Doctors have come up with a novel idea for helping Japan keep pace with its rapidly ageing population: raising the definition of senior citizen to those aged 75 years and older.
A leading campaigner says the commonly accepted 65-year threshold is “terribly outdated” and needs to be lifted to take account of longer life expectancy and changing social attitudes to ageing.
Dr Yasuyoshi Ouchi, a hospital president and former chairman of the Japan Geriatrics Society, said the proposal was not meant to give political cover for increasing the pension age. Instead, people in their late-60s should be given greater flexibility to continue working or volunteering for community groups if they wished to do so, he said.
“Those who feel that they are still healthy when they reach 60 or 65 are forced to retire, and that means those who are used to supporting others become those who need to be supported by others instead,” Mr Ouchi told an audience at the Foreign Press Centre Japan on Tuesday. “We think this kind of treatment is so outdated.”
Under the proposals advanced by a joint committee of the Japan Gerontological Society and the Japan Geriatrics Society, people aged 65-74 would be classified as “pre-old age” and those over 75 would be considered to be in the “old age” category. Those who have passed their 90th birthday would be described as “super-old”.
Demographic challenges
Japan has long grappled with demographic challenges as older people increasingly represent a greater share of a population that, overall, is declining in number. The proportion of the population that is over 65 is projected to rise from 27 per cent now to 38 per cent in 2065.
This poses budgetary challenges as dwindling numbers of working-age taxpayers will need to support greater demands on health and care services. While one senior citizen was supported by an average of 2.3 workers in 2015, this ratio is expected to go down to one senior for 1.3 workers by 2065, according to official data.
Mr Ouchi, who serves as president of Toranomon hospital in Tokyo, said Japan's ageing population was sometimes portrayed in a negative light but he saw a vibrant future in which older people were empowered to contribute to society if they still had the desire and ability to do so.
He pointed to a cabinet office survey that showed only about one in 20 respondents considered someone aged over 65 to be old. He also cited evidence of “rejuvenation” in the health of older people in Japan in the past few decades.
For example, while the risk of stroke still increases as people get older, there has been an overall decline in the rates experienced among 65-79-year-olds between 1995 and 2010. Another study found an increase in older people’s walking speed and grip strength between 1992 and 2002, with the latter phenomenon most pronounced among women.
“We believe that 75-year-old mark is quite appropriate because we can see from clinical experience that usually 75 years of age will present a major turning point,” Mr Ouchi said.
Positive ageing
One of Japan's foremost advocates of positive ageing, Shigeaki Hinohara, died on Tuesday at the age of 105. The honorary head of St Luke's International hospital in Tokyo had continued practising medicine after he turned 100.
Hinohara was a prolific lecturer who often called on older people to maintain an active social life and take control of their own destinies. He was among 65,692 centenarians living in Japan last year – a record high.
The total population of Japan is projected to decline from 127 million in 2015 to 88 million by 2065, but the over-65 segment is likely to increase from about 34 million now to a peak of 39 million by the 2040s before slipping back to 34 million in 2065.
While longer lifespans are positive, health services are also braced for an increase in the number of people with dementia. Japan’s ministry of health, labour and welfare predicts about seven million – or one in five over-65s – will have the condition in 2025, Kyodo News reported.
– Guardian service