Disaster and associated changes in physical and mental health in older residents.

BACKGROUND Long-term health consequences of disasters have not been studied extensively, one reason amongst others is that no pre-disaster observation is available. This study focuses on an aeroplane crash on an Amsterdam suburb. The ongoing Longitudinal Aging Study Amsterdam has one pre-disaster and several post-disaster observations, making it possible to study changes in health, taking pre-disaster health characteristics into account. METHODS Three exposure groups are distinguished: those living within a radius of 1 km from the disaster (initial n=39), those living between a radius of 1 and 2 km from the disaster (initial n=56), and those living in the rest of the city of Amsterdam (initial n=508). Health measures include general health, health in comparison with age peers, functional limitations, disability and cognitive functioning. These measures are based on self-ratings, interviewer observations, or both. RESULTS Older persons living closest to the disaster area are likely to experience health decline in the wake of a disaster, over and above the health decline that would occur normally with aging. The disaster-associated health decline is small, and most obvious in the ability to perform actions (such as mobility), but is not observed in either disability in daily functioning, nor in self-perceptions of health. Cognitive functioning even shows a short-term improvement. CONCLUSION These findings suggest substantial resilience in older adults, despite their common health problems.