Psychological and Physical Impacts of Extreme Events on Older Adults: Implications for Communications

McClelland, Erin E.; Amlôt, Richard; Rogers, M. Brooke; Rubin, G. James; Tesh, John; Pearce, Julia M.

doi:10.1017/dmp.2016.118

Cited by 19 publications

(27 citation statements)

References 58 publications

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“…Analyses of medical records from before vs. after natural catastrophes such as Hurricane Katrina in 2005 [ 1 , 19 ] and the 2011 earthquake/tsunami in Japan [ 39 , 131 ] have indicated disproportionately increased morbidity and mortality among the elderly [ 118 ]. This has not been a universal finding, however [ 183 ].…”

Section: The Eas and Biomarkers Of Risk With Applications To Covid-1mentioning

confidence: 99%

The extended autonomic system, dyshomeostasis, and COVID-19

2020

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The pandemic viral illness COVID-19 is especially life-threatening in the elderly and in those with any of a variety of chronic medical conditions. This essay explores the possibility that the heightened risk may involve activation of the "extended autonomic system" (EAS). Traditionally, the autonomic nervous system has been viewed as consisting of the sympathetic nervous system, the parasympathetic nervous system, and the enteric nervous system. Over the past century, however, neuroendocrine and neuroimmune systems have come to the fore, justifying expansion of the meaning of "autonomic." Additional facets include the sympathetic adrenergic system, for which adrenaline is the key effector; the hypothalamic-pituitary-adrenocortical axis; arginine vasopressin (synonymous with anti-diuretic hormone); the renin-angiotensin-aldosterone system, with angiotensin II and aldosterone the main effectors; and cholinergic anti-inflammatory and sympathetic inflammasomal pathways. A hierarchical brain network-the "central autonomic network"-regulates these systems; embedded within it are components of the Chrousos/Gold "stress system." Acute, coordinated alterations in homeostatic settings (allostasis) can be crucial for surviving stressors such as traumatic hemorrhage, asphyxiation, and sepsis, which throughout human evolution have threatened homeostasis; however, intense or long-term EAS activation may cause harm. While required for appropriate responses in emergencies, EAS activation in the setting of chronically decreased homeostatic efficiencies (dyshomeostasis) may reduce thresholds for induction of destabilizing, lethal vicious cycles. Testable hypotheses derived from these concepts are that biomarkers of EAS activation correlate with clinical and pathophysiologic data and predict outcome in COVID-19 and that treatments targeting specific abnormalities identified in individual patients may be beneficial.

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Section: The Eas and Biomarkers Of Risk With Applications To Covid-1mentioning

confidence: 99%

The extended autonomic system, dyshomeostasis, and COVID-19

2020

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“…For example, post-Hurricane Katrina, many older adults relied on the informal relationships and social networks to respond to impacts and were not willing to accept formal support offered or available to them [41]. In addition to physical impacts, the psychological impacts of disasters are also more pronounced in older persons than in younger adults and require a special attention from practitioners and policy-makers, especially in a form of customized risk communication [42]. For example, among people displaced by Hurricane Katrina, the psychological well-being was positively correlated to their age, physical status, and functionality within the immediate family, while the broader socioeconomic determinants like income, education, and race were less impactful on psychological status [43].…”

Section: Introductionmentioning

confidence: 99%

Aging in Flood-Prone Coastal Areas: Discerning the Health and Well-Being Risk for Older Residents

Bukvic

Gohlke

Borate

et al. 2018

IJERPH

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Coastal communities are increasingly exposed to more intense and frequent hurricanes, accelerated sea-level rise, and prolonged tidal inundation, yet they are often a preferred retirement destination for older adults vulnerable to flooding and extreme weather events. The unique physical and psychosocial challenges of older population age 65 and over may affect their level of preparedness, capacity to cope with, and ability to respond and recover from a hazard event. Despite the clear vulnerabilities of older residents living in high-risk areas when compared to younger coastal populations, there is a lack of empirical research on the integrated flood risks to this population group in the coastal context. This paper provides a holistic assessment of this emerging problem along the U.S. East Coast by measuring the exposure of older population to sea level rise and storm surge in coastal counties. It further evaluates how age-related vulnerabilities differ between rural and urban settings using the case study approach and geospatial and statistical analysis the paper also conducts a review of scientific literature to identify gaps in the current understanding of health and well-being risks to aging populations in coastal communities. The results show that older populations are unevenly distributed along the U.S. East Coast with some states and counties having significantly higher percent of residents age 65 and older living along the shoreline. Many places with larger older populations have other attributes that further shape the vulnerability of this age group such as older housing stock, disabilities, and lower income and that often differ between rural and urban settings. Lastly, our study found that vast majority of research on aging in high-risk coastal locations has been conducted in relation to major disasters and almost none on the recurrent nuisance flooding that is already affecting many coastal communities.

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“…15 Considerable chaos occurs, and stress is provoked in those with chronic diseases and the elderly. 16 Disasters also affect the health care sector. Hospitals and community dialysis units can be compromised or closed by damage to supplies or staff shortages.…”

mentioning

confidence: 99%

Renal Failure Patients in Disasters

Lempert

Kopp

2019

Disaster med. public health prep.

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Disasters occur regularly, and frequently large numbers of patients treated with maintenance dialysis or with the recent onset of acute kidney injury are put at risk owing to the lack of access to dialysis care precipitating also a kidney failure disaster. The absence of necessary dialysis treatments can result in excessive emergency department visits, hospitalizations, morbidity, or an early death. Those with kidney failure are often evaluated in disaster medical locations or hospitals without nephrologists in attendance. Here we offer guidance for medical personnel evaluating such patients so that dialysis-dependent individuals can be properly assessed and managed with the need for urgent dialysis recognized. A disaster dialysis triage system is proposed. (Disaster Med Public Health Preparedness. 2019;13:782–790)

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Psychological and Physical Impacts of Extreme Events on Older Adults: Implications for Communications

Cited by 19 publications

References 58 publications

The extended autonomic system, dyshomeostasis, and COVID-19

The extended autonomic system, dyshomeostasis, and COVID-19

Aging in Flood-Prone Coastal Areas: Discerning the Health and Well-Being Risk for Older Residents

Renal Failure Patients in Disasters

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