For decades, medical problems of atherosclerosis has been in focus for adequate management for various patients [1]. From anti-aging point of view, adequate treatment and care would be required for atherosclerosis [2]. Atherosclerosis can be often observed in atherosclerotic cardiovascular disease (ASCVD), including cerebral vascular accident (CVA), ischemic heart disease (IHD), and peripheral artery disease (PAD) [3]. Some factors would be required for anti-aging medicine, such as the decrease of glycation and the recommendation of low carbohydrate diet [4,5].

In order to continue the optimal daily health for long years, physical factors are fundamentally required such as nutrition and exercise [6,7]. Furthermore, psychological and social factors would be more important for human community to live with various people [8,9]. For various philosophy, holistic medicine with patient-oriented model and Hinohara-ism seem to contribute human well-being and happiness [10,11]. Authors and collaborators have continued clinical practice and treated lots of patients with various health problems. Among them, we experienced an impressive elderly female who has kept regular lifestyle, developed sport achievements, and provided educational and cultural contribution in the community. Their outline and related perspectives are described in this article.

Medical H & P

The current case has been an 85-year-old elderly female. Concerning the medical history, she has been treated for dyslipidemia, and continued to visit our clinic from 76 years old. When she was teenager, she has been an elite gymnastic athlete. Then, she has an excellent balance sensation and athletic ability at that time. When she underwent health check up in the middle of 70s’, the doctor in charge asked her whether she can run fast. The reason was that gymnastic athlete has higher level of all exercise abilities including short-distance dash.

After that, she attended short-distance races in the competition of Masters Athletics competition from 76 years old. In the assembly of Japan Masters Athletics (JMA), her performance was excellent due to her gifted predisposition, continuous effort and her pleasant positive character. She won all of track sprint races of 60m, 100m, 200m, 400m, and established the new all-time record so far in Kagawa JMA competitions?(Figure 1).

Figure 1: Start of short-distance dash in masters’ athlete competition (2017).

Her physical examination showed as follows: vital signs were unremarkable for BP 134/80, pulse 68/min and SpO₂ 98%. Her statue showed height 146.8cm, weight 41.0kg, and BMI 19.0 kg/m². There were no remarkable findings for consciousness, speech, head, face, neck, lung, heart, abdomen or neurological examinations. She did not complain of any particular symptoms, such as dizziness, chest oppression, or fatigue.

Social History

She has worked for long years in Kagawa as a Certified Social Insurance and Labor Consultant. She started her career in the local government office. She was very good at working in the office for writing official documents. In the early days, she created documents using a mimeograph, then moved on to a typewriter, a word processor, and now to the PC. She has adapted to the ever-evolving technology and continued working even after retirement. For some decades, the workplace environment has also changed. The novel era has come for “gender equality”, and she had the opportunity to speak as a representative of the official announcement. She has conducted the cadastral survey and presented the research in the Japan National Land Fair in 2000 (Figure 2).

Figure 2: Speech of community research in Japan National Land Fair in 2000.

Consequently, she has been one of the most trusted persons in the community, and then she was asked to give some lectures and write some commentaries in the newsletters. From these episodes, an impressive project in the community has launched including the novel educational project for children and adults. It is “Gio-College Summer School” (annual and additional activities), which are supported by local government, educational committee, and other community associations. The director is her son, Prof. Shoichi Kiyokawa, Kyushu University and his disciples always collaborate the 3 days project (Figure 3). Many disciples always come and stay at her home, then she is always busy for taking care as if she would be a grandmother or hotel manager.

Figure 3: The flyer of Gio-College workshop in 2025.

Several Exams

Blood chemistry examinations showed unremarkable values, which is summarized in Table 1. From mentioned above, she has been provided some oral medicine. They include atorvastatin 10mg, Acetylsalicylic acid 100mg, and zolpidem tartrate 5mg. Chest X-ray showed negative results, and electrocardiogram (ECG) revealed ordinary sinus rhythm (OSR), with unremarkable ST-T changes as within normal limits (WNL) (Figure 4).

Table 1: The progress of blood chemistry examination.

The current female case was an 85-year-old female. She has several characteristic points from clinical and anti-aging medicine points of view. Ther notable features include in the followings.

i) She showed excellent academic achievements from a young age, excelled in gymnastics and sports, and kept a good health for long time with her regular life.

ii) She has worked for long in administrative positions, took some speech in the national congress for community research, and continued working as a social insurance labor consultant into her 70s.

iii) A sport doctor, incidentally, noticed her athletic ability and recommended her to participate in masters athletic competition events.

iv) She has established local prefectural records in the short distance dash for 60, 100, 200, 400, and 800 meters.

v) Due to these activities and existing relationships of trust, she was invited to give lectures and write articles in the community activities.

vi) The Geo-College Summer School, an annual program and related events, has now begun, which was established her son (University Prof) and community-based educational and cultural activities have been expanding so far.

vii) In terms of her bio-psycho-social health, she has maintained a healthy lifestyle. Several medical indicators of arteriosclerosis have remained unchanged or shown some improvement despite her advanced age. This is a valuable case as a model for anti-aging .

Furthermore, we will consider arteriosclerosis in more detail. She had dyslipidemia and has been taking atorvastatin for years. Routine blood tests showed no remarkable changes, her electrocardiogram was within the normal range, and no particular cardiovascular or orthopedic problems were noted even during exercise. Arterial stiffness (AS) has been evaluated by the degree of brachial-ankle pulse wave velocity (baPWV) [12]. Her PWV showed a stable ABI value over many years. CAVI showed a tendency for arteriosclerosis to remain stable or slightly improve over the years, rather than progressing annually [13].

The reasons for this minimal progression of arteriosclerosis may be due to several fact and progress. They are i) dyslipidemia was managed with medication, ii) her blood sugar and blood pressure had remained stable for long, iii) her physical activity as part of her lifestyle, iv) her ongoing work as a social insurance labor consultant with her junior colleagues, and v) her son's long-standing trust in the community. Such characteristics have played a major role in starting and developing community activities for children and adults in their native hometown. They contributed much to their sense of value and existence [14]. Her son's university colleagues and juniors constantly come and cooperate, often staying a few days. During them, she was expected to be looked after in every way, leading to a fulfilling life [15,16].

Some limitation may be present for this report. This elderly case has stable biochemical data and certain degree of arteriosclerosis. From bio-psycho-social point of view, several positive factors may be involved in her clinical progress. They include her physical control, psychological stability and social contribution. We will follow up the future course with attention.

In summary, 85-year-old female with stable persistence of arteriosclerosis has been introduced, where some bio-psycho-social perspectives were included. Probably, her regular lifestyle and ikigai (Raison D’etre) may be the main power to bring satisfactory QOL and well-being.

Conflict of interest: The authors declare no conflict of interest.

Funding: There was no funding received for this paper.

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