Modified and translated by CFJA
Difficulties in Independent Living Increase for Individuals Over 85?
In Japan, the Long-Term Care Insurance System was established in 2000. This is a system to support individuals who have difficulty living independently. The starting age for this support is generally 65 years old, but individuals with specific illnesses can start using it from the age of 40. According to the “Outline of the Survey on the Actual Situation of Long-Term Care Benefits and Expenses for Fiscal Year 2017” by the Ministry of Health, Labor, and Welfare, the utilization rate for men and women is almost the same up to the age of 74. The utilization rates can be summarized as follows:
Age Group Men Women
65-69 years old 114,000 people 92,500 people
70-74 years old 161,000 people 170,000 people
75-79 years old 242,000 people 362,000 people
80-84 years old 345,000 people 735,000 people
85-89 years old 351,000 people 997,000 people
90-94 years old 200,000 people 761,000 people
95 years and older 56,000 people 342,000 people
(Fiscal Year 2017, November examination)
The average life expectancy for Japanese men is 81.47 years (July 2022, Ministry of Health, Labor, and Welfare), so it is estimated that the utilization rates are in line with the average lifespan, considering the period from 78 to around 86 as the typical lifespan. The average life expectancy for Japanese women (2021) is 87.57 years. Considering the period from 84 to around 92 as the typical lifespan, the number of users in their 80s and beyond is 2 to 3 times higher for women compared to men. Looking at women specifically, the number of users in the 80-84 age group is more than twice that of the 75-79 age group, and the number of users in the 85-89 age group is nearly three times higher. While the reasons for using long-term care insurance in Japan vary, it seems that individuals or their families in their 80s feel some anxiety about their daily lives and start utilizing the system. According to the survey overview, the peak age for both men and women is between 85 and 89. It can be inferred that many people find day to day tasks more difficult to complete independently after the age of 85.
Regular Exercise is Essential in the 80s!
The Ministry of Health, Labor, and Welfare in Japan classifies individuals aged 65 to 74 as early-stage elderly and those aged 75 and above as late-stage elderly. As the average life expectancy increases and the elderly population grows, there have been discussions about changing the classification of the elderly. The Japan Geriatrics Society and the Japanese Society of Geriatric Medicine propose the following classification
- 65-74 years old: Pre-elderly
- 75-89 years old: Elderly
- 90 years and older: Very elderly
Both societies state that based on the data regarding the health of the elderly, there has been a “rejuvenation effect” of about 5-10 years compared to 10-20 years ago (delayed appearance of age-related physical functional changes). The increasing number of people aged 90 and above symbolizes Japan as a healthy country. We are approaching an era of 100-year lifespans. However, with the declining birth rate, the number of caregivers will continue to decrease. To minimize the need for caregiving and maintain an independent lifestyle, exercise to prevent muscle weakness is necessary. Based on our clinical experience, we suggest the following minimum exercise times for each age group:
- Early 60s: 2 days a week, 1-1.5 hours
- Late 60s: 3 days a week, 50 minutes to 1 hour
- Early 70s: 4 days a week, about 40 minutes
- Late 70s: 5 days a week, about 30 minutes
- 80s: 6 days a week, about 20 minutes
- 90s: 7 days a week, about 15 minutes
The above are the minimum exercise times necessary to prevent muscle weakness. When you reach 80, your cardiovascular function decreases further, and you may not be able to exercise for extended periods. Exercising at the same intensity as when you were younger can quickly lead to muscle fatigue, joint pain, and discomfort. Therefore, it becomes necessary to exercise frequently and consistently every day. The classification of individuals aged 75 to 89 as “elderly” by the Japan Geriatrics Society and the Japanese Society of Geriatric Medicine is likely based on similar physical data for this age group. Starting from the age of 75, it is important to engage in frequent daily exercise.
Walking is particularly important for preventing muscle weakness. However, as age progresses, walking speed tends to decrease. Many people in their 80s experience a sense of urgency due to realizing they cannot walk as fast as they used to. For this age group, the following tendencies can be observed:
1. Feeling the need to walk quickly due to knowing they cannot walk fast
2. Tending to look down while walking because of unsteady footing
3. Decreased muscle strength leading to poor posture while walking
4. Narrowed field of vision due to looking down while walking
5. Forward-leaning posture during walking resulting in shallow breathing
People in their 80s may easily feel tired simply by walking around the neighborhood or going shopping due to the above-mentioned factors. As you age, muscle weakness and decreased cardiorespiratory function become more pronounced. Even if you have the intention to improve muscle strength by walking, poor posture can have a counterproductive effect. Therefore, it is important to first raise your head, breathe slowly, and wave your hands while walking. Waving your hands naturally lifts your head. It becomes difficult to wave your hands while keeping your head down, so I suggest practicing waving your hands while standing still and getting used to the sensation. By raising your head, breathing becomes easier, and your field of vision expands. This allows you to have more mental space and reduces the urge to walk quickly. Finding a balance that is comfortable for maintaining body alignment is key when waving your hands. Carrying items in a way that allows you to wave your hands is necessary, such as wearing a backpack. You don’t need to make large swinging motions when waving your hands. Find an angle that allows for balance in your body. Walking with your head up and looking ahead while walking in all directions is ideal, but it may be challenging to maintain a good posture at this age. For now, waving your hands and facing forward is the first step towards improvement. Walking with the correct posture helps to acquire well-balanced muscle strength necessary for walking. It also facilitates better breathing, making it easier to walk for longer periods without getting tired.