Toward the development of a vibrant, super‐aged society: The future of medicine and society in Japan

Background As Japan's population continues to age, it is estimated that the number of people aged ≥75 years will exceed 20 million by 2025. Furthermore, over the past 10 years, we have not reduced the difference between life expectancy and healthy life expectancy. Therefore, the extension of healthy life expectancy and the development of a healthy society are the most urgent issues. In terms of medical care, the changing times have inevitably led to changes in disease structures and medical demands; therefore, the medical delivery system has had to be changed to meet these demands. As dementia rapidly increases, it is important to address “frailty,” a condition in which people become more vulnerable to environmental factors as they age, and there is a need to provide services to older people, particularly the old‐old, that emphasize quality of life in addition to medical care. To realize a super‐aged society that will remain vigorous and vibrant for many years, we need to rethink the future of Japanese medicine and healthcare, and the state of society. Current situation and problems Disparity between healthy life expectancy and average life expectancy in the realization of a healthy society It is a challenge to build a society with a long and healthy life expectancy through comprehensive prevention and management of lifestyle‐related diseases, as well as the elucidation of the factors that explain sex differences in healthy life expectancy, based on the recognition that lifestyle‐related diseases in midlife are risk factors for frailty and dementia in old age. Challenges in medical care for building a super‐aged and healthy society The challenges include promoting clinical guidelines suitable for older people, including lifestyle‐related disease management, promoting comprehensive research on aging (basic research, clinical research and community collaboration research), and embodying a paradigm shift from “cure‐seeking medical care” to “cure‐ and support‐seeking medical care.” Furthermore, the key to the future of integrated community care is the development of a comprehensive medical care system for older people in each region and the development of the next generation of medical personnel. Dissemination of frailty prevention measures in a super‐aged society The concept of frailty encompasses the meaning of multifacetedness and reversibility; therefore, a comprehensive approach is required, including the renewal of conventional prevention activities in e