Abstract
Physical and mental changes that were once regarded as aging phenomena with no room for intervention are now being viewed from a new perspective as diseases or disease-like conditions due to the aging of the population. Representative examples are sarcopenia and frailty. These two conditions have been reported to have a significant impact on healthy life expectancy, inducing the development of new diseases, falls, fractures, cognitive decline, and social isolation, and increasing the risk of long-term care, hospitalization, and death.
The importance of sarcopenia has been proposed because age-related atrophy of skeletal muscles leads to the risk of health problems such as falls and fractures in older people. On the other hand, frailty is a condition in which the body's reserve capacity gradually declines with age, leading to physical dysfunction, and the concept of frailty as a reversible state that can be restored to health through various appropriate interventions has emerged. Since muscle strength and physical function (e.g. walking speed) are common diagnostic criteria, it is easy to imagine that there is an overlap between the two. However, sarcopenia refers to the decline of skeletal muscles, while frailty is a broader concept that includes not only muscle decline but also nutritional status, psychological status, physical activity, and other diagnostic items.
In Japan, the high-risk approach has been implemented by local governments and other organizations, but has yet to yield significant results. One of the reasons for this is that the intervention was conducted for a certain period of time, but the sustainability of the intervention could not be guaranteed. This approach requires not only local governments, but also industry, education, and other sectors to work together. The population approach should include measures to create an environment in which these preventive effects occur naturally (zero-level prevention), and it is desirable to take a multifaceted approach for older people.
