Routine health checkups and cognitive resilience among older survivors of the 2011 Japan Tsunami.

We examined whether annual health check-up attendance was associated with a lower risk of cognitive decline, including among older survivors who lost housing during the 2011 Japan Earthquake and Tsunami. Baseline data were collected seven months before the disaster from 4873 adults aged 65 years or older in Iwanuma City, Miyagi Prefecture. Follow-up surveys in 2013 and 2016 assessed health status, lifestyle, and disaster experiences, and were linked to municipal health check-up records and cognitive function assessments. Using augmented inverse probability weighting adjusted for 40 covariates, we estimated absolute risk differences in percentage points (pp): health check-up attendance was associated with lower risk of cognitive decline (risk difference [RD] -1.12pp, 95% confidence interval [CI] -1.35 to -0.88), with a stronger protective association among those whose homes were destroyed (RD -2.38pp, 95% CI -3.51 to -1.24). Maintaining health check-ups after disasters may mitigate health and lifestyle disruption and support cognitive resilience.