At the age of 100, anxiety about old age is spreading. Hospitalization due to illness, need for long-term care, suffering from dementia, anxiety factors such as pensions, and the issue of 20 million yen after retirement are common on the Internet.
But are we really basing ourselves on the right information?
Some people get older, need long-term care, or develop dementia, but few know exactly how many people actually develop it.
So, in what form do people grow old and die?And how we grow old and die.
One in four males dies before the age of 75:
According to the simplified life table of Reiwa 3, the average life expectancy for men is 81At 47 years old, the average life expectancy for women is 87He was 57 years old. Although the average life expectancy has decreased over the past few years due to the impact of the coronavirus, it has continued to increase in the long post-war period. The result is one of the longest-lived countries in the world today.
But, of course, not everyone lives to the average life expectancy, and on average, about half of them die from some cause before reaching that age.
So, how many people lived to what age, and how many died?This is shown in Figure 1. This is a simplified life table based on Reiwa 3 and shows the percentage of the population that lives to a certain age.
Figure 1: Percentage of the population that survives to a certain age.
According to this, for example, the proportion of the population that survives to the age of 65 is 898% and 94 females6%。Rather, it means 102% of males and 54% of women will die before the age of 65.
Naturally, survival rates decline with age, with a quarter of men dying around the age of 75 and half having an average life expectancy of 81Died at the age of 47.
Women have a higher survival rate than men, but they still die at age 85, half of them at an average life expectancy of 87Died at the age of 57.
Starting in the 80s, the demand for long-term care increased.
Between the state of health and the state of death, there is the so-called "state requiring long-term care". However, not everyone needs long-term care. Long-term care status refers to the difficulty of living independently due to cerebrovascular disease, joint disease, fracture or fall, old age, dementia, etc.
So, how many people really need long-term care (including support)?
Figure 2: Percentage of certified long-term care need by sex and age group.
When healthy life expectancy is exhausted, it is not a "state in need of long-term care".
Figure 2 shows the rate of long-term care certifications by sex and age group. To put this into perspective, only a few percent of people in their 60s are certified to be in need of long-term care. The rate of long-term care certifications began to increase in the late 70s, and in the early 80s, 20% of men and 30% of women were certified as requiring long-term care.
There is often a misconception that after a healthy life expectancy, you will need long-term care. Healthy life expectancy is defined as "the period during which you can live without health problems affecting your daily life", which is a basic survey of living conditions in the National Survey of Living Conditions, which is considered "healthy" by those who say they are currently in "good", "fairly good" or "normal" health, and "not very well" or "not very good" or "not good" as "unhealthy".
Therefore, it is best to think of healthy life expectancy as an indicator of the average life expectancy that is currently in a healthy state.
So, how many people really need long-term care?You need to note that there is a certain number of people who actually die at that age for some reason, such as illness, before they are proven to be in need of long-term care. In other words, the certification rate in Figure 2 is based on the number of survivors in this age group. This is obvious, but we tend to forget this fact.
Thus, Figures 3-1 and 3-2 show the composition of the age composition ratio (excluding the rate of long-term care need) + rate of long-term care need + mortality taking into account survival, taking into account mortality at the relevant age.
Figure 3-1: Survival, long-term care need, and mortality ratios by age group (male).
Figure 3-2: Survival, long-term care need, and mortality ratios by age group (female).
The vast majority of women are in need of preventive care.
What should be noted here is the age change in the rate of long-term care required. In the case of men, the average life expectancy is shorter than that of women, so many people die without long-term care. Taking into account the mortality rate, the actual long-term care certification rate is not very high, about 10% for people in their 80s. In conclusion, before that, the man died from another factor.
On the other hand, women with a longer average life expectancy tend to have higher rates of requiring long-term care, with 20 per cent of women in their early 80s and 30 per cent of women in their 80s proving to require long-term care.
Looking at it this way, we can see that men and women actually have different ideas about what they should prepare for old age.
Men don't have to be desperately afraid of needing long-term care. On the contrary, it can be seen that efforts to prevent deaths are more important.
On the other hand, studies have found that women are more likely than men to need long-term care. The vast majority of women are important in preparing for preventive care.
Until the 70s, the number one cause of death was "cancer", and from the 80s it was "other".
So, at each age, what causes do people die?It is well known that the main cause of death in Japan is "cancer (malignant tumor)". However, this is not always the case at any age, and the factors of death vary depending on the age stage.
Figures 4-1 and 4-2 show the breakdown of mortality by cause of death in Figure 3.
Figure 4-1: Composition of survival, long-term care, and mortality factors by age group (male).
Figure 4-2: Composition of survival, long-term care and mortality factors by age group (female).
It can be seen that before the beginning of the 70s, the proportion of malignant tumors in men was high, but after that the proportion of heart disease (except hypertension), cerebrovascular diseases and pneumonia increased. The fastest growing is in the "Other" category. Others include "other respiratory diseases", "other digestive diseases", and "neurological diseases".
In the case of women, a slightly higher proportion of malignant tumors can be seen. From the late 80s, the number of heart diseases, cerebrovascular diseases, and aging increased. Aging refers to death associated with the weakening of various bodily functions associated with aging.
In recent years, aging has become the third leading cause of death in Japan after malignant tumors and heart disease (before that, cerebrovascular diseases ranked third). On the other hand, many deaths are due to weakness rather than due to some kind of disease, which can be said to be the result of advances in medical technology in Japan.