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Purpose: A stroke is a debilitating condition that can cause lifelong disability, severely limiting the ability of individuals to perform daily activities. In Japan, strokes are the fourth leading cause of death; however, no previous studies have examined the influence of strokes on a disabled or disability-free life for older Japanese residents. This study aims to address this gap.Methods: The study used data from the Nihon University Japanese Longitudinal Study of Aging (NUJLSOA) and incidence-based multistate life tables to estimate disabled and disability-free life expectancy based on the stroke status of Japanese residents aged 65 and older.Results: Japanese stroke survivors aged 65 who experienced an initial disability-free state could expect to live approximately 3 fewer total years of life, 4-5 fewer years in a disability-free state, and 1-2 more years in a disabled state compared to those without history of a stroke (p < 0.05). For those disabled at the beginning of the survey interval, the differences between individuals with and without stroke history were also similar to those disability-free at the beginning of the survey interval (2-4 and 5-6 fewer total and disability-free years, respectively) (p < 0.05). The same pattern was observed for older age groups.Conclusion: Older adults who have experienced a stroke could experience a shorter total life expectancy, shorter disability-free life expectancy, and longer disabled life expectancy than those who have not experienced a stroke. These results can inform policymakers and rehabilitation practitioners on stroke survivor long-term care needs and their post-stroke health status. [ABSTRACT FROM AUTHOR]

In recent years, several rapidly aging countries have looked towards the introduction of a national long-term care insurance (LTCI) policy to deal with the needs of their graying population. This article presents a comprehensive overview of the LTCI policy in Japan and the reforms made, and discusses the successes and challenges of the policy over the ten-year period since its implementation in April 2000. The objective is to provide some policy guidelines so that other countries can benefit from Japan's early experience. All Japanese adults aged 65+ are covered by the LTCI program and are eligible for both in-home and institutional-care services after a systematic and thorough care-level certification process. The utilization of services is planned and coordinated by care managers. The program is financed by a mix of general tax revenues from the three levels of government, income-tested premiums, and standardized co-payments. Reforms in later years included the introduction of preventive services and the levy of charges on accommodation and meals at institutional facilities. A key success of the policy is its universal and comprehensive coverage. Notwithstanding this success, increasing costs continue to remain a challenge as Japan's population ages further and the number of LTCI users increases. [ABSTRACT FROM AUTHOR]

Objectives To investigate the robust education–health association found in Western developed nations in the Japanese context. We examined disability and mortality transitions and computed active life expectancy (ALE) by educational attainment for a cohort of Japanese adults aged 65+ years. Method Nationally representative data from the Nihon University Japanese Longitudinal Study of Aging over a 10-year period in Japan (1999, 2001, 2003, 2006, and 2009) were used (N = 4,968). Disability was measured by difficulties in performing daily activities. A multistate life table method was employed using an interpolated Markov chain approach. Results There is little effect of education on disability and mortality transitions. Except for transiting from an active to inactive state (disability incidence), the other health transitions, including to mortality, are not statistically significant. ALE computations show that Japanese men and women with more education can expect more years of remaining life and active life. Discussion The robust education–health relationship found in Western societies does not seem applicable in Japan. We discuss the casual mechanisms addressed in the literature in relation to Japan’s relatively egalitarian society and specific characteristics. [ABSTRACT FROM PUBLISHER]

Aim: The aims of this study are to investigate the accuracy of self-reported height, weight, and derived BMI of community-dwelling Japanese aged 70 and older, and to assess the concordance between report-based and measurement-based BMI categories. Methods: We compared self-reported height and weight with physical measurements from data from a nationally representative sample ( n = 1634). Results: Self-reported values were strongly correlated with measured values (Pearson's r: 0.92 and 0.89 for men and women, respectively, for height; 0.96 for both sexes for weight; 0.93 and 0.91 for men and women, respectively, for BMI). The differences in mean values were small. On average, height was overreported by 0.93 cm (SD = 2.48) for men and 1.23 cm (SD = 2.84) for women. Weight was underreported by 1.08 kg (SD = 2.55) for men and 0.88 kg (SD = 2.45) for women. BMI was underestimated by 0.68 kg/m2 (SD = 1.16) for men and 0.79 kg/m2 (SD = 1.49) for women. As age increases, height overreporting increased, particularly among women, but weight underreporting decreased for women. BMI underestimation increased for both sexes. Weighted kappa values showed a reasonably high concordance at 0.715 and 0.670 for men and women, respectively ( P < 0.0001). Overweight (BMI 25.0 to 29.9) and obesity (BMI ≥ 30) prevalence rates were underestimated, with better specificity (range: 94.4-100%) than sensitivity (range: 59.3-65.1%). Conclusion: The accuracy of self-reported height and weight is reasonably high among elderly Japanese, suggesting that the information can be used in epidemiological surveys. However, caution should be exercised for the oldest age group (age 85+), as the accuracy declined. Geriatr Gerontol Int 2012; 12: 247-256. [ABSTRACT FROM AUTHOR]

Using a nationally representative sample of 4,511 Singaporeans aged 55+ from the 2005 National Survey of Senior Citizens (NSSC), this paper examines gender differences in specific diseases, impairments, and disabilities, and computes health expectancies for these health dimensions. Results show that women have higher prevalence for hypertension, bone/joint, eye/vision, and walking problems, while heart diseases and stroke are more common among men, particularly at younger ages. At ages 75+, women have more disabilities related to basic activities of daily living (bathing, dressing, toileting, transferring, and feeding) than men. Health expectancies computations by the Sullivan method reveal that while women live longer than men, they can also expect more years of life both without and with diseases, impairments, and disabilities. At age 65, a larger proportion of women's remaining life is with hypertension, bone/joint problems, vision impairments, walking difficulties, and functional disabilities compared to same-aged men. The findings largely support the gender health-survival paradox found in Western countries-that women have higher morbidity rates despite longer life expectancy. The morbidity differences between men and women, however, vary depending on the particular health dimension and measure examined. Older women in Singapore tend to be advantaged in prevalence of diseases and disease-free life expectancy, but have more impairments and functional disabilities, and a larger proportion of remaining life with these difficulties compared to older men. Health policies and programs in Singapore will need to cater to these gender differences in specific health dimensions and measures. [ABSTRACT FROM AUTHOR]

Objective: To examine changes in the prevalence of mobility limitations and mobile life expectancy of Singaporeans aged 55+. Method: Data came from the cross-sectional 1995 and 2005 National Survey of Senior Citizens (NSSC; n = 4,750 and n = 4,591, respectively). The prevalence-based Sullivan method was used to disaggregate total life expectancy into expected life time without and with mobility limitations. Results: Increases in life expectancy in the city-state were accompanied by increases in the prevalence of mobility limitations--from 3.0% to 5.7% for men and 5.1% to 9.7% for women. The impairments mostly began after age 65 and increased with age particularly at ages 85+. The proportion of life expectancy without mobility limitations declined over time, at all ages, and for both genders, with women still experiencing a higher proportion with mobility problems compared to men. Discussion: The overall results provided support for the expansion of morbidity hypothesis, and we discussed some possible reasons. From a policy perspective, the findings could suggest a need to develop infrastructures that would enable older Singaporeans to remain mobile in a highly urban setting. [ABSTRACT FROM AUTHOR]