Abstract
In the developed countries including Japan, the average life expectancy is expected to exceed 90 years in the near future. And major causes of death of the super-elderly shift from cancer and cardiac infarction to senility, dementia and pneumonia. These diseases of super-elderly are related to gradual deterioration of both physical and mental abilities to maintain proper condition of daily activities. Several terms have been suggested to describe weaken condition of the super-elderly such as geriatric syndrome, locomotive syndrome, sarcopenia and frailty. Among them, frailty seems to provide an easy-to-understand concept as a word that comprehensively captures both physical and mental deterioration caused by aging. Cycle of frailty causes not only sarcopenia and undernutrition but also decline of life defence mechanism including immune system, homeostasis and surface barrier system. To prevent from the frailty, muscle training, especially resistant muscle training, has been reported as beneficial. Traditional resistance trainings for elderly including Yoga in India, Tai chi, Falun Gong and Qigong in China, may be beneficial since those trainings use abdominal breathing. In Japan, Judo exercises are also tried to prevent the frailty.
Highlights
Mausner and Kramer described a definition of primary, secondary and tertiary prevention in their famous epidemiology text together with the famous schematic representation of the natural history of the disease [1]
The global COVID-19 pandemic revealed a strong dependence of the age on the degree of deterioration in health due to unexpected external factors, the existence of excessive mortality from influenza or pneumonia among elderlies has been known for a long time (Figure 1)
Pneumonia and senility begin to increase at a much later age, but the rate of the increase is faster in pneumonia and much faster in senility, so the mortality rate of malignant neoplasm is exceeded by them before the age of 95
Summary
Mausner and Kramer described a definition of primary, secondary and tertiary prevention in their famous epidemiology text together with the famous schematic representation of the natural history of the disease [1]. Recent improvements in health care standards in the developed countries including Japan, are entering the stage of how to maintain the health of super-elderly who have no particular illness other than ageappropriate decline both mentally and physically. Malignant neoplasm, cardiac diseases and cerebrovascular diseases were the three leading causes of death in Japan.
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