By: Dr Noriko Cable, UCL

This blog is one in a series of blogs on the Future of Ageing, published in the lead up to the ILC-UK Future of Ageing conference on the 24th November. To register to attend this conference, click here.

Given the growth in the population of older adults in the UK, people have been encouraged to maintain good health in preparation for healthy ageing. In Japan, one quarter of adults are aged 65 and over.

This places them in a unique position to offer other developed countries, such as the UK realistic pictures about potential problems in an ageing society and ideas for possible strategies which will promote healthy ageing.

Social isolation has been linked with loneliness among older adults, which may have a deleterious effect on their well-being. On the other hand, having extensive friend networks was a driving factor for better psychological well-being1. Researchers from the Japan Gerontological Evaluation Study (JAGES)2 have implemented and evaluated an area-based intervention which was designed to promote optimum physical functioning of older adults. In short, they set up an infrastructure, referred to as ‘salon’, for the community dwelling older adults.

The concept of the ‘salon’

In 2007 Aichi Gerontological Evaluation Study (the predecessor for the JAGES) implemented the first ‘salon’ in Taketoyo which is a town located in the central part of Japan. It aimed to facilitate the healthy ageing of older adults in the area as well as provide an increase in the social functioning of the area (i.e. social capital). To achieve their aim, an unconventional approach was taken to set up and manage the salon.

1. Two level approach: The salon was designed to promote the physical functioning of older adults in the town (=individual level) as well as to increase social capital of the area (=community level) by serving as a focal point for the locals to gather and meet and receive information and social support.
2. Sites: Salons would be set up within walking distance of local older adults to enable them to engage with salon based activities easily. Another two salons were opened following the opening of the first one in 2007. Currently, they have 11 salons in Taketoyo and over 900 participants in total (=10% of the ageing population in the town).
3. Management: Salons are managed by a group of volunteers who are drawn from among the recipients of the service. The volunteers organize the day-to-day activities which are not limited to exercises. The ratio of participants and volunteers is around 1:5 in 2007 and 1:4 in 2013.
4. Integration with local administrators: Support from local administrators has been sought for financial support, advertisement of salons, and provision places.

Evaluation of ‘salon’

Volunteers and participants of the salon reported that they received information related to health and diet at the salon. Volunteers perceived their role positively and noticed increases in interactions and self-fulfillment through helping others.

Additionally, the self-rated health of the participants was improved twofold when compared with the baseline level of self-rated health. These individual level results considered factors including socio-demographic characteristics such as age, sex and income as well as potential bias due to reverse causation and unobserved confounders (i.e. instrumental variable method)3. Similarly, participants’ 5 year incidence of onset of disability function was less than half compared to non-participants4. Moreover, at community level, frequency of participants’ salon attendance was determined by the numbers of the salon within a 350m radius from their home. These research based evaluations suggest that an intervention that integrates with the local infrastructure can promote healthy ageing of older adults at population level.

Source:

5. Cable N., Bartley M, Chandra T, Sacker A. (2013). Friends are equally important to men and women, but family matters more for men’s well-being. Journal of Epidemiology and Community Health, 67, 166-71.
6. Japan Gerontological Evaluation Study. https://www.jages.net/
7. Ichida Y, Hirai H, Kondo K, Kawachi I, Takeda T, Endo H. (2013). Does social participation improve self-rated health in the older population? A quasi-experimental intervention study. Social Science and Medicine, 94, 83-90.
8. Hikichi H, Kondo N, Kondo K, Aida J, Takeda T, Kawachi I. (2015). Effect of a community intervention programme promoting social interactions on functional disability prevention for older adults, JAGES Taketoyo study. Journal of Epidemiology and Community Health, 69, 905-10.