by Elyse M. Rogers
Tokyo Metropolitan Gerontology Center — Yoikuin
Most Japanese are well aware that the aging society will soon be a very real part of their lives. Even the foreign population here is aware of the statistics often quoted in the local papers regarding the aging composition of the Japanese society. It’s estimated that in the year 2000, 15 percent of all Japanese will be above 65 years of age, and that by the year 2020, the figure will jump to 25 percent. Then, Japan will become the most “aged” society on the globe.
As one Japanese told me recently. “It’s ironic that years ago such statistics would have been a reason for rejoicing in this country; now they simply worry us. The economic implications are enormous, and the problem of quality of life for the aging is an uneasy concern even for the young.”
Doesn’t it always seem that way in life, and in medicine as well? We solve one problem only to come up with others that prove equally difficult or more difficult to solve. We wiped out smallpox and got AIDS: we increased longevity and got Alzheimer’s disease to deal with.
It was with such thoughts in mind that I went to see Torn Tsumita, M.D., the director of The Tokyo Institute of Gerontology. Dr. Tsumita has been the head of this research branch of the Gerontology Center for the last three years. He comes well qualified, having been head of the Biochemistry Department at the University of Tokyo’s Department of Medical Sciences.
Since biomedical research is an important part of the research being conducted at the institute. Dr. Tsumita should feel right at home. In fact in his work at Todai he studied the formation of senile cataracts, a subject on which he has already given a symposium at the center.
Being appointed to this position after his retirement from academia, he finds it enjoyable but different. “Most of my responsibilities are administrative,” he says, “rather than research oriented.”
HISTORY OF THE CENTER
Since the institute or research center is part of the larger body. Yoikuin, let’s talk about the long history of the main organization. By the way, the word Yoikuin, if translated literally, means “Institution for Protection and Fostering,” which is rather a nice concept.
The center was actually started more than 100 years ago in 1872, right after the shosunate turned over the government to Emperor Meiji and the Meiji Restoration started. The purpose of the center at that time was to protect the many people in Tokyo Prefecture who had been left homeless by the ushering in of the new era.
The center went through several changes throughout its first century of existence, but perhaps the most dramatic occurred after World War II. Nine-tenths of the buildings on the Itabashi Campus (the present location which has been rebuilt) were destroyed as a result of air raids, and the focus of the center changed. Because of the need for services for parentless or homeless children, the service was directed toward that use.
In 1963, with the enforcement of the Law for the Welfare of Old People, all the Public Assistance Institutions which belonged to the Yoikuin at the time became Homes for the Aged. In 1972 (the centennial anniversary of the center) the present Geriatric Hospital opened its doors. The whole focus and legitimacy of the center was enhanced by the Law for the Health Services of Old People which was put into force in 1983.
It is most interesting that there is no National Agency for the Elderly in Japan. In the United States, for example, the National Institute on Aging (NIA) which is part of the National Institutes of Health, has a leadership role in all programs and research directed toward the aging population.
However, because of the lack of a national agency here, the Tokyo Metropolitan Gerontology Center sort of fills that bill. It’s a credit to the city and people of Tokyo, I think, that they have assumed that vital role for so long. (There are plans. I understand, to form a national agency in the future, but no one is quite sure of when that will happen.)
The institute itself was begun in 1969, when a special committee was organized by the governor to plan a research institute for the Yoikuin. In 1970 construction on the institute building (at the main Itabashi Campus) was started and it was completed in 1972. In 1981 the Institute was reorganized and became a private foundation to promote active and creative research. In 1984, an agreement was reached on research collaboration with the National Institute of Aging (NIA) in the U.S.
This U.S.-Japan association has been a fruitful and vibrant one, according to Dr. Tsumita, which is shown by the fact that in November, 1988, 10 people from the Tokyo Institute traveled to the NIA in Maryland to discuss the topic joint research project which is in an area of concern to both countries — osteoporosis “Aging and Disease” with fellow U.S. researchers. Another interesting aspect of the collaboration is a first (bone loss associated aging).
GOALS AND PROGRAMS
Dr. Tsumita names the two main goals of the institute:
1. To discover, through research, how people might enjoy a more healthy aging period. (Through basic research on the aging process or diseases related to aging, and by means of epidemiological studies, new data on the problems of aging will be gathered and acted upon.)
2. To suggest to all citizens of Japan (of all ages) ways in which they could help ensure a better quality of aging life. (In other words, to suggest life-style measures which would statistically help to reduce health problems of the aging, such as a lower-salt diet, routine exercise, etc.)
Since there are 31 research sections of the institute, I can’t cover them all or even list them all. But I would like to name a few so that you get the general idea of the programs they are pursuing:
- Longitudinal Studies on Aging and Life Span. Biochemical researchers have come up with a sort of hypothetical life-span limitation. In other words, if human cells functioned as they should, with no diseases to wipe them out or alter then, how long would they last? Currently the theory is that humans have a total of 115 years, and that’s it. Which is why, as Dr. Tsumita explains, there are 2,600 centenarians (people over 100 years of age) in Japan, but only two over 110 years of age.
- Aging of Blood Vessels and Cerebral Blood Flow of the Aging. Both of these studies are aimed at the problem of brain health in the elderly. If blood flow to the brain is decreased, or if the vessels become weakened or diseased, dementia (senility) problems often occur. This is an area that worries many of us — we fear loss of mental acuity for our family members or ourselves in the aging process. The Institute has other projects on “Age-related Dementia” and such studies and programs are an important aspect of the institute’s focus.
- Ordinary Research Departments conduct their own on-going studies or investigations. Departments of Pathology, Biochemistry, Pharacology, Psychology, etc., are busily pursuing important studies in those specific areas. For example, in the Department of Sociology they are doing studies on the social aspects of aging or on the social needs of the aging population. The need for housing, the changing of the family structure (towards the nuclear family), the problems of self-care, and the relationship of mandatory retirement to aging are all being addressed by the Institute’s Department of Sociology.
For research purposes many animals are raised at the center. Believe it or not. they have a population of 6,000 mice and 2,000 rats for lifespan studies. These animals are kept in special pathogen-free areas and allowed to live out their lifespan. (The idea being to investigate the pure, normal aging process as compared with the aging process in which outside diseases play a part.) In addition, the laboratory animal population numbers more than 500, which includes a few guinea pigs, rabbits, dogs and cats.
As part of their on-going charge not only to do research on the aging, but also disseminate information to the public, the institute conducts two yearly seminars, open to any citizen of Tokyo. These are held twice a year in the Asahi Life Insurance building auditorium, usually to packed audiences of 650.
One recent seminar, held in November, 1988. was entitled “Life-Span—Past, Present, and Future.” Some of the other past seminar topics have been, “Incontinence — Cause and Treatment,” “Aging and Cataracts,” etc.
According to Dr. Tsumita, at the seminars there are always lots of questions from the audience, too, which “keeps us on our toes.”
THE ITABASHI CAMPUS
I keep talking about “campuses” and you may wonder if I’m regressing to my days at Purdue. But in Japan, governmental and medical complexes are often referred to as “campuses.” In this case the main campus or location of the Gerontology center is in Itabashi, and it certainly is a large one. In addition to the Institute the campus contains a huge geriatric hospital with a capacity of 703 beds, a nursing home with a capacity of 610 beds and a home for the aged which has 521 beds.
The total staff of the Yoikuin numbers more than 2,000, which includes the institute staff of 186 (100 have doctorate degrees). The Itabashi campus also includes a school of nursing, with 100 students enrolled.
There is another campus at Higashi-Murayama, which has two homes for the aged (bed capacity of 920 and 210), and the Tama Geriatric Hospital with a capacity of 320 beds. A new nursing home is scheduled for opening later this year.
For future expansion, which the center knows is imperative, they have the problem of available real estate. (They face the same problem as does every business and organization in Tokyo), They arc looking to reclaimed land for possible future building sites, according to Dr. Tsumita.
Although you probably won’t be strolling around any of the Yoikuin campuses, in case you have a specific need or question, here’s the address and phone number of the main campus: Yoikuin (Tokyo Metropolitan Gerontology Center), 35-2 Sakaecho, Itabashi-ku, Tokyo 173. Phone 964-1131.