Objective:Demonstration of the current status of the elderly with dementia in Japan.
Design:Crystallize the issues of the demented elderly by reviewing the recently published demographic data and evaluate the efforts to cope with the issues in Japan. Materials and Methods:Published reports of Ministry of Health, Welfare and Labor, Japanese Psychogeriatirc Society, Japanese Mental Hospital Society, and Medical Center for Dementing Disorders were reviewed.
Results:The average life span of men and women are 77,64 and 84,62 years respectively. Currently, 18.9% of the general population is over 65 years of age. Rate of prevalence of dementia in the elderly over 65 years is 8.6 % .The most common cause of dementia is Alzheimer's disease (AD). Until recently, vascular dementia (VD) used to be a most frequent cause of dementia. Recent VD/AD ratio decreased remarkably until 0.7 in 1996. Now, 142 "Medical Centers for Dementing Disorders", affiliated to the General Hospital or Hospital of Medical University, are functioning as clinical and research centers for the dementing disorders in the elderly. There are 1058 Mental Hospitals with approximately 357,000 inpatients in the year 2002. Numbers of elderly patients in Mental Hospitals are approximately 103,000 (AD:10,612,VD: 22,773, and Other Organic Mental Disorders: 61,624). Elderly patients with dementia are commonly treated by physicians, psychiatrists and neurologists. Japanese Psychogeriatric Society (JPGS) have 2519 members in the year 2002. As specialists JPS certified 385 members at the moment. The names of Specialists can be found in the website of JPGS (http://www.rounen.org). There are three types of Institutions for the elderly with dementia. Namely, "Special Nursing Home for the Elderly" (340.000 beds) , "Nursing Home for Elderly People" (95,000 beds) and "Health Service Facility for the Elderly"(283,000 beds) . Beside these institutions, there are 2,200 "Group Home" for the slightly demented peoples, who are able to live together in the small group in the community. Most of elderly peoples with dementia (73.9%) are in home. Approximately 80 % of caregivers feel the care as physical, psychological and economical burdens. New insurance system; "Long-term Care Insurance" started, since the year 2000. Municipal governments manage this Insurance. All Citizens, over 45 years of age, have to pay the premium for the insurance. And, peoples, over 65 years of age, have a right to receive care services in homes or in institutions, if its necessities are approved by the Operating Committee. The Insurance covers the expenses of institutional care. "Day Care" or "Short-stay" in institutions, arranged and financially covered by the Insurance, may reduce the burdens of the caregivers in home.
Conclusion:Although the increase of the aged in general population causes serious problem in the society, good results have been obtained by collaborative efforts of Government, medical and paramedical professionals and community to cope with the issues of the elderly with dementia in Japan.
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