Abstract
For many Japanese, fear about senility is not primarily expressed in relation to pathological conditions like Alzheimer's Disease (AD). Instead, as people grow older, their concern focuses on a widely recognized category of decline in old age which, although symptomatically and conceptually overlapping with AD and other forms of senile dementia, is distinguished from unambiguously pathological conditions. This article examines the meaning and experience of this condition, known as boke, and shows that senility in Japan is culturally constructed in a way distinct from the clinical biomedical construction of senility-as-pathology which has become increasingly the norm in North America. Rather than being a disease, boke is viewed as an illness over which people are believed to have some degree of agency in relation to its onset – through activity, particularly within the context of groups, it may be prevented or at least delayed. The data discussed also suggest the importance of culture in defining the meanings of normal or abnormal aging. While from a clinical perspective it may be clear where the line is to be drawn between what is normal and what is pathological aging, from the perspective of older people, the basis of what is considered normal or abnormal aging may not have a direct link to disease.
Similar content being viewed by others
References
Ariyoshi, S. (1984). The twilight years (Mildred Tahara, trans.). New York: Kodansha International.
Atchley, R. C. (1989). A continuity theory of normal aging, The Gerontologist 29: 183–190.
Atchley, R. C. (1993). Continuity theory and the evolution of activity in later adulthood. In J. R. Kelly (ed.), Activity and aging (pp. 5–16). Newbury Park: Sage Publications.
Beall, C. S., Baumhover, L. A., Maxwell, A. J. & Pieroni, R. E. (1996). Normal versus pathological aging: knowledge of family practice residents, The Gerontologist 36(1): 113–117.
Befu, H. (1967). Gift-giving in a modernizing Japan, Monumenta Nipponica 23(3–4): 445–456.
Cohen, L. (1995). Toward an anthropology of senility: Anger, weakness, and Alzheimer's in Banaras, India, Medical Anthropology Quarterly 9(3): 314–334.
Cummings, J. L. (1995). Dementia: the failing brain, The Lancet (th American Edition) 345: 1481–1484.
Fabrega, H. (1975). The need for an ethnomedical science, Science 189: 969–975.
Hashimoto, A. (1996). The gift of generations: Japanese and American perspectives on aging and the social contract. New York: Cambridge University Press.
Hayakawa, K. (1992). Boke nai hanashi, rôke nai hanashi [Talking about not being senile, not being old]. Tokyo: Shôgakkan.
Henderson, J. N. & Gutierrez-Mayka, M. (1992). Ethnocultural themes in caregiving to Alzheimer's patients in Hispanic families, Clinical Gerontologist 11: 59–74.
Henderson, J. N. (1997). Dementia in cultural context: Development and decline of a caregiver support group in a Latin population. In J. Sokolovsky (ed.), The cultural context of aging: Worldwide perspectives 2nd edn (pp. 425–442). Westport: Bergin & Garvey.
Herskovits, E. (1995). Struggling over subjectivity: debates about the 'self' and Alzheimer's Disease, Medical Anthropology Quarterly 9(2): 146–164.
Ikeda, H. (1995). Rônenki chihô no korin de fusegeru ka? [Does choline from egg yolks protect against senile dementia?]. Tokyo: Kodansha.
Ineichen, B. (1996). Senile dementia in Japan: Prevalence and response, Social Science and Medicine 42(2): 169–172.
Kalab, K. A. (1992). Paying gateball: A game of the Japanese elderly, Journal of Aging Studies 6(1): 23–40.
Khachaturian, Z. S. & Radebaugh, T. S. (1996). Synthesis of critical topics in Alzheimer's Disease. In Z. S. Khachaturian & T. S. Radebaugh (eds.), Alzheimer's Disease: cause(s), diagnosis, treatment, and care (pp. 3–12). New York: CRC Press.
Kikkawa, T. (1995). Hito wa naze bokeru no ka: Boke no genin to keaa [Why do people become senile? The causes and care of senility]. Tokyo: Shinseidehansha.
Kondo, D. K. (1987). Creating an ideal self: Theories of selfhood and pedagogy at a Japanese ethics retreat, Ethos 15(3): 241–272.
Kondo, D. K. (1990). Crafting selves: power, gender, and discourses of identity in a Japanese workplace. Chicago: University of Chicago Press.
Lebra, T. S. (1976). Japanese patterns of behavior. Honolulu: University of Hawaii Press.
Lock, M. (1980). East Asian medicine in urban Japan: Varieties of medical experience. Berkeley: University of California Press.
Lock, M. M. (1993). Encounters with aging: Mythologies of menopause in Japan and North America. Berkeley: University of California Press.
Long, S. O. (1997). Reflections on becoming a cucumber: Images of the good death in Japan and the U.S. Unpublished paper presented at the Center for Japanese Studies, University of Michigan.
Morris, J. C. (1996). Diagnosis of Alzheimer's Disease. In Z. S. Khachaturian & T. S. Radebaugh (eds.), Alzheimer's Disease: Cause(s), diagnosis, treatment, and care (pp. 76–84). New York: CRC Press.
Ohnuki-Tierney, E. (1984). Illness and culture in contemporary Japan: An anthropological view. New York: Cambridge University Press.
Plath, D. W. (1980). Long engagements: Maturity in modern Japan. Stanford, CA: Stanford University Press.
Sae, S. (1995). Kôraku. Tokyo: Shichôsha.
Traphagan, J. W. (1997). In the shadow of Obasuteyama: Old age and the disembodiment of social values in a Japanese town. PhD Dissertation, University of Pittsburgh.
Traphagan, J. W. (1998). Contesting the transition to old age in Japan, Ethnology (in press).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Traphagan, J.W. Localizing senility: Illness and agency among older Japanese. Journal of Cross-Cultural Gerontology 13, 81–98 (1998). https://doi.org/10.1023/A:1006566300463
Issue Date:
DOI: https://doi.org/10.1023/A:1006566300463