With an average age of 45 years old and a population where one third of people is over the age of 65, Japan has one of the oldest populations on earth. This is due to two factors: one of the...Show moreWith an average age of 45 years old and a population where one third of people is over the age of 65, Japan has one of the oldest populations on earth. This is due to two factors: one of the highest life-expectancies on earth, and one of the lowest birth-rates on earth. As a result of this Japan's demographic pyramid has been flipped on its head, figuratively and literally. A demographic imbalance like this comes with many challenges, such as disappearing towns, pressure on health and pension funds, and the closure of schools across the country. There are many challenges to overcome, but arguably the key one's are two questions: how to increase the birth-rate, and how to take care of the elderly population. In this thesis we will look at how Japan has tried to tackle these two challenges, see what has been effective, and see what we can learn from it for a future where more and more developed countries are faced with aging populations and low birth ratesShow less
Frailty, an age-related decline in multiple physiological systems, increases risks to adverse health outcomes and mortality and is characterized by accelerated processes also seen in non...Show moreFrailty, an age-related decline in multiple physiological systems, increases risks to adverse health outcomes and mortality and is characterized by accelerated processes also seen in non-pathological ageing. According to neuroscientific models, a loss of sensorimotor stimulation due to degraded sensory input, and central processing deficits result in the development of maladaptive plasticity. To stop or reverse the underlying correlates of maladaptive plasticity, a tablet-based at-home sensorimotor training was administered to 48 frail German older adults. Pre-intervention, severity of frailty was assessed using the frailty phenotype framework as well as the Deficit Accumulation model. A reduced number of participants also had an MRI (n = 22) and fMRI (n = 18) scan done to assess regional gray matter volume and intra-network functional connectivity, respectively. Following randomization, the experimental group (n = 24) trained on unimodal and bimodal sensory discrimination tasks in the visual, auditory, and tactile domain. The control group (n = 24) engaged in an app-based relaxation training. After 60 days of training, both groups were reassessed on the above parameters. Results indicated that the sensorimotor intervention had a tendency towards an effect on frailty as assessed using the frailty phenotype model (p = .058). Furthermore, in the experimental group, gray matter volume decline in the precentral gyrus halted compared to the control condition (p = .007). As such, this result provides preliminary evidence that a neuroplasticity-oriented approach to targeting frailty could be of merit. This thesis underlines the importance of using longitudinal data to establish causality in the research on frailty and signposts the need to assess relationships between brain and frailty as an entity in its whole, beyond its subcomponents.Show less
