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Lessons For The World From A Dramatically Aging Japan

China's GDP has overtaken that of Japan. If there's one key area where Japan can still teach the Chinese, it is Japan's demographic crisis.

Four smiles in Japan
Four smiles in Japan
Daisuke Kondo

TOKYO — Last week on my 50th birthday I strolled to the coffee shop near Tokyo University where I used to spend a lot of time as a student. It's located underground with dim lighting, and plays classical music all day long, loudly. I had expected to find the shop shut long ago, but to my surprise, it's still around. The middle-aged man who used to run it is still there, now a grey-haired elderly man. I looked around, and apart from my middle-aged self, all the other customers were old men.

There, I listened to Schubert's impromptus that I used to listen to 30 years back, which remind me very much of the first half of my life. I realize that I haven't changed much. I used to drink coffee, read and write. I liked listening to classical music and play piano. Over the years, all those daily habits remain, which is perhaps why I rarely notice the passage of time. It's probable that most Japanese people feel the same. Tokyo has stayed nearly unchanged in the past decades. Meanwhile, over the last 30 years, the "other" country I have called home over the years, China, has been through enormous changes. Tokyo experienced its own drastic changes during the 30 years after World War II. The shopping centers, office blocks and subways built at that time are still being used today.

The site of that café where I hadn't been for 30 years made me think that, unwittingly, Japan has gone from "economic power" to "elderly power."

Last year, the proportion of over 65-year-olds exceeded 25% of Japan's total population. It is estimated that in 10 years time the proportion will soar to one out of three Japanese being a senior citizen. At the current rate, by 2060, this figure will be one out of two.

Just look around in Tokyo: taking buses, shopping in supermarkets or buying books, one sees mostly old people around. Even taxi drivers are mostly older men. In my apartment building in Tokyo, two-thirds of the 230 households are elderly families. Nearby, there is a 500-meter-long pedestrian paradise. It has become entirely a shopping mall for the elderly.

If longevity is just about health there won't be much a problem. Hideyoshi Miyazaki from Kyoto, has raced into the Guinness World Records, at 105 after running 100 meters in 42.22 seconds in Kyoto. Shigeaki Hinohara, honorary chairman of the board of trustees at Tokyo's St. Luke's International Hospital, is 104 and remains active, carrying around with him a notebook to update his 10-year work plan.

Former Japanese Prime Minister Yasuhiro Nakasone is now 97 years old. He remains hale and hearty and is still piping up with political comments in the newspapers.

But of course such "senior stars" are rare cases. Age-related problems are gradually becoming the biggest issue in Japan, including growing incidence of Alzheimer's disease. Currently, in the population over 80-year-old in Japan, nearly 20% are afflicted with the disease, some five million eldely people with senile dementia, or the early signs of it, which is expected to double to account for 10% of Japan's demography in the coming years. Japan is entering a unprecedented era of the history of mankind.

Burdened nations and families

Two weeks ago, a 73-year-old man, in Miyazaki Kyushu, drove his car onto the sidewalk killing two and severely injuring five other. He was found to be a patient with early stage Alzheimer's, and couldn't recall a thing about what happened before or after the accident. Japanese police also report an increase in cases where old people with dementia take things without paying.

It is a huge burden to have a dementia sufferer in one's family, and the weight accumulates across society. Japan recorded 10,783 Alzheimer patients last year who were reported lost or missing. Some 100,000 people per year resign their jobs to take care of their parents suffering from the condition. This adds to a serious labor shortage already created by the nation's low birth-rate.

[rebelmouse-image 27089670 alt="""" original_size="639x479" expand=1]

Feeling the weight in Tokyo — Photo: Mailas

Still, families where children are capable of looking after their elders are already better off than couples who both suffer from dementia or who are childless.

Japan was the world's first country, in 2000, to develop a nursing care insurance law. The elderly can obtain a subsidy, in accordance with five categories, to obtain nursing care. Still, facilities and staff can't meet the need, and Japan is currently spending an astronomical $118 billion dollars on such care. To fundamentally solve its demograhic crisis, Japan must try to attract immigrants.

Having long outsourced most of its manufacturing sector, Japan must rely on foreign students working part-time to keep its service industries operation. And not always. Last weekend, I met up with an old friend visitng back from his current home in Brussels, and we wanted to get a drink at the big hotel in Tokyo's Shibuya district where he was staying. But both the bar and café were already closed, and the hotel told us they were simply short of staff. It took us nearly one hour wandering the neighborhood to find a place to sit down. When I was at college, Shibuya was a bustling downtown area, with pubs and bars open all night. Now they shut down by 11 p.m.

My friend, who works for the European Union, sighed: "Europe's biggest social issue for the moment is the Syrian immigrants. But in reality every country is competing to grab young refugees. The whole of European history is a history of immigrants and refugees. Twenty percent of Germany's population is of immigrant origin. In the 1970s, it relied on Turkish immigrants to achieve its position as an economic power. Meanwhile, even our capital city has become a city of old people, and our immigration policy remains closed. The government worries about security, when it should be worrying about demography. Japan will die sooner or later if this doesn't change."

The question of immigration, demography and security connects us all, from Brussels to Beijing to my old university neighborhood in Tokyo.

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The Benefits Of "Buongiorno"

Our Naples-based psychiatrist reflects on her morning walk to work, as she passes by people who simply want to see a friendly smile.

Photograph of a woman looking down onto the street from her balcony in Naples

A woman looks down from her balcony in Naples

Ciro Pipoli/Instagram
Mariateresa Fichele

In Naples, lonely people leave their homes early in the morning. You can tell they're lonely by the look in their eyes. Mostly men, often walking a dog, typically mixed breeds that look as scruffy as their owners. You see them heading to the coffee bar, chatting with the newsstand owner, buying cigarettes, timidly interacting with each another.

This morning as I was going to work, I tried to put myself in their shoes. I woke up tired and moody, but as soon as I left the building, I felt compelled, like every day, to say to dozens of "buongiorno!" (good morning!) and smile in return just as many times.

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