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The global burden of cardiovascular disease is spreading rapidly worldwide, not only in developed but also in developing countries, including Southeast Asian countries. I am involved in the ongoing (since 1990) longitudinal study on comprehensive geriatric assessment of community-dwelling elderly in Kochi Japan, which measures the incidence of metabolic syndrome associated with cardiovascular risk factors.

To compare with our findings of Japanese elderly, we carried out geriatric surveys of community-dwelling elderly in Southeast Asian countries. We found increasing prevalence of metabolic syndrome among the elderly in Khon Kaen, Thailand, but low prevalence among the elderly in Savannakhet, Laos, and among ethnic Isan elderly in Khon Kaen, Thailand. In addition, we started programs to prevent diabetes and metabolic syndrome in Tosa (Japan), Khon Kaen, and Savannakhet, and conducted an education program to promote awareness and exercise among the elderly in Khon Kaen and Savannakhet in order to prevent metabolic syndrome.

In another comparison, we found higher subjective happiness (quality of life) among the elderly in a nursing home in Myanmar than among those living in a welfare home in Osaka, Japan. We will continue to survey and compare what the elderly prefer in the end-of-life stage in Southeast Asia compared with Japan.