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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.

To promote digital transformation, equal emphasis needs to be placed on digital skills development as to infrastructure development. Integral to investment in digital skills development is the subsequent management and evaluation of digital training programmes. This paper assesses mechanisms to ensure digital training programmes are adequately managed using a standardized data collection framework to measure an internationally accepted digital literacy index. Such an index requires an agile definition of digital literacy, responsive to the fluid nature of the digital economy. The paper also explores the extent to which a G20 advisory body may inform a nationally representative data collection strategy within the context of a data collection process that is cognizant of the evolving demands of businesses and users alike.

Background This research was conducted to investigate the association between cognitive function and smartphone ownership among very old adults, a rapidly growing age group. Additionally, we conducted a longitudinal investigation as a sub-analysis to determine whether owning a smartphone affects the level of long-term care certification as a proxy outcome for cognitive decline. Method Data from a cross-sectional and longitudinal survey of the Kawasaki Aging and Wellbeing Project (KAWP) was used. Multivariate regression analysis was performed to examine the relationship between the Mini-Mental State Examination (MMSE) score and smartphone ownership. We also examined the association between smartphone ownership and the level of nursing care 1,278 days after the baseline. Results Among 483 participants aged 85–90 years at baseline, 165 (46.9%) were male, and 131 (27.1%) owned a smartphone. In adjusted regression, smartphone ownership was associated with an MMSE score of ≥ 27 (odds ratio [OR]: 1.76, 95% confidence interval [CI]: 1.13–2.77), after controlling for potential confounders, including hypertension (OR: 1.65, 95% CI: 1.01–2.69). The results revealed no relationship between smartphone ownership and long-term care level. Discussion Our results suggest that minimal cognitive decline in very old adults could make the ownership of a smartphone difficult.

People are living longer, and our life has become more digital. Hence, the benefits from digital technology, including economic growth, increasing labor productivity, and ensuring health equity in the face of an aging population emerged as a vital topic for countries around the world. Japan, the Republic of Korea (ROK), Singapore, and Thailand are in the top ten rankings in terms of information and communication technology (ICT) development within the Asia Pacific Region and all are facing challenges of population aging. Well-designed national ICT policy and health promotion policies enabled the countries to make significant progress and development in terms of digitalization and healthy aging. This paper aims to answer questions regarding digitization and health promotion: when it started, how it is going, what are the achievements, and what it holds for the future, considering healthy aging and digitalization by reviewing the national ICT policy and health promotion policies of Japan, Korea, Singapore, and Thailand. This paper is expected to help readers build a comprehensive understanding of each country’s journey towards building a healthy aging digital society. Furthermore, we hope this paper can be a source for countries to exchange experiences and learn from each other with a joint goal of building a healthy aging digital society.

Background Internet use is increasing among older adults worldwide, raising interest in its potential empowering effects on healthy aging. However, the relationship between internet use and frailty among older adults remains underexplored. Methods We conducted a postal survey between February and March 2021 in Osaka, Japan. The survey included 1,288 respondents aged ≥ 65 years, yielding a response rate of 71.6%. Internet use patterns were divided based on the frequencies of 8 internet use activities using a k-means cluster analysis. Frailty was assessed using the Japanese Kihon Checklist with a cut-off score of ≥ 8 defining a frail status. Covariates included age, sex, living alone, economic status, work, multimorbidity, smoking, and physical activity. We employed logistic regression models to investigate the associations. Stratified analyses were also conducted by sex and age (65–74 years, ≥ 75 years). Results After excluding individuals with incomplete data on internet use or long-term care users or living a nursing home, we analyzed 908 participants (45.42% female, average age 73.74 years, 25.37% frail). The K-means cluster analysis identified three internet use patterns: “less use” ( n  = 478), “social use” ( n  = 261), and “functional use” ( n  = 169). Logistic regressions with less use as a reference showed a negative relationship between social use and frailty (adjusted OR, 0.54; 95% CI, 0.35–0.84). The stratified analysis revealed significant relationships between social use and frailty only in males aged 65–74 years and females ≥ 75 years. A relationship was not observed between functional use and frailty. Conclusions We confirmed the segmentation of internet use patterns and its associations with frailty in older populations, noting age-sex differences. The heterogeneity in the association between internet use and frailty provides evidence for the incorporation of digital technology into health care for older adults, highlighting its role in enhancing social interaction. These findings are cross-sectional, which limits causal inference. Further longitudinal study is needed.

Older adults might not use computers due to psychological barriers, environmental barriers such as not owning a computer or lack of internet access, and health-related barriers such as difficulties with fine motor skills, low cognitive function, or low vision. Given the health benefits of internet use among older adults, inadequate use of the internet is an urgent public health issue in many countries. We aimed to determine whether visual impairment is associated with internet use in a population-based sample of older adults. This cross-sectional study sourced data for the year 2016 from the Japan Gerontological Evaluation Study. It included functionally independent community-dwelling individuals aged ≥65 years (N=19,452) in Japan. The respondents reported their visual status by answering the question, \"Is your eyesight (without or with usual glasses or corrective lenses) excellent, very good, good, fair, or poor?\" We defined \"internet user\" as a person who uses the internet \"almost daily.\" We used multivariate logistic regression with multiple imputations to analyze visual status, daily internet use, and any correlations between them. We observed that 23.6% (4599/19,452) of respondents used the internet almost daily. Respondents with good visual status notably tended to use the internet more frequently than those with poor visual status. Specifically, 13% and 31% of respondents with poor and excellent vision, respectively, used the internet almost daily. In contrast, 66% and 45% of respondents with poor and excellent vision, respectively, did not use the internet. Even after adjusting for several covariates (age, sex, equivalized income, years of education, marital status, depression, history of systemic comorbidities, frequency of meeting friends, and total social participation score), significant associations persisted between visual status and daily internet usage. The odds ratios (ORs) tended to increase as visual status improved (P for trend <.001). The adjusted ORs for individuals with excellent and very good visual status who used the internet almost daily were 1.38 (95% CI 1.22-1.56) and 1.25 (95% CI 1.15-1.36), respectively. Conversely, the adjusted OR for those with fair or poor visual status was 0.73 (95% CI 0.62-0.86). In this study, we reaffirmed what several previous studies have pointed out using a very large dataset; visual impairment negatively impacted daily internet use by older adults. This highlights the need to address visual impairments to promote web use as health care services become more easily accessed on the web.

Drainage divide is a dynamic feature that migrates in response to tectonic activity. The asymmetric uplift between two adjacent basins causes the divide migration from a slower to faster uplift area. Sado Island, Japan, has been affected by southeastward tilting uplift for ca. 300k years. Despite the faster uplift on the northwest, the main divides have existed on the southeast side of the geometric center of the island, with no other feature suggesting tectonic inversion of the tilting direction. In this study, we conducted a digital elevation model (DEM) based investigation that focused on divide migration. A spectrum from very inactive to active divide migration in the northwest. Regardless of their position, actively migrating divides are comprehensible, but inactive divides located in a relatively slow uplift area remain unclear. We concluded that some divides slowed down owing to the local balance of erosion rates across the divides, which does not imply balance between uplift and river erosion at the basin scale, reflecting disequilibrium in river longitudinal profiles. The main divides of Sado have presumably continued to slowly migrate toward the area of faster uplift; however, they are most likely to have never overcome the moving geometric center owing to land expansion at the seacoast due to asymmetric uplift.

Background To answer whether older adults' cognitive function benefits from ICT use, we (1) examined the relationship between ICT use and cognitive decline during the COVID-19 pandemic and (2) explored the potential role of ICT use in mitigating the relationship between loneliness, social isolation, and cognitive decline among community-dwelling older adults. Methods From February to March 2021, a mail survey was distributed to 1,400 older adults aged 70–89 years old. Responded participants were 1,003 (71.6% response rate). Subjective cognitive decline (SCD) was the independent variable. ICT use was assessed based on ICT use history and current ICT use activities. Loneliness was based on the Japanese version of the Three-Item Loneliness Scale. Social isolation was a total score of six items. Covariate-adjusted logistic regressions were performed and stratified by age groups (70–79 and ≥ 80 years). Results During the COVID-19 epidemic, the proportion of people aged ≥ 80 years who reported cognitive decline was twice that of 70s. Non-ICT use was independently associated with a higher risk of cognitive decline in participants aged ≥ 80 years. Furthermore, the significant associations between cognitive decline and interaction items (non-ICT use by loneliness or social isolation) were observed in the ≥ 80 age group. No association was found in the 70–79 age group. Conclusions Non-ICT users with high loneliness or social isolation scores were more likely to experience cognitive decline for adults age ≥ 80 years. For older adults who were vulnerable to poor social relationships, ICT use is potentially an efficient intervention. Further longitudinal investigations are needed.

Background Competency in the use of information science and technology (IST) is essential for medical students. This study identified learning objectives and competencies that correspond with low self-assessment related to use of IST and factors that improve such self-assessment among medical students. Methods A questionnaire was administered to sixth-year medical students across 82 medical schools in Japan between November 2022 and February 2023. Results Three learning objectives were identified as difficult for the students to achieve: (1) provide an overview of the regulations, laws, and guidelines related to IST in medicine; (2) discuss ethical issues, such as social disparities caused by the digital divide that may arise in the use of IST in medicine; and (3) understand IST related to medical care. Further, problem-based learning, engaging with IST beyond class, and learning approach impacted the students’ acquisition of competencies related to IST. Furthermore, it was recognized that the competencies required by medical students may change over the course of an updated medical school curriculum. Conclusions It is important for medical students to recognize the significance of learning, establishing active learning methods, and gaining experience in practically applying these competencies.