Abstract
Both life expectancy and healthy life expectancy in Japan have been increasing and are among the highest in the world, but the gap between them has also been widening. To examine the recent trends in old age disability, chronic medical conditions and mortality in Japan, we retrospectively analyzed three nationally representative datasets: Comprehensive Survey of Living Conditions (2001–2013), Patient Survey (1996–2011) and Vital Statistics (1995–2010). We obtained the sex- and age-stratified trends in disability rate, treatment rates of nine selected chronic medical conditions (cerebrovascular diseases, joint disorders, fractures, osteoporosis, ischemic heart disease, diabetes mellitus, hypertension, pneumonia and malignant neoplasms), total mortality rate and mortality rates from specific causes (cerebrovascular diseases, heart diseases, pneumonia and malignant neoplasms) in both sexes in four age strata (65–69, 70–74, 75–79, 80–84 years). Disability rates declined significantly in both sexes. Treatment rates of all selected medical conditions also decreased significantly, except for fractures in women and pneumonia. Both total mortality rate and cause-specific mortality rates decreased in both sexes. We concluded that the recent decline in disability rates, treatment rates of chronic medical conditions and mortality rates points toward overall improvement in health conditions in adults over the age of 65 years in Japan. Nonetheless, considering the increase in the number of older adults, the absolute number of older adults with disability or chronic medical conditions will continue to increase and challenge medical and long-term care systems.
Highlights
Japan’s life expectancy has increased steadily over the past several decades and is one of the highest in the world [1,2,3]
Ischemic heart disease and osteoporosis, the downward trend was statistically significant for all age strata (65–69, 70–74, 75–79 and 80–84) in each sex
In the analysis of nationally representative datasets, we demonstrated that the disability rate and mortality rate declined significantly over time in old adults aged between 65 and 84 in Japan
Summary
Japan’s life expectancy has increased steadily over the past several decades and is one of the highest in the world [1,2,3]. The Survey on the Senior Citizens’ Attitude toward Daily Life, conducted by the Cabinet Office of the Government of Japan in 2009, reported that the majority of respondents considered that the threshold for old age should be higher than the current one, 65 years, and more than 40% thought it should be 70 years [6]. This survey showed that more than a quarter of the respondents answered that an even higher threshold of 75 years is appropriate for old age [6] This may reflect the change in people’s perception towards aging, and it is possible that the biological age, which involves multitudinous factors including elapsed time and nutrition, living environment and medical conditions, may be going down compared with the chronological age. This hypothesis is compatible with the increase in healthy life expectancy that has occurred simultaneously with the increase in life expectancy [1, 3, 7]
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