SUIZA - SALUD

May 21st, 2012, Neue Zürcher Zeitung

Learning to learn only not stop

Views on dementia society - the example of Japan

The mind wants to be trained, just not too quiet - also in old age.(Image: Gregory Lengler / LAIF)

The 130-Jährigen of tomorrow play in kindergarten at the corner. To imagine what that means us, our fancy overtaxed, because long-term anticipation offered no particular evolutionary advantage for our species. Ageing makes it today but essential to revise the whole life planning.

Florian Coulmas

Shigeaki Hinohara believes in lifelong learning. By profession doctor, he faced two years for the first time on the stage, in order to participate in a musical. Get off from the routine and once something completely different is a challenge which stimulating effect. Not that Mr Hinohara ought to fear the boredom of the routine. In addition to his work at the St. Luke's Hospital in Tokyo, which he founded, and one who made most of the city and where he treated patients still he held more than a dozen posts in Board members and nonprofits, writes books and lectures - on learning, healthy life, by disease threatened life, care, recovery, art and God and the world.

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His writing is quite successful for an ancillary activity. His 2007 book «from the good life» sold 1.2 million copies. And this is only one of over twenty books, the it since the beginning of the century - this century! -out has brought. «Memento Mori.» was released in 2002 by him «About the death». But that is long forgotten. Now he has turned to again upbeat themes. On his 100th birthday last year he published a book «about the joy of art».

It is never too late

Lifelong learning is one of the principles of that propagates Hinohara and embodies, convinced that life is not only richer, but also better and longer through learning. Who would oppose him?
Not only life, but also of life learn to make and is at the same time leave what comes, is a tenet of his philosophy of life. It is never too late. In 1970, on the way to a Congress, he sat in the Japan Airlines flight 351 from Tokyo to Fukuoka. The aircraft was hijacked by members of the Japanese Rote-Armee-Fraktion. The prudent kidnappers had something brought to read for the 129 hostages on board, Lenin's collected writings, as well as by Kim Il Sung and - somewhat surprisingly - also something by Dostoevsky. Hinohara chose to be «The Brothers Karamazov» the great Russian novelists. He was the only one who read on the flight of fear over Fukuoka and Seoul after Pjongjang according to your own. One can never know.
Mr Hinohara is a cheerful person, an optimist who holds nothing to put your hands in your lap or to give up prematurely. As a physician, the death is not alien to him, and many of his writings which act as if one accepts it as part of life. He knows that it is not only important to delay him. But he himself has managed and with him many other Japanese. In the course of the twentieth century they could double, so incredible as it may seem, their life expectancy. In other industrialized countries, the trend in the same direction goes, but the speed with which that which was in Japan, is unique in the history of mankind. 2011 About 40 000 Japanese their 100th could celebrate birthday with Hinohara. A generation ago, the number of such employees was still three digits.
That the Japanese have postponed the death within a short century by decades, is evidence of the very successful exploitation of technical and scientific achievements, a good health system and a society on the whole, well functioning and also mentally healthy. The demographic shifts associated with aging, yet force this successful company to enormous adjustments.

A common illness

It goes well so not all elderly such as Mr Hinohara;. He knows this very well. One of his books is called: «100 advice: up to 100 without dementia». The audience is great, because as in all industrialized countries, the number of neuro-degenerative diseases increasing rapidly. Earlier, people died of infectious diseases or old age, before senile dementia of skills robbed them, that it needs for independent living. Great advances in the general hygiene and molecular medicine and longevity, which moved them to themselves, have made but from dementia a widespread disease.
In Japan alone see Alzheimer's disease and other neurodegenerative diseases is estimated currently suffering to 1.7 million. By 2020 she should rise to projections of Japanese Alzheimer's society to 3.3 million. In East Asia, old age is traditionally considered lucky, but this proverbial Association in question is made by the rapid increase in the risk of dementia. Who will maintain the sufferer of senile dementia? One of the biggest challenges of Japan is to enable a happy or even decent existence them and many other dependent persons, today. The approximately 10 000 members of Alzheimer's society are working more information on and to spread understanding of dementia diseases and thus those affected and their families fear to take. In the face of population growth, this is urgent.

Many active old

Because while the age cohorts over 65 continue to grow, the decline in the population as a whole accelerated at the same time. by 2030 there will be less 10 million Japanese Belgium than it is today - once. While the working population goes back the fastest, from 68 per cent in 2000 to 60 percent by 2020 and 53 percent by the mid-century. Meanwhile, the proportion of the over 65 is increasing from 25 percent to 35 percent. It moves slowly from previously marked 65 as in Western Europe the threshold to the age, but from this definition.
Mr Hinohara would be retired today 35 years after the traditional conception of retirement age, works but still. As a person, he is exzeptionell, but he embodies the sunny side of the key trends which currently features the Japanese society. The energetic senior is not unusual; There are many other active old. But he is more in the spotlight and is admired because it has optimally used genetic equipment given him to a long to make healthy and fulfilling life; safe with ups and downs, but on balance a good life. The interaction of genetics and the environment that determines our aging has optimized Hinohara.
His advice for a dementia-free age draw therefore wide attention; less for his peers as in the generation of their children; because she must worry about the increasing age care intensive diseases. His own successful aging lends credibility to his advice. They include Zaubertrankrezepturen for eternal life nor strict dietary requirements - three times a week broccoli-, not to mention anti ageing products of which he knows like any doctor that they have no effect except on the wallet of the patient. Hinohara popularized primarily general findings of aging research. You have more to do with lifestyle than with pharmacy: wake up early, enough sleep, a certain regularity of lifestyle, physical activity, moderate food and drink, diverse intellectual activity and - most especially important - social integration in private and professional relationships; not much so that would go beyond common sense or would be contrary to him.
Alone, common sense or the ability to obey him, is given not each. Phenomenal population ageing brings, regarding which new requests. People, as individuals and as groups, are not very good, long to plan ahead, because a life expectancy, which was 25 years on average only about even in Roman times, always the here and now of paramount importance, long-term anticipation was no real evolutionary advantage for survival so. Only the quantum leap of in life expectancy in the 20th century has changed that. He has brought wide circles of the population practically over night additional decades lifetime that they not reasonably to be learned. It is difficult the 30s to plan, although they have a good chance to experience him for her 100th birthday.
When we say that in the nursery next door the first generation of the 130-Jährigen grows, this is so abstract that it be taken virtually no consequences. People save too little for her own age, and the State behaves a little differently. In Japan, this is very clear and reflected a threatening weakness of the democratic form of Government. Although Japan was never been so rich as it is today, the public funds are not only empty, but in the deepest minus. The pay-as-you-go system of care of the old, resigning from the labor force population no longer works. If the retirement age is not drastically raised, 1.5 workers must maintain the mid-century a pensioner. Everyone knows that the resulting deficits in pensions and maintenance funds only by tax increases to compensate for are. This is not an attractive option for politicians who want to be re-elected. For them, a time horizon of several decades is just as unattractive as the own 100th birthday for a 30. There are reasons that militate against a tax increase, anyway, especially if an election is imminent.
Although population growth fairly reliable long-term projections, entities and States behave hardly weitsichtiger as individuals. In two or three decades to imagine our own lives, our imagination as well as a society in which every second over 60 is overwhelmed. If however the 100th Lord Hinohara publicly, gives interviews and speaks on issues of daily life, then it will be practical, and we can imagine that it affects us; that we and not only future generations need to reschedule the default life cycle, because the ageing in the context of the given structures now has led idle for many to two decades at the end.

Remain active until the end

Growing up, learning, working, resting - these four stages no meaningful classification represent. Not only an economic necessity is to let the people in a shrinking and further ageing society work longer; except for the infirm and ill that meets their needs also. Here lies the true meaning of lifelong learning. It represents no occupational therapy for the elderly, who are otherwise would be bored, but the precondition to remain active.
Not all will be as old as Mr Hinohara and as long as he the desire, the ability and the opportunity to make a contribution to society. The number of dependent persons will increase further. It is even more important for those who are able to work, to exploit the potential through active participation in working life or in voluntary and voluntary activities, the the State facing loads are increasing everywhere. In many industrialized countries, Japan included, we can meet this trend as a result to give individuals more responsibility for its own future. Who not all dominant State wants, that can only welcome. Alone, so far still no model has been developed, in which increased personal responsibility does not cause a widening of disparities in society.
It is known that health problems in low income layer pile and that income inequality is increasing with age. Poverty makes sick and disease is poor. The bitter dictum «Because du arm bist du früher sterben» is still true, and further gains in life expectancy will be because if everything continues as until now, nothing change.
What would have to change to counteract social inequality of health is learning, both in terms of content and time. Herein lies the real importance of lifelong learning in the ageing society, because the by far most influential factor healthy and successful aging is the formation: the higher the level of education, the higher the income and the longer disability-free life. Inequality in health at the age reflected: not only physical affliction pensioners on lower incomes suffer more frequently than those with higher incomes, but also from senile dementia and clinical depression, sleep disorders and other mental conditions.

Growth industry

Lifelong learning is therefore a growth industry, in which the State must have a interest; because in the long run, it will help to keep the inevitable increasing with aging health cost and not to grow the disparities in health care. Right understood means not only periodic training and (also) learning in the age, but as a child of the age to learn lifelong learning always and again to be able to acquire the intellectual and social skills, which are needed in order not to miss the following always faster to current developments.
Mr Hinohara contributes its part to do so. "What is life?" is the title of the lecture he will soon keep the life planning center he founded in Tokyo in a room, which can accommodate 800 listeners.
Florian Coulmas is Director of the German Institute for Japan studies in Tokyo. Together with Judith Stalpers, he has written the book published 2011 by C. H. Beck last: «Fukushima: from the earthquake to the nuclear disaster».