title: The Mental Health of Older Persons After Human-Induced Disasters: A Systematic Review and Meta-Analysis of Epidemiological Data.
abstract: 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.
authors.affiliation: School of Medicine, University of Queensland, Brisbane, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia; Diamantina Health Partners: Centre for Neuroscience Recovery and Mental Health, Brisbane, Australia. Electronic address: d.siskind@uq.edu.au.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Siskind
authors.affiliation: School of Medicine, James Cook University, Townsville, Australia.
authors.forename: Emily
authors.initials: E
authors.lastname: Sawyer
authors.affiliation: School of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Irene
authors.initials: I
authors.lastname: Lee
authors.affiliation: Centre for Research in Geriatric Medicine, University of Queensland, Brisbane, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia; Diamantina Health Partners: Centre for Neuroscience Recovery and Mental Health, Brisbane, Australia; School of Human Services and Social Work, Griffith University, Brisbane, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: Lie
authors.affiliation: School of Medicine, University of Queensland, Brisbane, Australia.
authors.forename: Melinda
authors.initials: M
authors.lastname: Martin-Khan
authors.affiliation: School of Medicine, University of Queensland, Brisbane, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia.
authors.forename: Julia
authors.initials: J
authors.lastname: Farrington
authors.affiliation: School of Medicine, University of Queensland, Brisbane, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia; Diamantina Health Partners: Centre for Neuroscience Recovery and Mental Health, Brisbane, Australia; Queensland University Technology School of Public Health and Social Work, Kelvin Grove, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Crompton
authors.affiliation: School of Medicine, University of Queensland, Brisbane, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia; Diamantina Health Partners: Centre for Neuroscience Recovery and Mental Health, Brisbane, Australia; Griffith Institute of Health, Griffith University, Brisbane, Australia.
authors.forename: Steve
authors.initials: S
authors.lastname: Kisely
mesh_terms: D000060:Accidents, Aviation / Q000706:statistics & numerical data; D004190:Disasters / Q000706:statistics & numerical data*; D005107:Explosions / Q000706:statistics & numerical data; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D047851:September 11 Terrorist Attacks / Q000706:statistics & numerical data; D014857:Warfare
keywords: Mental health; human-induced disaster; meta-analysis; older persons; post-traumatic stress disorder