Healthy Aging, and Digital Inclusion

12^thDIHAC policy review meeting analysis report
Japanese report 
Nadila Mulati, Myat Yadana Kyaw, Hope Edwards, Noriko Kondo, Myo Nyein Aung, Matthew Farrow, Malcolm Field

Populations around the world are aging. This global phenomenon of demographic shift requires all sectors to work together to help and maintain the health and well-being of the older population. The United Nations Decade of Healthy Aging (2021-2030) aims to optimize the functional ability of older people. As the main two focuses of our DIHAC study are “healthy aging” and “digital inclusion”, the12th Digitally Inclusive, Healthy Ageing Communities (DIHAC) study policy review meeting held via Zoom on 12th August 2022, focused on these two key areas. DIHAC study investigator and advisor, Professor Malcolm Field chaired this meeting.

Aging is often accompanied by changes in body composition, specifically, a decrease in skeletal muscle mass. This age-related loss in skeletal muscle has been referred to as sarcopenia(1). It presents the risk of falling, frailty, functional decline, and mortality (1). The first presenter, Ms. Hope Edwards, a first-year Ph.D. student from the University of Bradford, UK presented her research project plan, that aimed to develop effective sarcopenia interventions while investigating potential molecular markers for sarcopenia. The detailed project background, objectives, and methodology. The study aims to compare molecular biomarkers of normal older people and sarcopenic older people, to find out the effects of exercise programs and protein and nitrate on physical function and molecular markers of sarcopenic patients and develop an effective exercise protocol for sarcopenic patients. The participants will include young people aged (19-34), middle age (35-64) from the community, and older people (65 and above) from the elderly cohort in Bradford and the physiotherapy clinic of Bradford University. People with a muscle disorder, taking drugs that affects muscle function, pregnant and breast-feeding mothers and people with a known allergy, and people with blood thinners will be excluded. The older people will be screened for sarcopenia with the SARC-F questionnaire for probable sarcopenia and confirmed by the European Working Group on Sarcopenia in Older people classification. Exercise intervention will be targeted only to older people including personalized and regularly monitored resistance training, aerobic training, and multimodal training according to the guidance from NHS, UK. The nutritional intervention will be taken every day for a year either nitrate or protein. A food and exercise diary will be asked to keep for monitoring and prevention of possible confounding factors. Follow-up will be at 3,6-,9- and 12-month intervals for clinical and muscle function assessment. Participants discussed the primary outcome measurements, and exercise intervention, how to retain participants throughout the study period, ways to prevent contamination of each subgroup, and data collection and analysis. In addition, some suggestions about using the digital device to keep track of the participants’ nutrition and personal health data.

In the context of digitalization, closing the gray digital divide became vital for the well-being of older adults. Lack of digital skills and confidence might be the barriers for older adults to use the internet among many others. In Japan, more than 95 percent of the people from 13 to 59 used the internet in 2020, and this percentage is small for those aged 60-69 (82.7%), aged 70-79 (59.6%), and lastly age 80 and over (25.6%). The Japanese government, along with the close work with the public and private sectors, aimed to help older adults adopt digital technology. For example, mobile carriers, community centers, and silver citizen clubs provide classes to teach how to use mobile phones and computers in daily life and use them for online administration, etc. Our second speaker, Ms. Noriko Kondo, Director and Volunteer Coordinator of NPO Broadband School Association who has experience with leading empowerment activities in the Japanese community shared her experiences. Japan has a long history of community-based mutual help and supports systems; it also plays a vital role in the digital adaptation of its older residents. Ms. Noriko Kondo introduced activities, for example, internet emergency training, and how to use Microsoft software or mobile phone by introducing easy and fun games for community-dwelling older residents. Friendship, mutual support, and fun are the three keywords that Ms. Noriko emphasized. She shared her perspective and from her experiences that friendship is a strong motivation for older people to start learning digital technology. In a place that is easy to access, and can meet friends and neighbors, affordable and age-friendly devices are facilitators for digital adaptation for the older person. Moreover, community-driven, people-centered interventions, and programs that use easy and fun methods are always the best way to introduce digital technology.

• Exercise and nutrition are two ways to prevent sarcopenia. Digital technology could be used to track the physical activity and nutrition of individuals. 
• Friendship, mutual support, and having fun are the keys to the digital adoption of older people. 

The next Digitally Inclusive, Healthy Ageing Communities (DIHAC) study policy review meeting is scheduled to be held in October 2022.

References

1. Evans WJ. What Is Sarcopenia? The Journals of Gerontology: Series A. 1995;50A(Special_Issue):5-8.

About authors

Nadila Mulati is a Ph.D. student at the Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan.

Myat Yadana Kyaw MD is a Ph.D. student at the Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan.

Hope Edwards MSci, is a Ph.D. student in the School of Pharmacy and Medical Sciences at the University of Bradford.

Noriko Kondo, Director, NPO Broadband School Association

Myo Nyein Aung MD, MSc, Ph.D. is an Associate Professor at the Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan. He is also affiliated with the Advanced Research Institute for Health Sciences and the Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan. He chaired the follow-up meeting.

Matthew Farrow Assistant Professor. The University of Bradford, School of Pharmacy and Medical Science

Malcolm Field Ph.D. Professor, Faculty of Social Sciences, Kyorin University and Faculty of International Liberal Arts, Waseda University