Fumiya Tanji1, Yumi Sugawara2, Yasutake Tomata2, Takashi Watanabe2, Kemmyo Sugiyama2, Yu Kaiho2, Hiroaki Tomita3, Ichiro Tsuji2. 1. Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan. Electronic address: ftanji-thk@umin.ac.jp. 2. Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan. 3. Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.
Abstract
BACKGROUND: We conducted a prospective cohort study to investigate whether psychological distress would have increased the incident risk of functional disability after the 2011 Great East Japan Earthquake. METHODS: First phase data pertaining to psychological distress and other lifestyle factors were collected from 1037 subjects aged ≥ 65 years, from June to December 2011, in four affected areas of Miyagi prefecture in Japan. Psychological distress was measured by the Kessler 6-item psychological distress scale (K6), and classified into three categories (K6 score ≤ 9, 10-12, ≥ 13). Outcome data on functional disability were collected from the public Long-term Care Insurance database. Participants were followed up for about 2.6 years. The Cox model was used to calculate the multivariate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: During the follow-up period, 118 participants were certified as incident disability (43.8 disability events per 1000 person-years). Compared with the lowest category (K6 score ≤ 9), participants in the highest category (K6 score ≥ 13) had a significantly higher risk of functional disability (HR = 2.65, 95% CI = 1.35-5.18, p = 0.002). In order to consider reverse causality, we conducted analysis excluding all incidents and deaths that occurred within the first year of follow-up, but our findings remained unchanged. LIMITATIONS: We did not consider all potential confounders and use of appropriate medication. CONCLUSIONS: The present study has demonstrated that psychological distress was associated with an increased risk of functional disability among elderly survivors of a natural disaster.
BACKGROUND: We conducted a prospective cohort study to investigate whether psychological distress would have increased the incident risk of functional disability after the 2011 Great East Japan Earthquake. METHODS: First phase data pertaining to psychological distress and other lifestyle factors were collected from 1037 subjects aged ≥ 65 years, from June to December 2011, in four affected areas of Miyagi prefecture in Japan. Psychological distress was measured by the Kessler 6-item psychological distress scale (K6), and classified into three categories (K6 score ≤ 9, 10-12, ≥ 13). Outcome data on functional disability were collected from the public Long-term Care Insurance database. Participants were followed up for about 2.6 years. The Cox model was used to calculate the multivariate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: During the follow-up period, 118 participants were certified as incident disability (43.8 disability events per 1000 person-years). Compared with the lowest category (K6 score ≤ 9), participants in the highest category (K6 score ≥ 13) had a significantly higher risk of functional disability (HR = 2.65, 95% CI = 1.35-5.18, p = 0.002). In order to consider reverse causality, we conducted analysis excluding all incidents and deaths that occurred within the first year of follow-up, but our findings remained unchanged. LIMITATIONS: We did not consider all potential confounders and use of appropriate medication. CONCLUSIONS: The present study has demonstrated that psychological distress was associated with an increased risk of functional disability among elderly survivors of a natural disaster.
Authors: Yasutake Tomata; Takashi Watanabe; Fumiya Tanji; Shu Zhang; Yumi Sugawara; Ichiro Tsuji Journal: Int J Environ Res Public Health Date: 2018-11-08 Impact factor: 3.390