Two-and-a-half years after the calamity, the researchers conducted a follow-up survey among the same group.

Out of 3,566 survivors of the calamity disaster aged 65 or older - some who were able to remain in their homes and some who were forced out - 38.0% aforesaid they lost relatives and/or friends and 58.9% according property damage. In the pre-calamity survey, 4.1% of respondents had been assessed with dementedness symptoms; after the calamity, the percentage jumped to 11.5%. The prevalence of stroke accrued, from 2.8% to 6.5%, as did the prevalence of high blood pressure (54.0% to 57.2%). The percentage of people who according not interacting with their neighbors - not even with greetings - nearly double, from 1.5% to 2.9%.

Those who wound up in temporary housing after their houses were either destroyed or sustained major damage had the highest levels of psychological feature decline. There was a strong dose-response association: People whose houses were more severely damaged experient more psychological feature decline. Depression and declines in informal social interactions with friends and neighbors appeared to play a role in the link.

By contrast, loss of relatives and/or friends did not seem to impact psychological feature abilities.

Other Harvard Chan School authors enclosed S V Subramanian and Ichiro Kawachi, senior author of the study.

Funding for the study came from the National Institutes of Health (R01 AG042463); Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (KAKENHI 23243070, KAKENHI 22390400, and KAKENHI 24390469); a Health Labour Sciences Research Grant from the Japanese Ministry of Health, Labour and Welfare (H24-Choju-Wakate-009); and a grant from the Strategic Research Foundation Grant-Aided Project for Private Universities from the Japanese Ministry of Education, Culture, Sports, Science and Technology (S0991035).

Article: accrued risk of dementedness in the aftermath of the 2011 Great East Japan Earthquake and calamity, Hiroyuki Hikichi, Jun Aida, Katsunori Kondo, Toru Tsuboya, Yusuke Matsuyama, S.V. Subramanian, and Ichiro Kawachi, PNAS, doi: 10.1073/pnas.1607793113, published online 24 October 2016.

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Elderly may face increased dementia risk after a disaster
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