Introduction: We previously established that housing loss and residential dislocation in the 2011 Japan earthquake and tsunami was a risk factor for cognitive decline among older survivors. The present study extends the follow-up of survivors out to 6 years. Methods: The baseline for our natural experiment was established in a survey of older community-dwelling adults who lived 80 km west of the epicenter 7 months before the earthquake and tsunami. Two follow-up surveys were conducted approximately 2.5 years and 5.5 years after the disaster to ascertain the housing status and cognitive decline from 2810 older individuals (follow-up rate through three surveys: 68.4%). Results: The experience of housing loss was persistently associated with cognitive disability (coefficient = 0.14, 95% confidence interval: 0.04 to 0.23). Discussion: Experiences of housing loss continued to be significantly associated with cognitive disability even six years after the disaster.
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