Kaoru Ishiyama gets to an orthopedic clinic in Kawasaki early so he can chat with about 20 other retirees while they wait outside for it to open, each sitting on folding chairs brought from home.

"I come six times a week to have a doctor check my back and for rehabilitation," said Ishiyama, 82, who was injured in a car accident years ago.

"We see each other almost every day. Coming to this clinic to see my friends is the secret to staying in good spirits," he said, puffing on a cigarette.