On 28 September 2003, just 5 days before his 109th birthday, after 114-year-old Yukichi Chuganji's death, Nakamura became the oldest living man in Japan and thereby the first man to be the oldest living man in Japan under age 110 since the first Japanese male supercentenarian Eiju Tsuru's death in January 1990. He grew weak and was bedridden the last years of his life and was hospitalized in mid-May 2004 when he became unable to eat without being fed intravenously. At 0.27am the night of Thursday 20 May, Nakamura died of natural causes at age 109 years, 230 days, and was succeeded as Japan's oldest man by Minsho Ozawa who was just 8 days younger and died of pneumonia just 53 days later. Nakamura and Ozawa were the last living Japanese men born in 1894.