Abstract
Abstract
Background
It has been reported that psychological stress affects bone metabolism and increases the risk of fracture. However, the relationship between bone fractures and post-traumatic stress disorder (PTSD) is unclear. This study aimed to evaluate the effects of disaster-induced PTSD symptoms on fracture risk in older adults.
Methods
This study evaluated responses from 17,474 individuals aged ≥ 65 years without a history of fractures during the Great East Japan Earthquake who answered the Mental Health and Lifestyle Survey component of the Fukushima Health Management Survey conducted in 2011. The obtained data could determine the presence or absence of fractures until 2016. Age, sex, physical factors, social factors, psychological factors, and lifestyle factors were subsequently analyzed. Survival analysis was then performed to determine the relationship between the fractures and each factor. Thereafter, univariate and multivariate Cox proportional hazard models were constructed to identify fracture risk factors.
Results
In total, 2,097 (12.0%) fractures were observed throughout the follow-up period. Accordingly, univariate and multivariate Cox proportional hazard models showed that PTSD symptoms (total PTSD checklists scoring ≥ 44) [hazard ratio (HR): 1.26; 95% confidence interval (CI): 1.10–1.44; P = 0.001], history of cancer (HR: 1.49; 95% CI: 1.24–1.79; P < 0.001), history of stroke (HR: 1.25; 95% CI: 1.03–1.52; P = 0.023), history of heart disease (HR: 1.30; 95% CI: 1.13–1.50; P < 0.001), history of diabetes (HR: 1.23; 95% CI: 1.09–1.39; P < 0.001), current smoking (HR: 1.29; 95% CI: 1.02–1.63; P = 0.036), and high dissatisfaction with sleep or no sleep at all (HR: 1.33; 95% CI: 1.02–1.74; P = 0.035) promoted a significant increase in fracture risk independent of age and sex.
Conclusions
The present study indicates that disaster-induced PTSD symptoms and insomnia contribute to increased fracture risk among older adults residing in evacuation areas within the Fukushima Prefecture.
Funder
National Health Fund for Children and Adults Affected by the Nuclear Incident
Publisher
Springer Science and Business Media LLC
Subject
Geriatrics and Gerontology
Reference60 articles.
1. Kunii Y, Suzuki Y, Shiga T, Yabe H, Yasumura S, Maeda M, Niwa S, Otsuru A, Mashiko H, Abe M, Mental Health Group of the Fukushima Health Management Survey. Severe psychological distress of evacuees in evacuation zone caused by the Fukushima Daiichi nuclear power plant accident: The Fukushima Health Management Survey. PLoS One. 2016;11(7):e0158821.
2. Yabe H, Suzuki Y, Mashiko H, Nakayama Y, Hisata M, Niwa S, Yasumura S, Yamashita S, Kamiya K, Abe M, Mental Health Group of the Fukushima Health Management Survey. Psychological distress after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant accident: results of a mental health and lifestyle survey through the Fukushima Health Management Survey in FY2011 and FY2012. Fukushima J Med Sci. 2014;60(1):57–67.
3. Maeda M, Oe M. Mental health consequences and social issues after the Fukushima disaster. Asia Pac J Public Health. 2017;29(2_suppl):36S-46S.
4. Kukihara H, Yamawaki N, Uchiyama K, Arai S, Horikawa E. Trauma, depression, and resilience of earthquake/tsunami/nuclear disaster survivors of Hirono, Fukushima Japan. Psychiatry ClinNeurosci. 2014;68(7):524–33.
5. Jiang T, Veres K, KörmendinéFarkas D, Lash TL, ToftSørensen H, Gradus JL. Post-traumatic stress disorder and incident fractures in the Danish population. OsteoporosInt. 2018;29(11):2487–93.
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