The Mental Health of Older Persons After Human-Induced Disasters: A Systematic Review and Meta-Analysis of Epidemiological Data

Dan J. Siskind, Emily Sawyer, Irene Lee, David C. Lie, Melinda Martin-Khan, Julia Farrington, David Crompton, Steve Kisely

Older people are increasingly "in harm's way" following human-induced disasters (HIDs). There is debate in the literature as to the relative impact of disasters on their psychological health compared with other age groups. Natural disasters and HIDs are thought to affect survivors differentially, and this may extend to older adults as a group. In the absence of existing systematic reviews, we aimed to synthesize the available evidence and conduct meta-analyses of the effects of HIDs on the psychological health of older versus younger adults. A meta-analysis was conducted on papers identified through a systematic review. The primary outcomes measured were post-traumatic stress disorder (PTSD), depression, anxiety disorders, adjustment disorder, and psychological distress. We identified 11 papers from 10 studies on HIDs (N = 26,753), of which 8 had sufficient data for a random-effects meta-analysis. Older adults were 2.85 times less likely to experience PTSD symptoms following HID (95% CI: 1.42-5.70) when compared with younger adults. There was no statistically significant difference in terms of anxiety and depressive symptoms. Health and emergency services need to be increasingly prepared to meet the psychological needs of older people, given the global rise in the numbers of older adults affected by disasters of all kinds. Preliminary evidence suggests that old age may be a protective factor for the development of PTSD in the wake of HID.