Department of Public Health, Fukushima Medical University, Fukushima, Fukushima Prefecture 960-1295, Japan.
Department of Public Health, Iitate Village, Fukushima Prefecture 960-1803, Japan.
Int J Environ Res Public Health. 2018 Jul 6;15(7):1430. doi: 10.3390/ijerph15071430.
The aim of this study is to assess the risk factors for incident functional disability among long-term evacuees of Iitate village after Great East Japan Earthquake and nuclear disaster (GEJE). We also investigated the effectiveness of exercise classes as an intervention measure in this situation.
1159 subjects (75.2 ± 5.8 years, 57.5% female) were included at baseline, and followed-up for four years. Cox proportional hazard regression analysis was used to estimate the hazard ratio (HR) of incident functional disability according to the presence of risk factors evaluated by the municipality’s self-assessment Basic Checklist (BCL). Evacuees from Iitate who participated in the exercise classes and those who did not were matched using the propensity scores, which were then used to obtain the HR of incident functional disability.
New functional disability occurred in 280 (24.2%) participants during the follow-up. Participants who scored negative for the “Physical function” domain in the BCL had a HR of 2.04 (95% CI: 1.54⁻2.69) for incident functional disability when compared to those who scored positive for this domain. Similarly, the HR for “Cognitive function” was 1.37 (CI: 1.06⁻1.77), and 1.60 (CI: 1.24⁻2.08) for “Depression”. Using a Cox proportional hazard regression model, both the group with low-participation in the exercise program and the group with high-participation in the exercise program had a significantly lower rate of incident functional disability compared to those who did not participate at all (HR = 0.27, CI: 0.16⁻0.46; HR = 0.30, CI: 0.12⁻0.74, respectively).
Pre-disaster BCL domains were useful to identify individuals at risk of functional disability after a major socio-technical disaster. Therefore, this instrument can be used to identify at-risk older adults who would benefit from early exercise programs to prevent incident functional disability.
本研究旨在评估东日本大地震和核灾难（GEJE）后长尾村长期撤离者发生功能障碍的危险因素。我们还研究了运动课程作为干预措施在这种情况下的效果。
共有 1159 名受试者（75.2±5.8 岁，57.5%为女性）在基线时纳入研究，并随访四年。采用 Cox 比例风险回归分析，根据市政当局自我评估基本检查表（BCL）评估的危险因素，估计发生功能障碍的风险比（HR）。对参加运动课程和未参加运动课程的入组者进行倾向评分匹配，以获得发生功能障碍的 HR。
随访期间有 280 名（24.2%）参与者发生新的功能障碍。与“生理功能”域评分阳性的参与者相比，BCL 中“生理功能”域评分阴性的参与者发生功能障碍的 HR 为 2.04（95%CI：1.54⁻2.69）。同样，“认知功能”的 HR 为 1.37（CI：1.06⁻1.77），“抑郁”的 HR 为 1.60（CI：1.24⁻2.08）。采用 Cox 比例风险回归模型，低参与运动项目组和高参与运动项目组的功能障碍发生率均明显低于未参与组（HR=0.27，CI：0.16⁻0.46；HR=0.30，CI：0.12⁻0.74）。
灾难前 BCL 域有助于识别重大社会技术灾难后功能障碍的高危人群。因此，该工具可用于识别高危老年人，他们可以从早期运动计划中受益，以预防功能障碍的发生。
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