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 problem

Prenatal stress and its effect on infant development

In this dissertation the effect of prenatal maternal stress on infant development and behavior is discussed. In a prospective longitudinal study of 170 nulliparous women, data was gatheren on the maternal stress level three times during pregnancy by means of questionnaires and endocrinologic parameters (Cortisol, ACTH). After birth, the infants were examined up to the age of 8 months with the Bayley Scales of Infant Development and their behavior was rated by observation and by maternal report (Infant Characteristics Questionnaire; ICQ, Bates). The dissertations starts with a systematic review of studies concerning the influence of prenatal maternal stress on animal offspring. Next, the fears and stessors in human pregnancy are discussed in the preceeding chapters. In particular, pregnancy related anxieties and coping with stressors in a normal risk pregnancy are analyzed in detail. In addition, a multidimensional model of prenatal stress is presented. After describing the concept of prenatal maternal stress in humans, the effect of prenatal maternal stress on infant development and behavior are discussed. It is found that especially pregnancy-specific nxieties are negatively related to infant mental and motor development. In addition, women who experienced many fears during pregnancy have an increased risk of getting an infant with adaptational problems and difficult behavior in the first 8 months of life. Implications for clinical practice and recommendations for future research are offered