Association between post-traumatic stress disorder symptoms and bone fractures after the Great East Japan Earthquake in older adults: a prospective cohort study from the Fukushima Health Management Survey

被引：10

作者：

Hayashi, Fumikazu ^{[1
,2
]}

Ohira, Tetsuya ^{[1
,2
]}

Nakano, Hironori ^{[1
,2
]}

Nagao, Masanori ^{[1
,2
]}

Okazaki, Kanako ^{[2
]}

Harigane, Mayumi ^{[2
,3
]}

Yasumura, Seiji ^{[2
,3
]}

Maeda, Masaharu ^{[2
,4
]}

Takahashi, Atsushi ^{[2
,5
]}

Yabe, Hirooki ^{[2
,6
]}

Suzuki, Yuriko ^{[7
]}

Kamiya, Kenji ^{[2
]}

机构：

[1] Fukushima Med Univ, Sch Med, Dept Epidemiol, 1 Hikarigaoka, Fukushima 9601295, Japan

[2] Fukushima Med Univ, Radiat Med Sci Ctr Fukushima Hlth Management Surv, 1 Hikarigaoka, Fukushima, Fukushima 9601295, Japan

[3] Fukushima Med Univ, Sch Med, Dept Publ Hlth, 1 Hikarigaoka, Fukushima, Fukushima 9601295, Japan

[4] Fukushima Med Univ, Sch Med, Dept Disaster Psychiat, 1 Hikarigaoka, Fukushima, Fukushima 9601295, Japan

[5] Fukushima Med Univ, Sch Med, Dept Gastroenterol, 1 Hikarigaoka, Fukushima, Fukushima 9601295, Japan

[6] Fukushima Med Univ, Sch Med, Dept Neuropsychiat, 1 Hikarigaoka, Fukushima, Fukushima 9601295, Japan

[7] Natl Inst Mental Hlth, Dept Mental Hlth Policy, Natl Ctr Neurol & Psychiat, 4-1-1 Ogawa Higashi, Kodaira, Tokyo 1878553, Japan

来源：

BMC GERIATRICS | 2021年 / 21卷 / 01期

关键词：

Fractures; Mental health; Aged; Disaster victims; Fukushima nuclear accident;

D O I：

10.1186/s12877-020-01934-9

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

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.

引用

页数：13

共 60 条

[1] Salivary cortisol, posttraumatic stress symptoms, and general health in the acute phase and during 9-month follow-up [J].