@article{ref1,
title="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",
journal="BMC geriatrics",
year="2021",
author="Kamiya, Kenji and Maeda, Masaharu and Yasumura, Seiji and Harigane, Mayumi and Okazaki, Kanako and Nagao, Masanori and Nakano, Hironori and Ohira, Tetsuya and Hayashi, Fumikazu and Suzuki, Yuriko and Yabe, Hirooki and Takahashi, Atsushi",
volume="21",
number="1",
pages="e18-e18",
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. <br><br>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. <br><br>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. <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="1471-2318",
doi="10.1186/s12877-020-01934-9",
url="http://dx.doi.org/10.1186/s12877-020-01934-9"
}