OLDER ADULTS' VIEWS OF “SUCCESSFUL AGING”: COMPARISON OF OLDER JAPANESE AND AMERICANS

要旨

To the Editor: The attractive concept of “successful aging”1 implies a subjective sense of value of older people regarding the best quality of later life, as well as the absence of severe chronic disease and disability, maintenance of good physical and cognitive abilities, and preservation of the social and productive activities. One study reported older adults' subjective beliefs about the importance of 20 attributes of successful aging identified in the published literature in two elderly American populations: Japanese Americans and white Americans.2 The results showed that Japanese and white Americans similarly reported almost two-thirds of the 20 attributes found in the published literature as important to successful aging. To address this interesting issue, the same survey was conducted in 5,207 community-dwelling elderly subjects (2,261 men, 2,946 women, mean age 75.7) living in four towns in Japan. The study population consisted of 2,109 community-dwelling people aged 65 and older living in Sonobe in Kyoto (1,004 men, 1,105 women, mean age 75.3), 1,359 in Tosa in Kochi (560 men, 799 women, mean age 75.6), 575_15 in Urausu in Hokkaido (227 men, 331 women, mean age 75.5), and 1,181 in Miyagawa in Mie (470 men, 711 women, mean age 76.8). Sonobe in Kyoto, Urausu in Hokkaido, Tosa in Kochi, and Miyagawa in Mie are located in the central, north, south, and west parts of Japan, respectively. The elderly population in these four towns were answering a comprehensive geriatric assessment every year. A self-administered questionnaire including 20 attributes of successful aging translated into Japanese from the table reported by the previous study, as well as additional questions about activities of daily living (ADLs), instrumental ADLs, and quality of life was mailed to all eligible elderly subjects. Each subject was asked to answer “important,”“neutral,” or “not important” on each item of 20 attributes of successful aging. For ADL assessment, subjects rated their independence in seven items (walking, ascending and descending stairs, feeding, dressing, toileting, bathing, and grooming) and rated them from 3 to 0, with 3 indicating completely independent, 2 indicating needing some help, 1 indicating needing help much, and 0 indicating completely dependent. The items were added to give scores ranging from 0 to 21, with lower scores indicating greater disability.3,4 The rate of eligible elderly subjects who completed the questions about the 20 attributes of successful aging in Sonobe in Kyoto, Tosa in Kochi, Urausu in Hokkaido, and Miyagawa in Mie were 64%, 85%, 68%, and 81%, respectively. Table 1 shows the rates of respondents who answered “important” on each item of 20 attributes of successful aging among older people in these four towns and two American populations reported by the previous study. Although mean ADL scores were statistically significantly different between the elderly subjects in these four towns, each mean score was greater than 19.0 (range 0–21), indicating that the majority of the elderly participants were independent in ADLs and not so frail. The number of items 75% or more respondents rated as important varied from five to eight of the 20 attributes (7/20 in all Japanese) in Japanese elderly, whereas Japanese Americans and white Americans rated 13 and 14 of the 20 attributes as important, respectively. Both American groups commonly rated as important all items rated as important by Japanese elderly except item 4 (having the kind of genes (heredity) that help me age well). Japanese elderly people rated only one of three of the attributes found in the published literature as important to successful aging, whereas Japanese and white Americans rated almost two-thirds of them as important. Item 6 (staying involved), item 7 (make choices), item 8 (able to meet needs and wants), item 9 (not feeling lonely), item 16 (feeling good), item 17 (able to cope with the challenges), and item 18 (able to act according to own i

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