The proportion of elderly people is increasing. Both atherosclerosis and osteoporosis are important factors in the quality of life of elderly people. Homocysteine reportedly accelerates atherosclerotic changes in vessels and disturbs collagen cross-linking in the extracellular bone matrix. In this study, the clinical significance of serum homocyteine was investigated for health promotion and evaluation. The subjects consisted of 992 people (men: women=672 : 320, mean age=46.3±10.3 years) who participated in a health evaluation and promotion. The cutoff point was determined to be 22.0μmol/L for men and 14.0μmol/L for women. The serum homocycteine level was elevated in 4.6% of the men and 2.6% of the women. Hypertension and fatty liver were found in men with a relatively high level of serum homocysteine. Moreover, hypertension was found in 85.8% of the men with a relatively high level of serum homocysteine who did not meet the Japanese diagnostic criteria for metabolic syndrome and had an abdominal circumference under 85cm. This frequency was significantly higher than 9.2% among men with a serum homocysteine level within the normal range. The bone mineral density (BMD) was measured in 58 people (men: women=15 : 43, mean age=47.8±10.5 years). A low BMD was only observed in 6 women. The serum homocysteine level tended to be higher in 5 menopausal women with a low BMD. All these women had risk factors for atherosclerosis. The above results suggest that the serum homocysteine level plays an important role in the association between atherosclerosis and osteoporosis.

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 Prospective cohort studies examining gender differences in the elderly and including comprehensive assessments of morphology, physical functioning, and psychosocial activities have rarely been reported. The present study, which consisted of a sub-analysis of data from the Health Research Volunteer Study (HRVS), was performed to clarify these issues. Among the 407 subjects in the original HRVS, 257 subjects (115 men, aged 78 ± 4 years; 142 women, aged 77 ± 4 years) were selected. No gender differences in age, observation period, or ill-health (such as hypertension and hyperlipidemia) were observed, although diabetes mellitus and smoking were significantly more common among men than among women in this cohort. Although both men and women exhibited morphological reduction in muscle mass and force and bone density during the 5-year observation period, the reductions were significantly larger in women. Most of the functional parameters, except for hearing deficits, were superior in men. The upper arm blood pressure parameters were similar in men and women except for the upper arm diastolic pressure parameters at baseline, although the difference had disappeared at the end of the observation period. Although the baPWVs of both men and women increased significantly because of aging, no significant differences were observed between the groups. The small but significant differences in the ABI observed within and between the two groups were not physiopathological issues but might have been caused by gender differences in height. The low hemoglobin level at the end of the observation period is unexplained, and the reduced creatinine levels in both genders might have been caused by sarcopenia, rather than renal issues. Falls, reduced physical strength, low vitality, a depressive tendency, and pain were more common in women. Self-efficacy was slightly, but significantly, higher in men. Further studies are needed to confirm these findings.

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 Health evaluation and promotion among the elderly have become major social issues worldwide, especially in Japan. The New Elderly Citizens Association was launched in 2000 at the Life Planning Center Foundation under the direction of Dr. Shigeaki Hinohara. The main objectives of the society are to enhance physical and psycho-social activities among the elderly, promoting social contribution. Here, we summarize the results of a single-cohort, prospective, observational study (the Health Research volunteer Study [HRVS]) to explore the progress of frailty syndrome during a 5-year follow-up period; 407 people over the age of 70 years volunteered to participate in the study. A modified comprehensive geriatric assessment was performed for each participant. The 5-year outcomes were as follows: dropout, 8.4%; death, 5.4%; frailty, 16%; and non-frailty, 70.2%. A univariate analysis revealed significant differences between the frail and non-frail groups for 18 items. Of these items, timed walk, pulse pressure, cognition deficits, and auditory deficits were significant predictors of frailty in a multivariate analysis. Since the odds ratios for these four items were similar, a simple additive formula was used to create a prediction model for frailty (present = 1, absent = 0). A score of 0 had a 90% negative predictive value, while a score of 4 had a 70% positive predictive value for frailty. Interestingly, relations between these independent items and dementia are suspected, and an association between hypertension and dementia has long been discussed. Since no guidelines for hypertension have examined the issue of pulse pressure, the relevance of this topic to the diagnosis and treatment of frailty should be examined. The results of the HRVS will be useful in future studies examining the prediction of frailty in apparently healthy elderly, and further study to confirm our results as well as interventional research are needed.

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 School-age period is time when it is in the process of growth and development, and not only individual's body but also the standard of value is formed. During the period, the lifestyle and the pattern of behavior are formed. Schools play a critical role in promoting the health of young people and helping them establish lifelong healthy behavior patterns.

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 Thanks to post-WWII improvements in public health and living environments along with the establishment of a universal health insurance system in Japan, the general health of the public has significantly improved. The country's low infant mortality rate and long average life expectancy are among the best in the world. However, as the incidence of chronic diseases increases, preventive medicine is taking on greater importance in healthcare enterprise.
 In the field of healthcare in Japan today, focus should be placed on the extension of healthy life expectancy rather than only on longevity itself. In this context, preventive care to address the main causes of death in the country such as cancer and life-style related diseases including circulatory disorder is expected to play a more significant role in the future.
 Appropriate life-style teaching for children is critical in light of the importance of health education during school years. Such education should cover a wide range of topics to serve as a foundation for lifelong healthcare awareness, including infectious diseases, mental health, sex education and the importance of life itself.
 In the past, the health service authorities in Japan have focused on regular and specific medical checkups and vaccinations for people at different stages of life based on relevant laws. Many medical associations mainly on the municipal-level have supported people's well-being by actively engaging in such healthcare initiatives.
 Municipalities and medical associations must now step up their collaborative efforts to create effective community healthcare systems by exploring how current activities relate to community health education and Health Japan 21 (2nd edition).
 The Japan Medical Association is currently evaluating the framework of medical association activities for public community healthcare as well as future school-based medical checkups and health education. Here, the framework of JMA's participation in future community healthcare activities is discussed.

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