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transper_1pic.gif Leading the Way in Medicine for a Graying Society National Center for Geriatrics and Gerontology

Advances in the field of geriatrics are urgently needed in Japan, since its population is rapidly aging. In response to this need, the National Center for Geriatrics and Gerontology was established last March in Obu City, Aichi Prefecture. One of the world's few combined hospitals and research institutes specializing in this field, the center hopes to develop models for medical care for the aged and to conduct pioneering research on the aging process and the problems of the aged.

In 1950 the average life expectancy in Japan at the time of birth was 58.0 years for a male and 61.5 years for a female. As of 2003, the figures had lengthened all the way to 78.3 years for men and 85.2 years for women. Over that half-century the lives of the Japanese grew considerable longer, giving Japan the world’s longest-lived people.

A variety of factors have combined to produce this happy result, including a rising standard of living, progress in medical technology, and improvement in the provision of social security, but it remains true that longer lives also give rise to serious social problems. In 1970 Japan reached what the United Nations defines as the threshold of an aging society, in which those aged 65 or over have a share of 7% of the population. Just a quarter of a century later, in 1994, the Japanese population reached the next level of an aged society, in which the share of the elderly is 14% or higher. Advanced European countries have made the same transition, but they went through this process at a much more leisurely pace, from well over 100 years to 40 years at the fastest.

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The designers aimed to make the centerÉs hospital a cheerful place, and they paid close attention to the circumstances of the elderly, using a cushioning material in the floors, for instance, to prevent injury from falls.

The graying of Japanese society is, moreover, still in progress and is expected to go on for some time to come. Bolstering medical care for the elderly and consolidating a research base for the diseases of old age are, accordingly, crucial and pressing tasks. At just this juncture, the National Center for Geriatrics and Gerontology has been established. Located in Aichi Kenko no Mori (Aichi Health Village), an area of Obu City where health-care facilities are concentrated, the center opened its doors last March. Serving as its first president is Shin’ichi Oshima, who has previously been a professor at the Nagoya University Graduate School of Medicine and director of the Nagoya University Hospital.

The NCGG, which is Japan’s first and only state-managed institution in this field, has three parts. Its research center, named the National Institute for Longevity Sciences, was already in existence, having been established in 1995. It has built up a track record in both basic and applied research. The hospital, named the National Hospital for Geriatric Medicine, was newly created, and it aims to offer high-quality medical care using the most up-to-date techniques. Bringing these two parts together is the third part, the NCGG’s administrative branch. There are, moreover, a number of related facilities nearby backing up the center’s efforts to make this a community where the elderly can lead healthy and cheerful lives. Prominent among them are Aiko Home Obu-en, a home for elderly people requiring special care, Luminus Obu, a geriatric health services facility, the Obu Center for Dementia Care Research and Training, and Aichi Kenko Plaza, a comprehensive health facility run by the prefecture.

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Toshiki Ota, director of the National Hospital for Geriatrics Medicine. He stresses the importance of not just using the latest medical technologies but also engaging in conversation with patients and staff members.
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Toshiki Ota, director of the National Hospital for Geriatric Medicine, comments, “Medical care for the aged has conventionally been understood to be just an extension of general medicine for youths and adults, but actually it should be seen as a field unto itself.”

Consider, for instance, pneumonia, a rather common malady. In the case of old people, different methods need to be used both to prevent its occurrence and to treat it. Collecting basic data on such differences was not, as a general rule, easy to accomplish in the past. One of the center’s missions is, accordingly, to assemble data that can throw light on the diseases of old age. Since geriatrics will become an increasingly important medical field in the years to come, this data is expected to be extremely valuable.

A brain section as portrayed by the PET scanner. This instrument is particularly useful in diagnosing and investigating old-age dementia.
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Needless to say, innumerable benefits can be anticipated from the close liaison taking place between the NCGG’s hospital and research institute. Some of the hospital’s doctors are also participating in joint research projects, and they are in a position to input information from clinical practice directly into laboratory research, as well as to take back and apply the fruits of the research. Numerous benefits will also be realized from the assembly of a talented staff with access to cutting-edge medical equipment. One R&D project is attempting to produce an oral vaccine for Alzheimer’s disease. While the research is still at the stage of animal testing, it has drawn favorable comments from around the world for the safety and effectiveness of the vaccine. Since this could be a breakthrough product, the researchers are approaching their work with noteworthy intensity.

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Takeshi Tabira, director of the National Institute for Longevity Sciences
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Takeshi Tabira, director of the National Institute for Longevity Sciences, remarks, “The nature of the dementia associated with Alzheimer’s is so tangled that among researchers it’s developed a reputation even more unfavorable than cancer. The day of revolutionary treatment methods may not be that far off, however, even in the case of knotty diseases like this one.”

At the same time as the Japanese population ages, families are having fewer and fewer children. As a result, the share of persons aged 65 and over in the population is still swiftly growing, and it is projected to reach 19.6% in 2005 and 27.4% in 2025. At that point Japan will have an elderly society the likes of which have never been seen before anywhere in the world. With this situation in the offing, the hospital’s Director Ota offered the following comment on the role the NCGG needs to play:

“Japan today is in the vanguard of geriatrics. In view of this, the advanced medical technologies, the know-how, and the research results our center comes up with will need to be made widely available to communities everywhere in Japan. Meanwhile, other Asian countries are also moving rapidly down the road towards old-aged societies, and they are not that far behind our country. Our center is thus in a position to give valuable assistance to their medical professionals as well.”
(Takashi Sasaki; photos by Tadashi Aizawa)

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