Heterogeneity in cognitive disability after a major disaster: A natural experiment study

Abstract

Cognitive disability following traumatic experiences of disaster has been documented; however, little is known about heterogeneity in the association across individuals. In this natural experiment study of approximately 3000 Japanese older adults in an area directly affected by the 2011 Great East Japan Earthquake, the baseline survey was established 7 months before the 2011 earthquake. To inductively identify heterogeneity in postdisaster cognitive disability by predisaster characteristics, we applied a machine learning-based causal inference approach-generalized random forest. We identified strong evidence for heterogeneity in the association between home loss and cognitive disability objectively assessed 2.5 and 5.5 years after the 2011 earthquake. The subgroups with the strongest disaster-dementia associations tended to be from low socioeconomic backgrounds and have predisaster health problems. The study demonstrated that some subpopulations are particularly prone to experience cognitive disability after disasters, which could be overlooked in studies assessing population average associations only.

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“…The global community has committed to ambitious targets articulated in the Sustainable Development Goals (Burke et al, 2021;Daoud et al, 2016;Halleröd et al, 2013). Although many governments globally are vigilant in implementing public policies to improve human development for their populations (Conklin et al, 2018;Coutts et al, 2019;Ponce et al, 2017;Shiba et al, 2021), policymakers lack reliable methods to monitor the effects of their policies at a sufficiently granular level over time and space (Daoud, 2015). To tackle this lack, scholars are creating innovative methods that capitalizes on the predictive accuracy of ML and the visual granularity supplied by EO (Burke et al, 2021;Daoud and Dubhashi, 2020;Rolf et al, 2021).…”

Potential Mechanisms Underlying Resistance to Dementia in Non-Demented Individuals with Alzheimer’s Disease Neuropathology

“…Interestingly, accelerated cognitive decline was also observed in a recent study in individuals who lost their home during the 2011 earthquake in Japan [ 208 ]. Even though there was quite some heterogeneity between individuals, the individuals that seemed most vulnerable to post-disaster accelerated cognitive decline tended to be less educated, as well as older, unmarried, not working, living alone, and had also baseline health problems [ 208 ].…”

“…Additionally, another recently published study, which did not specifically look at IQ, but that investigated person-specific cognitive trajectories, also found that terminal decline contributes on average for about 70% to late-life cognitive loss in the investigated cohort [ 207 ]. Interestingly, accelerated cognitive decline was also observed in a recent study in individuals who lost their home during the 2011 earthquake in Japan [ 208 ]. Even though there was quite some heterogeneity between individuals, the individuals that seemed most vulnerable to post-disaster accelerated cognitive decline tended to be less educated, as well as older, unmarried, not working, living alone, and had also baseline health problems [ 208 ].…”

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