1. Reviewing the definition of “elderly”Based on comprehensive analysis of data on longitudinal studies of functional independence in the elderly and clinical and pathological data, I proposed the change of the definition of elderly to those over 75 years instead of the current 65 years.2. Philosophy and strategies of the medical care of elderly3. Concept of integrated medicine4. Kampo-medicine plays a major role as the main partner of the modern western medicine in establishing the integrated medical system in Japan, which will contribute to the upgrading of medical care of elderly.
Elderly ; Medical ; Century ; medical care ; System

Underwater weighing is based on the assumption that fat-free body density is roughly constant among humans. This assumption should be examined, because fat-free body density may in fact depend on the bone mineral and water contents of the body, with fat excluded. The purpose of this study was to investigate the effects of bone mineral content (BMC) and density (BMD) on the accuracy of body fat measured underwater. The subjects were 12 young men (25.1±3.7 years, mean ± SD), some of whom were trained athletes. BMC and BMD were measured by dual-energy x-ray absorptiometry (DXA), as was body fat, as a percentage of body weight; this method is not based on the assumption that fat-free body density is the same in different individual. Body fat as a percen tage of body weight was measured underwater, also. Body fat measured by DXA was significantly correlated with that found by underwater weighing (r = 0.83, p<0.01), as expected, but the mean body fat found by DXA was 4.3% higher. The differences between results by the two methods for individuals were from -11.5% to 2.7%, and the differences were negatively correlated with BMC/fat-free weight (FFW ; r=-0.82, p < 0.01) and BMD (r=-0.85, p<0.01) . Fat-free body density ranged from 1.097 to 1.111 g/cm³because BMC/FFWs varied with the individual. We concluded that individual differences in BMC/FFW and BMD affected the fat-free body density. The variations in fat-free body density would give rise to systematic errors in body composition measured underwater.

OBJECTIVES: This study aimed to identify factors associated with initiation and adherence of osteoporosis medication from a patient perspective. METHODS: A web-based survey was developed based on health behavior theories. Descriptive analyses were conducted for all survey items. Analyses in a structural equation modeling framework were conducted to identify factors associated with treatment initiation and adherence. RESULTS: Five hundred forty-five women completed the questionnaire. A majority were currently receiving medications for osteoporosis (n = 376, 69.0%) and 25.0% of these patients (n = 94) were considered adherent to their treatment. Knowledge was strongly associated with osteoporosis treatment initiation (standard error [SE], 0.58). Greater knowledge of disease was associated with increased likelihood of initiating medication. Medication complexity (SE, 0.49) and perceived susceptibility to fracture and loss of independence (SE, −0.37) were also associated with initiation. Perceived barriers (SE, −0.85) such as inconvenience, lack of efficacy and financial burden were observed to be the greatest obstacle to adherence. The greater the perceived barriers, the less likely patients were to adhere to medication. Patients' perception of self-efficacy (SE, 0.37) also affected adherence. The greater the patient perception of ability to independently manage their medication, the more likely they were to adhere to the medication. CONCLUSIONS: Different factors were found to be associated with initiation and adherence of osteoporosis medication. Patient knowledge of their disease and the perception of barriers were found to be the most influential. Empowering patients with the knowledge to better understand their disease and decreasing the perception of barriers through education initiatives may be effective in improving patient outcomes.
Education ; Female ; Health Behavior ; Humans ; Japan* ; Osteoporosis* ; Patient-Centered Care