LATEBREAKER
Environment/Climate Change
Association between annual health checkup attendance and functional disability among older survivors of the 2011 Japan Earthquake and Tsunami Hiroyuki Hikichi* Hiroyuki Hikichi Ichiro Kawachi
Objective: Research has demonstrated that participating in health checkups is associated with lower risks of physical and cognitive impairments in older adults. However, little is known about the association in older survivors of natural disasters. This study examined whether health checkup attendance could protect older survivors’ functional capacity after the 2011 Japan Earthquake and Tsunami, considering time-dependent confounders.
Methods: With the dataset becoming available only recently due to advancements in data processing, we seized the opportunity to conduct a comprehensive analysis. We initiated a survey in Iwanuma City, 80 km west of the epicenter, seven months before the disaster, continuing with follow-up surveys every three years until 2022. The primary outcome was functional disability levels from the Japan long-term care database. The key explanatory variable was annual health checkup participation for metabolic syndrome and frailty, recorded by the local government. Time-dependent covariates included smoking, drinking, and daily walking, adjusted using marginal structural models. We also considered housing damage, loss of loved ones, and socio-demographics. The analysis included 1,481 individuals, excluding 18 with baseline functional disabilities.
Results: Among participants in the 5-wave panel surveys, 56.6% were women, and the baseline average age was 71.0 years. The result of marginal structural models showed that health checkup attendance was associated with lower levels of functional disability (Coefficient -0.08, 95% CI -0.10 to -0.05, p < .01).
Conclusions: Participating in annual health checkups was protectively associated with a lower risk of functional disability among older disaster survivors. We conclude that encouraging annual health checkup attendance could protect the health and well-being of older survivors, who are especially vulnerable following a major disaster.