The effect of the 2018 Japan Floods on cognitive decline among long-term care insurance users in Japan: a retrospective cohort study

Environmental Health and Preventive Medicine

Shuhei Yoshida¹  Masatoshi Matsumoto¹  Saori Kashima² 

[1] Department of Community-Based Medical System, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima-shi, 734-8551, Hiroshima-ken, Japan;Environmental Health Sciences Laboratory, Graduate School of Advanced Science and Engineering, Hiroshima University, 1-3-2 Kagamiyama, Higashi-Hiroshima-shi, Hiroshima-ken, Japan;

关键词: Natural disaster;    Disaster preparedness;    Long-term care;    Claim data;    Cognitive decline;   

DOI  :  10.1186/s12199-021-01038-9

来源: Springer

【 摘 要 】

BackgroundThe July 2018 Japan Floods caused enormous damage to western Japan. Such disasters can especially impact elderly persons. Research has shown that natural disasters exacerbated a decline in cognitive function, but to date, there have been no studies examining the effects of this disaster on the elderly. The object of this study was to reveal the effect of this disaster in terms of cognitive decline among the elderly.MethodsStudy participants were certified users of the long-term care insurance (LTCI) system in Hiroshima, Okayama, and Ehime prefectures from May 2018 to June 2018. The observation period was from July 2018 to December 2018. Our primary outcome was cognitive decline after the disaster using a dementia symptomatology assessment. In addition to a crude model, a multivariate Cox proportional hazards model was used to assess the cognitive decline of victims, adjusting for age classification, gender, the level of dementia scale before the disaster occurred, residential environment, whether a participant used facilities shut down after the disaster, and population density. After we confirmed that the interaction term between victims and residential environment was statistically significant, we stratified them for the analysis.ResultsThe total number of participants was 264,614. Victims accounted for 1.10% of the total participants (n = 2,908). For the Cox proportional hazards model, the hazard ratio of the victims was 1.18 (95% confidential interval (CI): 1.05–1.32) in the crude model and 1.12 (95% CI: 1.00–1.26) in the adjusted model. After being stratified by residential environment, the hazard ratio of home victims was 1.20 (95% CI: 1.06–1.36) and the hazard ratio of facility victims was 0.89 (95% CI: 0.67–1.17).ConclusionsThis study showed that elderly living at home during the 2018 Japan Floods were at risk for cognitive decline. Medical providers, care providers, and local governments should establish a system to check on the cognitive function of elderly victims and provide necessary care support.

【 授权许可】

CC BY