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Japan has experienced pronounced population aging, and now has the highest proportion of elderly adults in the world. Yet few projections of Japan's future demography go beyond estimating population by age and sex to forecast the complex evolution of the health and functioning of the future elderly. This study adapts to the Japanese population the Future Elderly Model (FEM), a demographic and economic state-transition microsimulation model that projects the health conditions and functional status of Japan's elderly population in order to estimate disability, health, and need for long term care. Our FEM simulation suggests that by 2040, over 27 percent of Japan's elderly will exhibit 3 or more limitations in IADLs and social functioning; almost one in 4 will experience difficulties with 3 or more ADLs; and approximately one in 5 will suffer limitations in cognitive or intellectual functioning. Since the majority of the increase in disability arises from the aging of the Japanese population, prevention efforts that reduce age-specific disability (or future compression of morbidity among middle-aged Japanese) may have only a limited impact on reducing the overall prevalence of disability among Japanese elderly.

Based on data of Rosstat for 1989-2018, changes in structure of infectious mortality (IM) in population of Moscow are analyzed in comparison with situation in the country as a whole. Age structure of European population was used to calculate standardized death rates. The rise in IM after change in Russian socio-political structure was less pronounced and not as long in Moscow as in the country. During analyzed period, IM increased by 1.4 times among men and 2.2 times among women in Russia while in the capital male IM decreased by 8.9% and female IM increased by 1.4 times. IM of Muscovites was lower than average Russian IM by a quarter in 1989 and twice in 2018. The highest IM was observed at age of 85 years and older in 1989 and at age of 35-39 years in 2018. Proportion of tuberculosis (TB) has significantly decreased (from 60.8% in the country and 65.5% in the capital to 19.9% and 9.9%). In the country, male TB mortality decreased by 1.8 times and female TB mortality in 2018 approached the 1989 level; in the capital, mortality of men and women decreased by 4.6 and 2.9 times. Proportion of AIDS has increased. The death rates began to exceed TB mortality since 2015 among men and since 2014 among women in Russia and since 2010 and 2007 in Moscow. In 2018, the share of AIDS was 60.2% (58.2% and 62.9%) in country and 55.0% (55.8% and 52.9%) in capital. Proportion of viral hepatitis has increased. In the country, mortality increased by 3.8 times for men and 3.0 times for women, in the capital, mortality increased by 1.6 and 13.0 times respectively. In 2018, the share of viral hepatitis was 6.5% (6.1% and 6.8%) in country and 16.5% (7.1% and 37.1%) in Moscow. Proportion of socially significant diseases in IM increased from 63.9% in country and 69.4% in capital to 90.7% and 86.2%. The peculiarities of IM in Moscow, given the greater availability of antiretroviral therapy, suggest that this IM is caused by a fairly wide consumption of injecting drugs by residents of the capital. Key messages Proportion of socially significant diseases in infectious mortality increased from 63.9% in country and 69.4% in capital to 90.7% and 86.2%. The peculiarities of IM in Moscow, given the greater availability of antiretroviral therapy, suggest that this IM is caused by a fairly wide consumption of injecting drugs by residents of the capital.

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