Natural hazards and mental disorders in older adults: A meta-analysis on prevalences and comparison to younger cohorts

Objectives: Older adults (≥60 years) often report better mental health than younger cohorts but may be more vulnerable to natural hazards due to limited mobility and injury risk. This meta-analysis examined mental disorder prevalences among older adults post-hazard and compared them to younger populations. Methods: PRISMA guidelines were followed. We systematically searched MEDLINE, PsycINFO, and Web of Science for epidemiological studies published from inception to October 2024. Eligible studies focused on ICD-/DSM-based mental disorders ≥1 month post-hazard and reported prevalence estimates or odds ratio (OR) for age-related differences in prevalences (i.e., in adults ≥60 years vs. <60 years). Random-effects models were used for all analyses. Results: Thirty-eight studies (N = 29,342 older adults; N = 41,575 younger adults) were included. PTSD prevalence in older adults was 17.43% (95% CI [8.48%; 32.48%], k = 8, I2 = 97.10%) in the first year post-hazard and 10.07% (95% CI [6.32%; 17.45%], k = 14, I2 = 96.10%) in long-term assessments (range 15 months to 17 years). MDD prevalence (combined across time points) was 4.70% (95% CI [1.76; 12.00], k = 7, I2 = 92.60%). Older adults were not significantly more likely than younger adults to meet PTSD criteria in the first year post-hazard (OR = 1.22, 95% CI [0.80, 1.84], k = 12, p = .324, I2 = 70.00%) or in its long-term aftermath (OR = 1.24, 95% CI [76.38, 2.04], k = 9, I2 = 73.50%, p = .329). Heterogeneity was substantial across all analyses (I2 > 70%). Data for MDD-related comparisons were limited, and information on other mental disorders than PTSD and MDD in this population was scarcely reported. Conclusions: PTSD and MDD prevalences were elevated in older adults post-hazard but similar to younger adults. More research is needed on other mental disorders and age-related moderators of post-disaster mental health.