chronic disease in an older person does not necessarily indicate that he or she is no
longer healthy. Many older adults with one or more chronic diseases maintain good
functional abilities and report high levels of well-being.
The WHO framework to foster health aging is built around the new concept of
functional ability. Intrinsic capacity encompasses physical, emotional, and cognitive
capacity as well as vision, balance, and mobility, while functional ability, such as
person–environment fit, comprises health-related attributes that enable people to be
and do what they have reason to value. This new framework requires that health
systems transition from disease-based curative models toward provision of integrated care centered on older adults. It will further require initiation or refinement of
comprehensive systems for long-term care. Such a system necessitates a coordinated
response from multiple sectors and levels of government and will utilize better ways
of measuring and monitoring the health and functioning of older populations.
Besides, care and preventive care are being conducted mainly by older adults.
The problems of older adults are considered by different categories based on their
functional status, such as community-dwelling older adults, older adults in nursing
homes, and hospitalized older adults. Would healthy aging be achieved by such a
categorized group based on age and functional limitations? Translationality, in all or
part of a society, is needed to systemically change the framework of policy and
informatics of healthy aging that can be applied to ageing societies worldwide. This
axiom applies to every entity, including communities, hospitals, nursing homes, and
countries. Translationality underlies the transition from an existing system to a new
system. The present chapter focuses on several health indexes (ie, physical performance, nutritional biomarkers, and cognitive function) that overlap with intrinsic
capacity and functional ability, as described in the new WHO concept, and describes
health trajectories for aging among community-dwelling older Japanese. This population, which represents the super-aged society of Japan, may be an ideal target for
development of health promotion strategies in a global aging society. Using data and
information from the super-aged society of Japan, the author developed a framework
of policy and informatics of healthy aging that can be applied to aging societies
worldwide.
First, I will describe the participants and statistical analysis methods for the
studies discussed in this chapter. The participants were from the Kusatsu Longitudinal Study (Shinkai et al., 2016), which recruited residents of Kusatsu town, Gunma
Prefecture, Japan. Kusatsu has a population of approximately 7000, and 30% are
aged 65 years or older. The main industries are spas and tourism. Under the Health
Services for the Elderly Act, passed in 1983, municipal governments in Japan must
offer annual preventive health checkups for citizens aged 40 years or older. In
conjunction with this service, the Tokyo Metropolitan Institute of Gerontology
launched longitudinal studies of aging and health in 2001, in which older participants underwent an additional comprehensive geriatric assessment and a health
monitoring survey. All residents aged 65 years or older in Kusatsu town were invited
to participate in annual health checkups at the local public health center (Taniguchi,
Yoshida, Fujiwara, Motohashi, & Shinkai, 2012) and in health-monitoring surveys
by mail or home visit. The Kusatsu Longitudinal Study is ongoing, and the total
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Y. Taniguchi and H. Matsushita
longer healthy. Many older adults with one or more chronic diseases maintain good
functional abilities and report high levels of well-being.
The WHO framework to foster health aging is built around the new concept of
functional ability. Intrinsic capacity encompasses physical, emotional, and cognitive
capacity as well as vision, balance, and mobility, while functional ability, such as
person–environment fit, comprises health-related attributes that enable people to be
and do what they have reason to value. This new framework requires that health
systems transition from disease-based curative models toward provision of integrated care centered on older adults. It will further require initiation or refinement of
comprehensive systems for long-term care. Such a system necessitates a coordinated
response from multiple sectors and levels of government and will utilize better ways
of measuring and monitoring the health and functioning of older populations.
Besides, care and preventive care are being conducted mainly by older adults.
The problems of older adults are considered by different categories based on their
functional status, such as community-dwelling older adults, older adults in nursing
homes, and hospitalized older adults. Would healthy aging be achieved by such a
categorized group based on age and functional limitations? Translationality, in all or
part of a society, is needed to systemically change the framework of policy and
informatics of healthy aging that can be applied to ageing societies worldwide. This
axiom applies to every entity, including communities, hospitals, nursing homes, and
countries. Translationality underlies the transition from an existing system to a new
system. The present chapter focuses on several health indexes (ie, physical performance, nutritional biomarkers, and cognitive function) that overlap with intrinsic
capacity and functional ability, as described in the new WHO concept, and describes
health trajectories for aging among community-dwelling older Japanese. This population, which represents the super-aged society of Japan, may be an ideal target for
development of health promotion strategies in a global aging society. Using data and
information from the super-aged society of Japan, the author developed a framework
of policy and informatics of healthy aging that can be applied to aging societies
worldwide.
First, I will describe the participants and statistical analysis methods for the
studies discussed in this chapter. The participants were from the Kusatsu Longitudinal Study (Shinkai et al., 2016), which recruited residents of Kusatsu town, Gunma
Prefecture, Japan. Kusatsu has a population of approximately 7000, and 30% are
aged 65 years or older. The main industries are spas and tourism. Under the Health
Services for the Elderly Act, passed in 1983, municipal governments in Japan must
offer annual preventive health checkups for citizens aged 40 years or older. In
conjunction with this service, the Tokyo Metropolitan Institute of Gerontology
launched longitudinal studies of aging and health in 2001, in which older participants underwent an additional comprehensive geriatric assessment and a health
monitoring survey. All residents aged 65 years or older in Kusatsu town were invited
to participate in annual health checkups at the local public health center (Taniguchi,
Yoshida, Fujiwara, Motohashi, & Shinkai, 2012) and in health-monitoring surveys
by mail or home visit. The Kusatsu Longitudinal Study is ongoing, and the total
60
Y. Taniguchi and H. Matsushita