Building Hybrid Communities in the Era of 100-year Lifespans

With Japan experiencing a low birthrate and aging population that is unprecedented globally, there is a clear and present need to restructure all aspects of social systems in response to this rapid demographic change encompassing social security (including healthcare and care for those in need), the circumstances in which people live, social infrastructure, employment practices (including employment for the elderly), and interactions with the local community based around the connections between people. This includes an urgent need to create a society in which the Japanese people can enjoy long and healthy lives as well as working toward new social systems that, by encouraging their active participation in economic and community activity, enable the elderly to become “cornerstones of society.”

At a time when it is not uncommon for people to live to 100, extending healthy lifespans is at the core of the national strategy. Crucial to achieving this is the question of how to overcome frailty. This concept of frailty is giving new impetus to work on promoting health and preventing people from having to go into care.

Frailty is a multi-faceted phenomenon, encompassing not only physical issues (osteoarthritis of the knee and other mobility impairments, for example), but also mental (psychological) and social aspects (such as isolation, eating and living alone, and financial difficulty). These problems can also compound one another in various ways, impairing people’s ability to look after themselves. A major factor in this is sarcopenia, meaning the loss of muscle mass with aging. In terms of taking earlier action to prevent this growing frailty, there is a limit to how much can be achieved by relying solely on existing health promotion approaches (adequate protein intake and appropriate exercise habits). What is of particular importance, rather, is social engagement and community participation, including the forging of connections between people.

A major challenge for 2020 has been the COVID-19 pandemic. A study conducted by a research team working on frailty prevention at the University of Tokyo’s Institute of Gerontology that I head found that, along with the infection risk itself, there was clear evidence for secondary health damage (the emergence and exacerbation of frailty) caused by extended self-isolation by the elderly. That is, the study found that a longer time spent by elderly people living a constrained life out of an exaggerated fear of the virus was associated with a high degree of inactivity and disruption to eating habits as well as a loss of interactions with other people.

When we surveyed local governments that have introduced frailty checks for their elderly residents, we found one community where more than 40% of the elderly had experienced a marked drop off in the frequency of going out of the house, including 14% for whom the frequency of going out had fallen to less than once a week (indicating a tendency to social withdrawal). The negative impacts were not limited only to the frequency of going out and also included things like a failure to consume a balanced diet, an inability to get food because of being unable to go shopping, planning meals being too much trouble, or people becoming neglectful of meals and making do with simple food. Also evident from changes in the results measured before and after the COVID-19 pandemic were losses in grip strength, calf circumference, and muscle mass (in particular, an 8% loss in the trunk of the body).

The elderly in Japan, then, should be encouraged to be rational and smart in their fear of infectious disease and to take early steps to improve living practices together with mind and body function where there are signs of negative effects.

Accordingly, looking to how society will change during and after the pandemic, a key question will be to ask what is needed for Japan to undergo a major transformation. Specifically, in terms of national strategy, I would like to reiterate that three forms of protection are crucial: (1) Protection from infection, (2) Protection for the economy, and (3) Protection to maintain robust and healthy communities.

This includes individuals and communities taking up the challenge of establishing a “new normal.” Three areas are of particular importance if individual members of the public are to achieve a long and healthy life by taking early action to avoid frailty, namely, to engage with society on the basis of nutrition (food and mouth), physical activity (primarily exercise), and connecting with other people. Now, more than ever, there is a need to build hybrid communities to enable personal and community transformation.

There is a need to establish information and communication technology (ICT) platforms that support communities and that are implemented in ways that successfully take account of the real-world places where people have traditionally communed and gathered while also successfully combining this with online technology. That is, while there is no question that the new living practices required for preventing infection are important, I hope that we can also build communities in which people can become closer together in spirit even while remaining physically separate, using IT to empower and explore new ways for people to gather and connect with one another. By doing so, I hope that we can provide people who are physically distanced (the elderly especially, not just the younger generation) with opportunities to get together on the basis of shared interests and values, and to restore the bonds that have tended to be forgotten in existing communities (especially in the realm of ordinary daily life).

As for the challenge of whether we can transform the threat of COVID-19 into an opportunity, this equates to the question of how we can change the way people live in the post-COVID-19 era. Given the progress and spread of technology for bringing about a genuinely people-centric society in the era of Society 5.0, I continue to believe that, as we create a new community model for the next generation (a new digital society focused on people) without losing sight of those origins we should never forget, we can also create new value for the entire world to enrich society and bring people closer together in spirit (forging bonds).