I have mentioned on “what is the healthy long survival”. To make one's life healthy the factor of DNA is highly evaluated. However, new environment brings a great influence. Efforts to put one's existence into a new environment are highly evaluated. I emphasize the healthy condition is structured in a new environment. One should have courage to put it into an action. I introduced the association of the New Elderly which I started in 2000. As the elderly have a plenty of time, try to use your time to initiate a new thing and do it with courage. The members of the new elderly are encouraged to be involved in teaching kids on importance of the life and have time to visit them in their elementary schools. Health is the product of a good habit.

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 A new physical activity and exercise guideline (Exercise Guide 2006) asks Japanese, aged 20-69, to follow the slogan “Let's target 23 Ex (METs hour) per week by physical activity, of which 4 Ex by active exercise!” for preventing life-style related diseases. This amount of physical activity and exercise was conferred by systematic review on mainly epidemiological studies. Furthermore, this guideline shows level of physical fitness, especially maximal oxygen uptake necessary for preventing life-style related diseases.

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 The Japanese Food Guide Spinning Top was developed by the government as a new education tool for promoting healthy eating in 2005. The concept was unique in the world, not only due to its shape of a reverse triangle, but also due to “dish-based approach”, not “food-based” one, which was adopted to advance acceptability and usability especially in a fraction of less health-conscious people like middle-aged men. Serving sizes and reference ranges of servings were determined for grain dishes, vegetable dishes, fish and meat dishes, milk and fruits. In addition to those five major dish/food groups shown on the spinning top, snacks or beverages expressed as a string to rotate it, should be moderated to avoid the excess energy intake. One of the most important points of the Food Guide is to be widely disseminated through the food systems involving farm producers, food manufacturers and distributors including supermarkets, convenience stores, and catering establishments. In that context, the Food Guide has been expected to promote the linkage between “access to information” and “access to food” for the betterment of “food environment” in the population strategies for preventing lifestyle-related diseases.

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 In the era of old age, health maintenance and promotion of the elderly has become one of the most important political issues throughout the world. Although the comprehensive geriatric assessment has now been a common approach in the clinical situation, there must be another strategy in the practice of Health Evaluation and Promotion. The Health Research Volunteer study has initiated in 2002 as a single cohort observational study to elucidate the process of frailty among 408 voluntary members belonging to the Association of New Elder Citizens started as a movement aiming to achieve the new lifestyle based on good living concept of Socrates. Preliminary results of the study obtained from 318 people will be presented in the symposium. Dropout rate of the study was 8.8% and 18 deaths (6.2%) were observed. Frailty defined by the CSHA criteria was found in 30 subjects (10.3%) and its incidence was three times more in females than in males. Multiple logistic regression analysis revealed four significant predictors for frailty including non-fat mass, upper arm muscle area, walking speed and self-assessment of cognitive decline. Other objective parameters associated with aging during 5 years observations also identified. Based on these findings, essentially minimum items for detection of frailty were proposed in the practice of health evaluation and promotion for the elderly.

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 In order to determine the degree of disturbance of memorization in the consultation room, it is recommended that the physician ask questions about what the patient had for breakfast and how he or she reached the hospital (itinerary using the bus, train, car, etc.). These questions do not offend patients or impair the dignity of elderly patients. The physician may obtain the right answer from the accompanying family member. If the answer given by the patient is wrong, the diagnosis of disturbance of memorization can be made. A simple test may be made by asking the patient to remember three words, such as cherry, cat and train, and to repeat them immediately. Ask questions such as “what date is it today?”, “Where are you now?”, etc., and then, ask the patient to repeat the three words they have just remembered. If they fail to answer correctly, the diagnosis of disturbance of memorization can be made.

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