One out of three people in Japan will be an older person before 2040. Half of those currently do not utilize the internet, smartphone apps, or digital technology. On the other hand, more than 70% of seniors in Republic of Korea use the internet, and 55% in Singapore had access to it in 2019. The use of digital technology for health promotion has the potential to promote individual and community empowerment, advocating for healthy, active aging. Maintaining equity in health promotion practice requires the digital inclusion of every senior. Therefore, we propose a cross-cultural study to explain the contextual influences of digital inclusion and its consequences on healthy aging in Japan, Korea, Singapore, and Thailand. Quantitatively: digital skills, e-health literacy, participation in health promotion, and quality of life will be analyzed in structural equation models. Qualitatively: thematic analysis will be developed to identify cultural patterns and contextual factors, making sense of what older persons in different countries materialize, say, do, think, and feel to reveal deeper beliefs and core values about digital inclusion and healthy aging. Logics and methods from this protocol would be useful to replicate the study in many countries globally. Evidence from this study is expected to pave the way to digitally inclusive, healthy aging communities (DIHAC) across Japan and Asia.

Non-pharmacological interventions are expected to be important strategies for reducing the age-adjusted prevalence of senile dementia, considering that complete medical treatment for cognitive decline has not yet been developed. From the viewpoint of long-term continuity of activity, it is necessary to develop various cognitive stimulating programs. The aim of this study is to examine the effectiveness of a cognitive intervention through a training program for picture book reading for community-dwelling older adults. Fifty-eight Japanese older participants were divided into the intervention and control groups using simple randomization (n =29 vs 29). In the intervention group, participants took part in a program aimed at learning and mastering methods of picture book reading as a form of cognitive training intervention. The control group listened to lectures about elderly health maintenance. Cognitive tests were conducted individually before and after the programs. The rate of memory retention, computed by dividing Logical Memory delayed recall by immediate recall, showed a significant interaction (p < .05) in analysis of covariance. Simple main effects showed that the rate of memory retention of the intervention group improved after the program completion (p < .05). In the participants with mild cognitive impairment (MCI) examined by Japanese version of the Montreal Cognitive Assessment (MoCA-J) (n =14 vs 15), significant interactions were seen in Trail Making Test-A (p < .01), Trail Making Test-B (p < .05), Kana pick-out test (p < .05) and the Mini-Mental State Examination (p < .05). The intervention effect was found in delayed verbal memory. This program is also effective for improving attention and executive function in those with MCI. The short-term interventional findings suggest that this program might contribute to preventing a decline in memory and executive function. UMIN-CTR: UMIN000014712 (Date of ICMJE and WHO compliant trial information disclosure: 30 July 2014)

This study aims to identify the independent influence of face-to-face contact (FFC) and non-face-to-face contact (NFFC) on the subsequent decline in self-rated health and mental health status by age. A total of 12,000 participants were randomly selected among residents in the study area, and 1751 of them responded to both the 2016 and 2018 mail surveys. The participants were subsequently classified into three age groups (25–49: Young adults; 50–64: Mid-aged adults; and 65–84: Older adults). Social contact was assessed by computing the frequencies of FFC and NFFC. Multiple logistic regression analysis showed the risk of social contact on the decline in self-rated health and World Health Organization-Five Well-Being Index. Both FFC and NFFC were significantly associated with maintaining mental health; however, the impacts of FFC on mental health were more significant than that of NFFC among older adults and young adults. Compared with the no contact group, FFC was significantly associated with maintaining self-rated health in mid-aged adults. The influence of FFC and NFFC on health differed by age group.

Studies have suggested that frequent participation in social groups contributes to the well-being of older people. The primary aim of this study was to identify the number of days older adults should participate in the activities of social groups to maintain their health for 4 years. This study also aimed to examine whether the effective frequency differs by the type of social group activity. We examined a prospective cohort of 1,320 community-dwelling older adults over 65 years of age, who responded to both a baseline and a follow-up mail survey, in a suburban city of Tokyo, Japan. The dependent variable was the change in functional competence during 4 years. Logistic regression analyses were conducted to examine the effects of participation in the activities of the 5 most common social groups among older Japanese on maintaining functional competence. Nine hundred and ninety-four participants (76.5%) maintained their functional competence for 4 years. The results of the logistic regression analyses showed that participating in alumni groups less than once a month and being an inactive member were associated with higher odds of maintaining functional competence, after controlling for socioeconomic, demographic and baseline health status. Additionally, the odds of maintaining functional competence for 4 years increased upon participating in volunteer groups once a month or more. These results were also confirmed using logistic regression analysis, even after adjustment for the effects of participation in other social groups. The results indicated the effectiveness of volunteer activities that fulfill a social role in maintaining health. Therefore, older adults should be encouraged to participate in activities of volunteer groups at least once a month. Additionally, older adults can obtain positive health outcomes through less frequent participation in alumni groups, compared with the activities of volunteer groups.