Japan as the front‐runner of super‐aged societies: Perspectives from medicine and medical care in Japan

Background The demographic structure of a country changes dramatically with increasing trends toward general population aging and declining birth rates. In Japan, the percentage of the elderly population (aged ≥65 years) reached 25% in 2013; it is expected to exceed 30% in 2025 and reach 39.9% in 20...

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Bibliographic Details
Published in:Geriatrics & gerontology international 2015-06, Vol.15 (6), p.673-687
Main Authors: Arai, Hidenori, Ouchi, Yasuyoshi, Toba, Kenji, Endo, Tamao, Shimokado, Kentaro, Tsubota, Kazuo, Matsuo, Seiichi, Mori, Hidezo, Yumura, Wako, Yokode, Masayuki, Rakugi, Hiromi, Ohshima, Shinichi
Format: Article
Language:English
Subjects:
Activities of Daily Living
Aged, 80 and over
Aging
clinical medicine
Delivery of Health Care - trends
geriatric medicine
Geriatrics
Geriatrics - standards
Geriatrics - trends
Gross Domestic Product
Health care
Health education
Health Services Needs and Demand - trends
home‐based care
Humans
Japan
Life Expectancy - trends
multidisciplinary
Population Dynamics - trends
Quality of care
Quality of Life
super‐aged society
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Summary:Background The demographic structure of a country changes dramatically with increasing trends toward general population aging and declining birth rates. In Japan, the percentage of the elderly population (aged ≥65 years) reached 25% in 2013; it is expected to exceed 30% in 2025 and reach 39.9% in 2060. The national total population has been decreasing steadily since its peak reached in 2008, and it is expected to fall to the order of 80 million in 2060. Of the total population, those aged ≥75 years accounted for 12.3% as of 2013, and this is expected to reach 26.9% in 2060. As the demographic structure changes, the disease structure changes, and therefore the medical care demand changes. To accommodate the medical care demand changes, it is necessary to secure a system for providing medical care. Japan has thus far attained remarkable achievements in medical care, seeking a better prognosis for survival; however, its medical care demand is anticipated to change both qualitatively and quantitatively. As diseases in the elderly, particularly in the old‐old population, are often intractable, conventional medical care must be upgraded to one suitable for an aged society. What is required to this end is a shift from “cure‐seeking medical care” focusing on disease treatment on an organ‐specific basis to “cure and support‐seeking medical care” with treatments reprioritized to maximize the quality of life (QOL) for the patient, or a change from “hospital‐centered medical care” to “community‐oriented medical care” in correlation with nursing care and welfare. Current situation and problems (1)  Necessity for a paradigm shift to “cure‐and‐support seeking medical care” In addition to the process of aging with functional deterioration of multiple organs, the elderly often suffer from systemically disordering diseases, such as lifestyle‐related diseases, as well as geriatric syndrome and daily activity dysfunction; therefore, integrated and comprehensive medical care is required. In addition, with regard to diseases in the elderly, not only their acute stage, but also their chronic and intermediate stages must be emphasized in their treatment. Aiming to achieve a complete cure of disease by exploring the cause and implementing radical treatment, the conventional medical care model is difficult to apply to the medical care of the elderly; medical care suitable for the elderly is required. (2)  Spread of home‐based care and the necessity for human resources development M
ISSN:1444-1586
1447-0594
DOI:10.1111/ggi.12450