Clinically, the older adults who do not respond to administrative surveys are at high risk for dementia and other diseases in many cases. The aim of this study is 1) to examine this hypothesis, and 2) to establish a support system to reach out to them and help them live well, in the community-based participatory research (CBPR) in Chiyoda-ward, Tokyo, Japan, using a mail survey as a starting point to visit older community-residents who did not respond to the administrative survey.

The participants were residents aged 65+, living in Chiyoda ward, Tokyo, Japan in 2021 (N=4009, mean aged 74.2±6.6, female 54.9%). We conducted the survey by following three steps. First, we distributed self-administered questionnaire to all participants by mail. Second, a survey request letter was mailed to the older adults who did not return the survey (N=675, aged70+). We conducting visit investigation by visiting nurses for old-old people (N=87), and conducting assessment to evaluate risks of dementia and physical health. Third supporting people with high risk of dementia through cooperation among various organizations and various professions, and conducting watching support by visiting nurses as prophylactic care.

For the investigation by mail, 2050 participants sent back the investigation form. Of the 87 people living alone or in aged households who responded to the request for a visit survey, we were able to conduct home-visit surveys for 46 participants (implementation rate: 52.9%). As a result of the comprehensive assessment, 15 participants (mean aged 81.9±5.0, female 53.6%, MMSE: 25.2±2.8), were regarded as participants with high risk of dementia, and 3people of them were started watching support work.

We established a support system for people living with dementia that consist early detection and continuous support by the visiting nurse. There were many cases in which the home-visit nurses investigation led to continuous support. For the further research, it is necessary to review the long-term outcomes of those who received early support concerning whether they could maintain their quality of life.

The aim of this study was to examine the potential contribution of Death Cafés to the creation of a society that is inclusive of death, which is necessary for ACP, through an analysis of the motivations and orientations of Death Cafés hosts to run Death Cafés.

Interviews were conducted with 16 host of Death Cafés. Interview transcripts were segmented, coded and categorized, focusing on motivations and orientations for running Death Cafés.

Motivation for running Death Cafés were categorized into four categories: “The bereavement experience of the host”, “The identity crisis of the host”, “Dissatisfaction with a society in which death is taboo”, and “Unlocking new possibilities for Buddhist temples”

The orientation of Death Cafés was categorized into two categories. Namely, “Personal growth” and “Community development”.

Attitudes towards the attendees with grief were categorized in two categories. “Not mentioned” and ” Welcome participation/refer to more appropriate projects “.

The characteristics of the host and venue were categorized as “Buddhist monk and/or Buddhist temple” and “Other”.

The relationship between these four factors was examined. When the host's bereavement experience was the motivation for starting the Death Cafés, they tended to regard death as an overwhelming experience and to run an individually oriented Death Cafés with the intention of personal growth. When the motivation for starting the Death Cafés was dissatisfaction with a society that considered death a taboo subject, attitudes towards death tended to be neutral and the café tended to be socially oriented with the intention of community development. Where the motivation for starting the Death Cafés was to expand the possibilities of the Buddhist temple, which was one of the subcategories of “Community development”, attitudes towards death were neutral and café tended to be both individual and socially oriented.

Death Cafés held in Buddhist temples may have the potential to contribute to the creation of a death-inclusive society in Japan and could be an ACP implementation strategy.

Due to longevity, universal health coverage, declining population, and a stable society, it is estimated that the number of people with dementia will reach 10 million by the mid-21st century, accounting for 10% of the total population in Japan. To move toward a dementia-friendly community, it is essential to develop innovative and effective dementia care. However, human and economic resources are limited. Therefore, we focused on traditional Buddhist denominations that have organizations, educational systems, human resources, networks, and care venues. The fundamental question of this study is: Japanese Buddhism has created basis for mindfulness-based cognitive therapy, but is it also innovative in the care of older people?

We looked for papers that 1) were written in a medical rather than a religious context, 2) were written in English, and 3) dealt with the care of the older people in Japan.

1) Institutional care workers’ need for Buddhist priests for helping anxiety of older residents was reported. 2) Effectiveness of community cafés for the family caregivers of people with dementia in the Buddhist temples were reported. 3) Potentials of monthly visit to bereaved families, Buddhist priests’ tradition, as the outreach of grief care was suggested. 4) Care workers’ own ideas about death after working in the landscape of dying and death was reported by the interview which used Buddhist priests as the interviewers.

Participation of Buddhist priests as 1) spiritual cares for the residents in the institutions, 2) carers for the family carers in the community, 3) carers of the bereaved families in the outreach activity, and 4) carers for the care workers, were reported. However, robust evidence was not enough. From the standpoint of Japanese clinicians, there are too few papers compared to the actual contributions. More studies should be done which might also work as external monitoring. Traditional Buddhism in Japan has a closed membership system which is based on the family gravesite system and is generally not enthusiastic about propagation, which would also be compatible with a secular care system.

All older adults, including those already living with dementia, should be provided with adequate knowledge about dementia and be aware of how to navigate the social resources available to them. The purpose of this study was to develop a practical program to help older adults living in the community learn about cognitive decline and how to use related social resources.

Program participants included attendees of a community center for dementia support in a major Japanese city, as well as the residents of a large housing complex in the local area. Within the cohort, there were participants who willingly disclosed to having dementia. The program began in February 2021 and was held once a month for a total of 15 hour-long sessions. A participant survey was administered at each session to gather the demographic information of participants and their understanding of the program. Additionally, the staff conducted recorded verbal discussions about the program, which were then reviewed using thematic analysis.

The program structure was as follows: (1) participants decided the theme; (2) the first half of each session comprised lectures, while the second half included discussion and group work; and (3) rules for discussion were established (do not interrupt, do not unilaterally deny what people say, maintain confidentiality). The average number of participants per session was 12.1. Survey results indicated that 70.5% of participants were female and, in terms of age, the largest number of attendees were 81-90 years old (48.5 ). Most participants “understood the program content well” (72.5%) and indicated that “they would strongly like to participate again” (64.2%). The recorded participant discussions about the program were suggested, after review, to be more superficial as a result of Japanese people's particular attitude of not wanting to bother others.

Participants were highly satisfied with the program and were able to help develop a practical program for people living with dementia to learn effectively. A challenge was that participants had a “do not want to bother others” mindset, which could inhibit them from expressing their true wishes and make them less likely to use social resources.

During the spread of infectious diseases, social isolation increases among the elderly with cognitive impairment. The telephone may be a traditional but realistic and reliable tool to prevent social isolation. We report here a pilot study to examine the effects of regular telephone communication on elderly people with cognitive decline living in urban areas.

Seventeen elderly people (including four males) who attended a session for recruiting participants for a class using the board game “Go” in Tokyo were paired and talked on the phone once a week about Go issues and other interests during the 3-month class period, starting January 2022. At the end of the class in April 2022, a self-administered questionnaire (5 items, 4-point scale) and semi-structured interview were conducted. The Ethics Committee of the Tokyo Metropolitan Institute of Gerontology approved the study, and the participants’ written consent was obtained.

The participants’ mean age was 80.1 ± 5.5 years, and the mean score of the Montreal Cognitive Assessment, which screens for mild cognitive impairment, was 21.3 ± 3.1, with 16 subjects (94.1%) scoring below the cut-off value of 25. The percentages of “agree” or “somewhat agree” responses indicated that the telephone interaction was “enjoyable” (94.1%), “had a positive effect” (88.2%), and they “would like to talk on the phone sometimes in the future” (76.5%). In the interviews, the positive responses were “(Because I was looking forward to the phone call so eagerly) I couldn't wait for the phone call,” “I enjoyed playing Go,” “It was easy to talk about Go because it was a common topic,” “We talked about things other than Go,” and “I want to go out with my pair partner,” while others were “I was careful about what talk about” and “It was difficult to maintain psychological distance from my pair partner.”

The results suggest that telephone communication may be effective for preventing social isolation among the elderly with cognitive impairment. We believe that promoting telephone interaction during normal times between residents in the community with common interests will build supportive relationships and lead to a Dementia-friendly society.

A national prevalence study of early-onset dementia in Japan has provided data on their challenges and support needs, as documented by the individual and their family members. This study examined differences between 1) cases that the onset of early-onset dementia was detected by work colleagues, and 2) other cases.

After identifying medical or long-term care service offices used by people with early-onset dementia in 12 regions in Japan, a questionnaire was distributed to the individuals and their family members. The items surveyed were age at the time of the survey, gender, employment at the onset, age when the initial symptoms were detected, the person who detected the initial symptoms, and consideration received at the workplace. In this report, only those who were working at the onset were included in the analysis. Next, they were divided into two groups according to whether the person who detected the initial symptoms was a colleague or not, and a chi-square test was used to compare the two groups. This study was conducted with the approval of the Ethics Committee of the Tokyo Metropolitan Institute of Gerontology and Geriatric Medicine.

Of the 1035 questionnaires collected, 559 were were working at the time of onset of initial symptoms, and 149 (26.7%) of these cases were initially detected by a colleague. Comparison between groups revealed that the cases detected by colleagues 1) were recommended to see an occupational physician (P<0.001), 2) were referred to a specialist (P<0.001), 3) received consideration such as reassignment in the workplace (P<0.001), 4) received consideration regarding transportation (P=0.023), 5) had someone to talk to in the workplace (P<0.001), and 6) were significantly unlikely to receive no consideration at all (P=0.010).

Early-onset dementia was noticed by a colleague due to an increase mistake in the workplace but may have received reasonable accommodations that could have been considered by each workplace. The results of this study may help to promote dementia-friendly workplace strategies.

Repeated drug overdose is a major risk factor for suicide. Data are lacking on the effect of psychiatric intervention on preventing repeated drug overdose.

To investigate whether psychiatric intervention was associated with reduced readmission to emergency centres due to drug overdose.

Using a Japanese national in-patient database, we identified patients who were first admitted to emergency centres for drug overdose in 2010–2012. We used propensity score matching for patient and hospital factors to compare readmission rates between intervention (patients undergoing psychosocial assessment) and unexposed groups.

Of 29 564 eligible patients, 13 035 underwent psychiatric intervention. In the propensity-matched 7938 pairs, 1304 patients were readmitted because of drug overdose. Readmission rate was lower in the intervention than in the unexposed group (7.3% v. 9.1% respectively, P<0.001).

Psychiatric intervention was associated with reduced readmission in patients who had taken a drug overdose.