[Event Report] International symposium "Global aging, Healthy aging - Where we are and where we are going-" (held on February 28, 2022)

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On February 28, 2022, the international symposium "Global aging, Healthy aging -Where we are and where we are going-" was held online.

The Extending Healthy Life Expectancy Project team invited experts in various sectors around the world to discuss what is "healthy aging" and "healthy life expectancy", and what we can do now for our own later life. This two-hour online symposium was hosted by Professor Masako Toriya from Keio University Global Research Institute (KGRI), and as many as 70 people participated.

The symposium started with the opening remarks by Professor Masato Yasui from School of Medicine, Keio University, and the director of KGRI. He described the backgrounds of establishment of Keio University Global Research Institute (KGRI) in 2016, and the Research Project Keio 2040 in 2021. He also mentioned that this symposium is a part of the "Extending Healthy Life Expectancy Project" which aims to develop international multidisciplinary discussion on aging and healthy life expectancy.

The opening remarks were followed by a presentation of Professor Jin Nakahara from School of Medicine, Keio University and the deputy director of KGRI.

Professor Nakahara started his presentation with the overview of Japanese current and near-future issues as an aging society, which are so-called "2040 issues", including rapid decrease in working age population; "10-years gap" between life expectancy and healthy life expectancy; great numbers of nursing and care professionals who quit their job every year; approximately half of Japanese population who will live alone by 2040; and increase in medical and welfare expenses. Professor Nakahara emphasized that it is the quality of our lives that really matters, not the quantity, and we need to reset the goal of our lives as a society to live our lives more happily.

Next, three panelists gave presentations.

The first panelist was Professor Yasumichi Arai from Faculty of Nursing and Medical Care, Center for Supercentenarian Medical Research, Keio University. Professor Arai has been involved in studies of centenarians in Japan for 20 years, and his presentation entitled "How to promote Healthy Aging; Lessons from Supercentenarians" consisted of four parts: (1) overview of centenarians (100-104 years old), semi-supercentenarians (105-109 years old) and supercentenarians (over 110 years old) in Japan, (2) results of genetic and biological studies regarding supercentenarians, (3) influencing factors for longevity, and (4) results of his recent study on how COVID-19 pandemic influenced elder's lifestyle. He emphasized that in addition to genetic and biological factors, frequency of physical activity significantly affects mortality in people over the age of 85, and it is never too late to start exercising. The study on behavioral change and hygiene practices of Japanese older adults during COVID-19 pandemic revealed that having a daily neighborhood communication may prevent decline in conversation time even during emergencies, suggesting the significance of human interrelationship for our well-being. The presentation was concluded by illustrating four elements of healthy longevity: social function such as active working and financial security, wellbeing such as happiness and life satisfaction, biological aging such as frailty and disease of aging, and functional age such as cognitive, physical and sensory functions.

The second panelist was Dr. Daniel Holman from Department of Sociological Studies and the Healthy Lifespan Institute, the University of Sheffield. His presentation "Social determinants, health inequalities and healthy ageing" was composed of three parts: (1) the concept of healthy aging, (2) social determinants and health inequalities, and (3) what individuals and societies can do to promote healthy aging and increase healthy life expectancy. According to WHO, healthy aging is defined to have the functional ability to do what we/society value, and Dr. Holman explained that the functional ability is the result from intrinsic capacity of an individual, the environment that forms the context of an individual's life, and the interaction between the two. It was pointed out that social determinants of health and healthy life expectancy are often shaped by wider cultural, economic factors, which can lead to inequality of healthy aging. Therefore, policies must target the social determinants of health in the context of healthy aging inequality, and by doing so, health inequalities can be narrowed. He also highlighted that inequalities exist not only in place where people live, but also occupation, education, gender, ethnicity etc., which overlap and interact with each other, and we need to be aware of these intersectional factors when considering healthy aging. The presentation was concluded that individual responsibility and social determinants are both important for health behaviors, and decrease of inequality is a long-term policy goal.

The third panelist was Professor Douglas K. Sato from Institute of Geriatrics and Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul. In his presentation "Healthy Aging", Professor Sato firstly described aging situation in Brazil, secondly presented factors on health and healthy life expectancy, and lastly introduced some of the initiatives that he has been involved in his university to promote healthy aging. He explained that the issues of aging society that Japan is facing right now will also be seen in Brazil in the next few decades. He stressed the significance of changing the way people consider "health" by stating that although people tend to focus on physical factors when it comes to health, mental health, sleeping, eating, and body hygiene are also important factors. In addition, the combination of genetic, lifestyle, social, environmental factors can all impact healthy life expectancy. The initiatives that Professor Sato has been working on include "the University for Seniors @ PUCRS" which provides opportunities for older people to improve their physical and mental health as well as social relationships, and "physical activity incentive program for the elderly" whose objective is to prevent, treat and rehabilitate the older people with multiple pathologies through personalized physical activity and group activities. At the end of his presentation, Professor Sato introduced a program that is waiting to be implemented; in particular, he has been organizing a program of innovative network for the development and application of new technologies and businesses to promote healthy aging in collaboration with academic and startup companies.

These presentations were followed by discussion with all the panelists, Professor Nakahara, Professor Toriya, and Dr. Kazumi Ota from the Extending Healthy Life Expectancy Project team. There were questions from the project team and the audience.

Q1. When two people have the same kind and severity of disease, one may have a socially active lifestyle and good health behaviors whereas the other may withdraw from social activities and have poor health behaviors: What can be the influencing factors for different health-related behaviors that people take after they are diagnosed with certain diseases? If there is a stigma against certain diseases, especially dementia, why do you think it happens and what we can do to minimize it?

Professor Sato: I think there is a stigma, and some people believe that they are not capable. Through our initiatives, we try to reduce their self-criticism and encourage them by telling "It is OK to forget sometimes, but the important thing is to stay active". This is also one of the social interventions to reconnect people with others and society and reduce a risk of acceleration of dementia or other diseases.

Dr. Holman: One example is the concept of mental health literacy. Knowing about the disease including its cause, prevalence, and treatment can help to get rid of stereotypes that people may have and make people more likely to get treatments. Another example is the peer support groups, which can also be helpful to destigmatize.

Q2. When we emphasize healthy life expectancy, there is a risk that people who already have diseases or disabilities can be left behind: What kind of approach can we take to include them in a discussion of healthy life expectancy?

Professor Arai: There should be opportunities for those people with diseases and disabilities to participate in the society and community to maintain their health. There should be healthy aging strategies to include these people, not only healthy people.

Professor Nakahara: As mentioned in my presentation, like the patient who is very happy to be alive with the help of technologies despite having ALS, there are people in the world who are changing the definition of what is "healthy". It is not about accepting the diversity but to be diverse, and it is about how we can contribute to the society in a proactive way.

Professor Sato: The message is that people want to be useful no matter what kind of disabilities they have. So, I believe that if we can offer people the feeling of being helpful and useful, they will become happier. In our initiatives, we try to connect people to eliminate the feeling of loneliness, and also to make them feel that they can offer something; for example, advice from their life experiences to the society and younger generations such as being senior mentors in projects.

The symposium came to an end with the closing remarks by Professor Nakahara.

With the experts from various fields of study and countries, each presentation and answer for discussion illustrated unique point of view on health and healthy life expectancy, yet there were also common themes among them. This informative and insightful online symposium was also favorably received by the audience, and a successful starting point for the Extending Healthy Life Expectancy Project.

Note: The affiliations of the lecturers are as of Feb. 28, 2022

【Related News】
https://www.kgri.keio.ac.jp/news-event/092686.html

【Inquiries】
Keio University Global Research Institute (KGRI)
The Healthy Life Expectancy Project team
e-mail: kgri_2040pj[at]info.keio.ac.jp
(Please replace [at] to @ in the email address)