研究内容Research

Background

In developing countries, non-communicable diseases (NCDs) such as metabolic syndrome are rapidly increasing among middle-aged populations. At the same time, in countries approaching an aging society, frailty among older people is emerging as a growing concern. However, in many of these countries, healthcare workers lack sufficient knowledge and experience regarding NCDs, and diagnostic systems are often underdeveloped.

For the prevention of frailty in older adults, accurate assessment of frailty is essential. Yet, there is a global challenge in the absence of a comprehensive and objective method for its measurement. The "Fried Frailty Phenotype," proposed by Fried et al. in 2001, has been widely used; however, it assesses only physical frailty and nutritional status.

In Japan, there are tools such as the “25-item Basic Checklist” and the “15-item Questionnaire for the Latter-Stage Elderly,” which are designed for comprehensive frailty assessment. Both use simple yes/no questionnaire formats, making them convenient, but they rely on subjective evaluation.

Objectives

The study aims to develop two comprehensive assessment tools utilizing IT and AI technologies: one for the simple and efficient evaluation of metabolic syndrome among middle-aged individuals (aged 40 to 60) in developing countries, and another for the comprehensive assessment of frailty that can be implemented not only in developed countries but also in developing nations.

Findings

The study is being conducted in collaboration with the National University of Sciences and Technology (NUST) in Pakistan, which specializes in IT technologies. In fiscal year 2024, we developed a tool for assessing physical frailty using AI. Moving forward, we plan to sequentially develop devices and applications that utilize AI.

Background

Japan, as a super-aged society, has shifted its long-term care policy from "doing things for older adult" to "supporting independence and returning to normal life," to address shortages in social security funding and care personnel while aiming to extend healthy life expectancy and improve the quality of life (QOL) of older people. However, it has been repeatedly pointed out—such as in reports by the Ministry of Health, Labour and Welfare’s Social Security Council—that few older individuals regain their original functional abilities after receiving preventive care services.

In contrast, the "reablement" approach, which began in Europe about 20 years ago, has enabled approximately 60% of older adults to recover their functional abilities. Although this approach is now being gradually introduced in Japan, no studies have yet verified the effectiveness of the reablement in the Japanese context.

Therefore, the study aims to evaluate the effectiveness and efficiency of reablement through a mixed-methods approach, combining a randomized controlled trial (RCT) with focus group discussions. The goal is to establish a reablement model suited to Japan. We believe that scientifically validated reablement will not only help Japan confront the ‘2025 problem,’ when the baby boomer generation reaches advanced old age, but will also serve as a valuable care policy for other rapidly aging Asian countries.

Methods

In response to the question, "Why are older adults in Japan, despite the nation's policy of promoting independence, often unable to regain their original functional abilities even after receiving preventive care services?", the aim of this study is to establish a reablement model suited to the Japanese context by evaluating its effectiveness and efficiency using a mixed-methods approach.

To achieve this, a qualitative investigation will be conducted through focus group discussions and subsequent content analysis. In addition, a quantitative investigation will be carried out through a randomized controlled trial (RCT), using community comprehensive support centers in the Izu region as clusters.

Background

Spiritual health has increasingly been recognized as a crucial factor in overall well-being, as studies suggest its role in enhancing quality of life and improving the ability to cope with chronic diseases and other life stressors. However, this concept is understudied, and we conducted this study to assess spiritual health and its potential predictors in older populations in Japan, South Korea, and Taiwan.

Method

The study sample included 900 older adults, with 300 participants from each country. The study site in Japan (Shimane Prefecture), South Korea (Wonju, Gangwon Province) and Taiwan (Kaohsiung Community Centres and Taitung Home Clinic). We used the Purpose in Life (PIL) 20-item questionnaire as it was the most appropriate for this population, considering their religious orientations and cultural background.  PIL scores range from 20 to 140, with higher scores indicating a stronger sense of meaning in life. In addition, the ICECAP-O instrument evaluates the well-being of older adults in five domains: attachment, security, role, enjoyment and control, each scored on a scale of 0 to 1.   Inclusion and exclusion criteria were set as follows: The participants were older people who lived in the community, 65 years and older, who used facilities such as daycare and community centres. All participants had stable physical and mental health conditions and spoke their native language. The exclusion criteria, as self-reported by the participants, included institutionalised individuals, those with a history of dementia. Ethical approval was obtained from Juntendo University, and data collection was conducted from March 2024 to November 2024. All paper-based questionnaires were prepared in local languages for data collection.

Findings

Purpose in life (PIL):

 Japanese older people (mean age=75.50±6.6), South Korea (mean age=73.8±6.5 years) and Taiwan (mean age 72.9±7.2) respectively. Approximately half of the study participants in Japan (49.0 %), South Korea (47.32%) and Taiwan (82%) had low levels of PIL. Approximately 42% of Japanese respondents were classified as having high PIL levels; however, among South Korean and Taiwanese participants, a higher PIL was not found.

Among Japanese participants, Japanese participants, educational level, financial stability, faith or religious beliefs, participation in social activities, and perceived health status were significantly associated with higher PIL scores (p <0.05).  South Korean participants, university graduates, had significantly lower PIL levels than the reference group (p=0.04). However, living with care recipients was positively associated with PIL (p=0.001). Furthermore, participants with strong faith or religious beliefs showed a positive association with PIL (p<0.01). However, adherence to Shintoism was negatively associated with PIL (p=0.03). Participation in volunteer activities was negatively associated with PIL (p=0.01).

Among Taiwanese, several significant predictors of the PIL level were identified: age (65-74), higher household income (<55,000 TWD), divorce (vs. married), self-employment and belief in other religions except Buddhism, Shinto, Christianity, and Taoism, were significantly positively associated with a middle PIL level. However, older age (75), living with a spouse and having religious beliefs were associated with a low PIL level. Interestingly, individuals without religious beliefs showed higher odds of having moderate PIL.

ICECAP-O:

 Regarding the ICECAP-O indicators of Japanese participants, 40.66% of respondents reported the highest level ('all') for Attachment, while 35.62% did the same for Security. Similarly, 35.74% of the respondents selected the highest level for both role and enjoyment, while 46.73% reported 'completely' for control. The ICECAP-O score for the Korean participant was 10.14 ± 3.33, reflecting moderate well-being.

Taken from Abstract presented on the 39th East Regional Conference of Japan Association From Global Health

Background

The growing number of migrants crossing the Thai border reflects a broader humanitarian crisis that is shared across Asia. Migration to Thailand from neighboring countries including Myanmar, Cambodia, and Laos is driven by a complex interplay of factors such as armed conflict, political repression, poverty, labor demand, and lack of access to healthcare and education. These layered drivers highlight the need for an interdisciplinary response to effectively address the challenges faced by migrant populations. Moreover, to create sustainable change mechanisms, young researchers must be equipped with both theoretical grounding and field experience.

Objectives

This initiative aims to cultivate a new generation of interdisciplinary scholars through a Human-Centered Design approach, build a trust-based, cross-border partnership, and establish a regional platform enabling collaborative international research and dissemination.
 

Methods

The initiative began with an international online kickoff meeting on November 26, 2024, where 21 participants from Japan, Thailand, Taiwan, and the United States discussed the significance of migrant and refugee issues, shared regional research experiences, and explored interdisciplinary approaches. A collaborative workshop followed, focusing on organizing key themes, identifying research areas related to migrants in Thailand.

Early-career researchers were divided into mentor-supported groups based on their expertise and interests. Based on our initial discussion, the participants decided to conduct scoping reviews of respective areas of interest, using the PRISMA-ScR methodology. This process included selecting a specific topic area, developing literature search strategies, conducting literature search, screening the articles found, reviewing full texts, extracting data, and summarizing themes, and analyzing gaps in science. Interim findings were presented in March 2025, with ongoing group collaboration continuing thereafter.
Results

Following the workshop, participants organized into five interdisciplinary teams and developed scoping review protocols on themes including environmental health, oral health, mental health, food security, healthcare access, among migrants with mentorship support.

The first group, composed of public and global health experts and an environmental specialist, examined the health impacts of air pollution on migrants. Broadening their scope beyond Thailand border-related issues allowed the team to find more articles and highlighted the importance of flexibility in early research stages. The second group, made up of a global health researcher and a healthcare professional, focused on oral health. They gained experience with systematic review steps while addressing challenges related to topic breadth, screening tools, and time management. The third group, including an epidemiologist, a health social scientist, and a humanities scholar, investigated mental health among migrants across the globe. Integrating diverse disciplinary views helped them assess how intercultural factors influence migrant well-being. The fourth group featured specialists in global health, epidemiology, health promotion, and community health research. They explored food security among migrants in Low- and Middle-Income Countries (LMICs), benefiting from co-creation while facing challenges in synthesizing varied perspectives and scarce literature. The fifth group, composed of experts in economics, public policy, governance, and social/global health, addressed the geopolitics of healthcare access along Thailand’s borders, uncovering systemic and policy-level barriers.

By March 2025, most teams had completed the retrieval of literature. Themes such as legal status, mobility, and political context emerged as key determinants. The process reinforced the value of interdisciplinary collaboration and shared learning.

Conclusion

This initiative has advanced two goals: nurturing early-career researchers and building a sustainable international research platform. Through collaborative scoping reviews, participants developed thematic expertise and cross-cultural skills, establishing an Asia-led foundation for future interdisciplinary work. Challenges included aligning academic perspectives, time zone differences, and communication. Nevertheless, the project built a trust-based network linking health, social sciences, policy, and the environment.

At the Global Health Research Department, we encourage graduate students to pursue research aligned with their primary interests. Below are examples of ongoing graduate student research.

• A study on drug adherence of Type 2 Diabetes and performance of pharmacists in Malaysia
• Social Influence and 10-year cardiovascular risk impact of tobacco use among adults in Pyin Oo Lwin, Myanmar
• Analysis of Cancellation Cases of Rapid Response Car Activities during weekday nights, weekends and public holidays in the Central region of Saitama Prefecture, Japan.
• Life Satisfaction and Mental Health among Chinese older adults 
• Return Migration and functional dependency in older Mexican Adults
• Evaluation of Age-friendly City in Mexico
• A study on Medical Interpretation and Foreign Residents in Japan