Examining apathy prevalence and associated factors among older adults after the Great East Japan Earthquake: a...

Apathy is one of the psychological symptoms seen in post-disaster survivors. Apathy in older adults has been suggested to be associated with functional decline, but the actual situation and associated factors of apathy in the affected areas are unclear. This study aimed to clarify the sense of apathy experienced by older adults residing in areas affected by the Great East Japan Earthquake (GEJE) in 2011 and categorized the factors associated with apathy based on their narratives.

A triangulation-mixed-method sequential explanatory design was employed. Data were collected using a mail survey among 9754 randomly selected community-dwelling independent adults, aged between 65 and 84 years, living in Kesennuma City, one of the GEJE-affected areas, in October 2019. Of these, 7845 completed the analysis criteria, and participants who scored ≥ 2 on three apathy items of the Geriatric Depression Scale were considered to have apathy. An exploratory Poisson regression analysis was conducted to identify relevant factors of apathy. In addition, 36 participants were interviewed by telephone, and associated factors of apathy were categorized by thematic analysis of narrative data.

The mail survey results indicated that apathy had a prevalence of 44.2%. Four factors were commonly associated with apathy in both men and women: subjective cognitive decline (p < 0.05), frailty (p < 0.01), social participation (p < 0.01), and depressive mood (p < 0.01). The thematic analysis of the interviews revealed three types of apathy: (A) Decline, caused by decreased physical and social functioning due to aging or illness; (B) Crisis, caused by major life-changing events, such as bereavement, divorce, unexpected retirement, or disaster; and (C) Carry Over, caused by strained family relationships and stressful social situations during old age.

In addressing apathy, it is important to check for the co-occurrence of depression, life satisfaction, and the availability and utilization of social support.