Centenarians in Japan -- an Overview

Volume 2 I, No. 3 1989 Centenarians in Japan Centenarians in Japan An Overview Shigekazu Hishinuma S.M.I.A.J. President The Institute of Gerontology and Biotology Professor, Shiraume Womens’ College Tokyo, Japan 1. Trends of the number of centenarians Expectations of Life at Birth in 1963 were 67.21 for males and Since 1963, when the Old-age Welfare Law was introduced, 72.34 for females, which were much lower than those in the Ministry of Health and Welfare has been required to Sweden (71.60 for males, 75.70 for females) and in the Neth- erlands (71.1 for males, 75.9 for females), both for 1961-65; and present certificates and token gifts in the name of the Prime Minister to those who will become 100 years old between April still lower than those in U.S.A. (white, 67.5 for males, 74.4 for females) in 1963. But improvement in mortality was so out- of one year and March of the following year, and to publish a list of centenarians each year. standing in Japan after 1963 that it became the highest level in the world in 1987, with 75.61 for males and 81.39 for females. In 1983 the scope of presentations was expanded to include Increase of life expectancy was attributable to improvement in the survival of children, in particular a reduced infant those living abroad, in commemoration of 20th anniversary of Old-age Welfare Law. The presentations took place at embas- mortality, until the 1960s. After 1970 lower mortality in older ages was the major contributor. This fact may be the cause of sies and consulates under the auspices of the Ministry of the steady increase of centenarians. Foreign Affairs. The numbers of centenarians in the whole of Japan, in Okinawa Prefecture, where centenarians have the highest rate, and in Honolulu, as an example overseas, are Table 1 includes the number of centenarians in Honolulu as shown in Table I for 1963 and 1983 through 1988. The number an example abroad. Comparable figures in 1988 are available of centenarians in 1963 was 153 (20 male, 133 female), with a for San Francisco (2 male, 7 female, oldest 105 years old), Seattle (1 male, 1 female, oldest 101 years old), Chicago (1 low rate of 0.16 per 100,000 of population. It increased steadily to exceed 1,000 in 1981, when there were 1,072, and reached male, 2 female, oldest 105 years old), New York (2 female, 1,200 in 1982 with 1.01 per 100,000 (the figures for 1982 are not oldest 105 years old), Portland (2 female, oldest I04 years old) shown in the table). There were 2,668 in 1988, this was 17 times and Los Angeles (2 male, 7 female, oldest 105 years old). as many as in 1963, with 2.20 per 100,000. 2. Centenarians in Okinawa Prefecture and the Study of The number of centenarians will continue to increase and will Makoto Suzuki exceed 5,400 in the year 2000, with probably more than 4 per Okinawa Prefecture had by far the highest rate of centenarians 100,000. One of the reasons to explain this rapid increase in in all prefectures at 10.01 per 100,000 population in 1988. the number of centenarians is improved mortality of old Expectations of Life at Birth in Okinawa in 1985 were 75.9 for people. Expectations of Life at Birth and at Age 65 are shown males and 82.6 for females, the latter being Japan’s highest. for corresponding years for both sexes in Table 2. Table 1 Number of Centenarians Japan Okinawa Prefecture Honolulu Year Total Male Female Total Male Female Total Male Female 1963 153 (0.16) 20 133 1983 1354 (1.14) 269 1085 58 (5.1) 12 46 7 3 4 1984 1563 (1.30) 347 1216 68 (5.93) 11 57 19 5 14 1985 1740 (1.45) 359 1381 76 (6.55) 11 65 25 5 20 1986 1851 (1.53) 361 1490 90 (7.65) 22 68 26 6 20 1987 2271 (1.85) 462 1809 97 (8.23) 19 78 27 5 22 1988 2668 (2.20) 562 2106 118 (10.01) 18 100 32 7 25 Note: Figures in parentheses indicate rate per 100,000. 186 Journal of Insurance Medicine Volume 2 I, No. 3 1989 Table 2 the national average (4.8); however, mortality after birth Life Expectancy at Birth and at Age 65 would be lower than others because of the warm climate. In terms of cause of death mortality rates are low for malignant at Birth at Age 65 neoplasm, diabetes mellitus, heart disease, hypertension, cer- Year Male Female Male Female ebrovascular disease, and in particular for stomach cancer. 1963 67.21 72.34 12.10 14.70 Makoto Suzuki, Faculty of Medicine, University of Ryukus, 1981 73.79 79.13 14.85 17.93 wrote a book "Science of Centenarians" (1985, Shinchosha) 1982 74.22 79.66 15.18 18.35 about his continuing study on old people, including centenarians, in Okinawa Prefecture from 1976. The research included 1983 74.20 79.78 15.19 18.40 medical examinations. The following are his observations. 1984 74.54 80.18 15.43 18.71 1985 74.78 80.48 15.52 18.94 First, ADL (Activities of Daily Living) of centenarians were 1986 75.23 80.93 15.86 19.29 observed. ADL was evaluated on a scale of 5 points. 5 points is the maximum ability and 1 point is the minimum ability. 1987 75.61 81.39 16.12 19.67 Taking "meal" for example: 1 point is "fully dependent, full support"; 2 points is "support required"; 3 points is "only just Okinawa Prefecture is in the subtropical zone, with average independent"; 4 points is "independent but slow"; and 5 temperatures in Naha higher than 20°C. between April and points is "fully independent". November, and higher than 16°C. between December and March without any snow fall. This warmer climate is good for health. Suzuki compared the ADL of 81 centenarians in Okinawa One of the reasons for high expectation of life of the Japanese in from his study between 1976 and 1982 with 214 centenarians Hawaii (77.74 for males, 81.54 for females in 1980) is the warm in the whole of Japan, who were surveyed by the Japan climate. Infant mortality in Okinawa in 1988 (5.0) was higher than Institute for Gerontological Research and Development in Figure 1 ADL (Activities of Daily Livings) of Centenarians n 1 2 3 4 5 Average Point Japan Meal Okinawa Japan Point 1: [] Fully dependent, Evacuation Okinawa 80 ~ J (4.2) full support Japan Point 2: [] Support required Urination Okinawa 8O ] (4.1) ~ Point 3: [] Only just Japan independent Standing Okinawa Point 4. [] Independent, Japan but slow Area of Behavior Okinawa Point 5: [] Fully independent Japan Bathing Okinawa 78 ~Y:’Y:’. ~ (3.0) Japan 204 "JG%:: i i (3.2) Clothing Okinawa Japan Hearing Okinawa Japan Eyesight Okinawa 79 ~ J (3.9) Japan Expression of Will Okinawa Japan 205 ] (4.2) Comprehension [l~ ! I !:i ~ Okinawa 0 50 100% 187 ~ Volume 21, No. 3 1989 Centenarians in Japan Table 3 Toshihisa Matsuzaki points out 5% errors in their family reg- Family History of Centenarians istrations. The most common errors in family registers are: (1) no registration was made at birth, or an older dead sibling’s Age Father Mother Brother Sister Spouse registration was inherited, (2) error of recording in the register, (No. of persons) (3) error caused by rearrangement of the register after destruc- tion by natural calamity. >100 0 2 0 2 2 91-99 1 3 6 21 7 An example of error (1) is S. Kawada (female) listed on the list 81-90 6 14 19 28 12 of centenarians in 1977 as born on April 2, 1877. She corrected this in 1982, with the information that she inherited her dead > 80 30 28 88 75 72 elder sister’s registration, and her real age was 10 years youn- 68 Unknown 76 20 30 19 ger. M. Fujisawa (female), born on April 9,1876, was the oldest Total 114 114 133 156 112 living centenarian on the latest list, however, there is a suspi- cion that she inherited her sister’s registration, and she may 1975. As shown in Figure 1, Okinawa is superior in all aspects, have been only 99. The case of S. Akiyama (female) is a bit probably because old people can engage in outdoor farming different. Her date of birth was registered as November 4,1877 throughout the year. at her marriage. But it was her sister’s birth date, and the correct date was December 18, 1883. Second, 114 centenarians were asked about their family history in the survey made between 1976 and 1983. As shown in An example of error (2) is Y. Kamata (female), born on Febru- Table 3, there are too many "unknown" to make a definite ary 28, 1876. Her register was wrongly recorded when she conclusion, but their families enjoyed long lives in general. transferred it from Chiba Prefecture to Tokyo. The correct year Concerning longevity and family history, I will mention in of birth was 1886. S. Izumi (male, 1865.6.29-1986.2.21) is said Section 4 the results of the survey made by the Japan Health to be the oldest person in the Guiness Book, however, Promotion and Fitness Foundation in 1981. Matsuzaki believes his age at death was 105 instead of 120.

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