@article{ref1,
title="Do adverse childhood experiences modify the association between disaster-related trauma and cognitive disability?",
journal="American journal of epidemiology",
year="2023",
author="Okuzono, Sakurako S. and Slopen, Natalie and Shiba, Koichiro and Yazawa, Aki and Kondo, Katsunori and Kawachi, Ichiro",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Identifying subpopulations that are particularly vulnerable to long-term adverse health consequences of disaster-related trauma is needed. We examined whether child adversities (ACEs) potentiate the association between disaster-related trauma and subsequent cognitive disability among older adult disaster survivors. <br><br>METHODS: Data were from a prospective cohort study of older adults who survived the 2011 Great East Japan Earthquake. The baseline survey predated the disaster by 7 months. We included participants who completed follow-up surveys (2013 and 2016) and did not have a cognitive disability before the disaster (n=602). Disaster-related traumas (i.e., home loss, loss of friends, or pets) and ACEs were retrospectively assessed in 2013. Cognitive disability levels in 2016 were objectively assessed. <br><br>RESULTS: After adjusting for pre-disaster characteristics using a machine learning-based estimation approach, home loss (0.19, 95%CI=0.09, 0.28) was, on average, associated with greater cognitive disability. Among individuals with ACEs, home loss was associated with even higher cognitive disability levels (0.64, 95%CI=0.24, 1.03). Loss of friends (0.18, 95%CI=0.05, -.32) and pets (0.13, 95%CI=0.02, 0.25) were associated with higher cognitive disability levels only among those with ACEs. <br><br>CONCLUSION: Our findings suggest that individuals with a history of ACEs may be particularly vulnerable to adverse health consequences of specific disaster related.<p /> <p>Language: en</p>",
language="en",
issn="0002-9262",
doi="10.1093/aje/kwad158",
url="http://dx.doi.org/10.1093/aje/kwad158"
}