JP2022016348A - Computer program and dementia impairment occurrence possibility determination device - Google Patents

Abstract

To provide a computer program and a dementia impairment occurrence possibility determination device capable of simply determining the possibility of the occurrence of a mild cognitive impairment (MCI).SOLUTION: A computer program causes a computer having a screen and voice output means to execute: a display step of displaying a predetermined problem on the screen; an answer step of instructing a subject to answer, with voice by the voice output means; a storage step of acquiring a result of making the subject to answer, determining whether the answer is correct, and stores a result of the determination in a recording medium; and a determination step of determining the possibility of the occurrence mild cognitive impairment in the future by substituting the stored result into a predetermined expression and comparing a result of the substitution with a predetermined threshold.SELECTED DRAWING: Figure 2

Description

There is an application for application of Article 30, Paragraph 2 of the Patent Law. 6th Annual Meeting of the Japanese Physical Therapy Association (54th Annual Meeting of the Japanese Physical Therapy Association) Abstracts (Publisher: Japanese Physical Therapy Association, Issued: October 10, 2019) Title No. O- 23-1, Title "Prediction ability of MCI onset 2 years later by cognitive function test using tablet computer" 2. The 6th Annual Meeting of the Japanese Society of Preventive Physical Therapy (54th Annual Meeting of the Japanese Society of Physical Therapy) (Date: October 20, 1991, Venue: Hiroshima International Conference Hall 4th Venue (Cosmos), Title No. O- 23-1 validity of the Computer-Based Cognitive Assessment Tool for intervention in community-dwelling older individuals "issue Date: March 1, 2020, the issuer: Japan Geriatrics Society 4. Wiley onlinelibrary of the web page (https - // onlinelibrary.wiley. com / doi / full / 10.1111 / ggi.13836 https: //doi.org/10.1111/ggi.13836 (address at the time of first issue on January 8, 2020) Title: "Development and validation of" the Computer-Based Cognitive Assessment Tool for intervention in community-dwelling older individuals "issue Date: January 8, 2020, the issuer, such as: John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society 5.PMC (PubMed Central) Web page (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC70651226/) Title: "Development and validation of the Co"

The present invention relates to a program and a device for determining the possibility of dementia dysfunction, which can easily determine the possibility of mild cognitive impairment (MCI).

In the current situation where no therapeutic or preventive drug for dementia has been established for dementia control, it can be said that the most effective means is to detect and deal with mild cognitive impairment (MCI), which is a precursor of dementia, at an early stage. Since the most used evaluation method for cognitive function evaluation is a paper-based psychological test, there are problems such as the need for a trained inspector and the learning effect of repeated tests, so anyone can use it at any time. It is difficult to easily evaluate cognitive function.
Therefore, various methods for easily evaluating cognitive function or measures for dementia have been proposed.
For example, Patent Document 1 proposes to provide a dementia countermeasure system, a dementia countermeasure method, and a program that can promote improvement of brain function and lifestyle improvement related to long-term memory of a user. Specifically, a plurality of training problems classified according to the difficulty level, a problem storage unit in which lifestyle advice is stored, and a plurality of user information in which the user's identifier and the difficulty level information of the problem are associated with each other. Of a plurality of training problems, the training problem is used as an output problem based on the difficulty level information of the problem associated with the user information of the user when the training start request is received from the user information storage unit to be stored and the terminal device. A selection part to select from, a creation part to create a past confirmation question about at least one of the output problem and lifestyle advice output to the user, and an output question selected by the selection part, created by the creation part. A system has been proposed that outputs at least one of the past confirmation problem and the lifestyle advice stored in the problem memory unit.
Further, Patent Document 2 proposes to provide a cognitive function evaluation device, a cognitive function evaluation method, and a program capable of obtaining highly accurate cognitive function evaluation results in a short time. Specifically, in the cognitive function evaluation device, the formant analysis unit receives target data representing the time variation of the instantaneous sound pressure of a specific phoneme contained in the voice of the subject over a target period. Then, the formant analysis unit divides the target period into a plurality of frames, and obtains a specific formant frequency for each of the two or more target frames. The feature analysis unit obtains a feature amount for a specific formant frequency obtained for each target frame. The evaluation unit has proposed a device that evaluates the cognitive function of the subject based on the feature amount.
In addition, Patent Document 3 proposes one that enables targeting, individual measurement, and management of cognitive skill development by users, medical personnel, teachers, and parents. Specifically, as a game-based virtual learning curriculum for targeting and developing cognitive skills underlying executive functions, cognitive skills (eg, attention concentration, attention retention, cognitive suppression, behavioral suppression, selectivity) An effective and rapid video game-based training curriculum that improves attention, diversion, distributive attention, interference control, novelty suppression, satisfaction delay tolerance, inner voice, motivation suppression, and self-control). Has been proposed.
Further, the cognitive function evaluation method using a computer is reported in Non-Patent Documents 1 and 2, and Non-Patent Document 3 reports the prediction of the onset of dementia using a computer.
Further, as shown in Non-Patent Document 4, the present inventors have already reported on the possibility of cognitive function test using a tablet terminal.

Japanese Unexamined Patent Publication No. 2019-219538 Japanese Unexamined Patent Publication No. 2018-050847 Special Table 2018-533044 Gazette

Makizako H, Shimada H, Park H, Doi T, Yoshida D, Uemura K, et al. Evaluation of multidimensional neurocognitive function using a tablet personal computer: test-retest reliability and validity in community-dwelling older adults. Geriatr Gerontol Int. 2013 13 (4): 860-6. Paul Maruff YYL, David Darby, Kathryn A Ellis, Robert H Pietrzak, Peter J Snyder, Ashley I Bush, Cassandra Szoeke, Adrian Schembri, David Ames, Colin L Masters. Clinical utility of the cogstate brief battery in identifying cognitive impairment in mild cognitive impairment and Alzheimer's disease. BMC Pharmacology and Toxicology. 2013; 1. Shimada H, Makizako H, Park H, Doi T, Lee S. Validity of the National Center for Geriatrics and Gerontology-Functional Assessment Tool and Mini-Mental State Examination for detecting the incidence of dementia in older Japanese adults. Geriatr Gerontol Int. 2017 17 (12): 2383-8. Abstracts of the 77th Annual Meeting of the Japanese Society of Public Health, published on October 9, 2018, presentation number O-2301-5, title "Development of cognitive function test using tablet computer and examination of its validity"

However, the devices and systems according to the proposals of the above-mentioned patent documents and non-patent documents have not yet been suggested to predict mild cognitive impairment (MCI). If it becomes possible to predict the occurrence of MCI easily and objectively, various measures can be taken to prevent the transition to dementia. In addition, the parties have time to recognize the risks from an early stage and prepare for coexistence with cognitive decline. Further, even in the report in Non-Patent Document 4, there is a problem that the cognitive function test cannot be performed with sufficient accuracy.
Therefore, an object of the present invention is to propose a computer program and a device for determining the possibility of dementia dysfunction, which can easily and accurately determine the possibility of mild cognitive impairment (MCI).

As a result of diligent studies to solve the above problems, the present inventors have found that the above object can be achieved by carefully selecting the problems and performing ROC analysis using the results obtained by using the problems. The present invention has been completed based on such findings.
That is, the present invention provides the following inventions.
1. 1. A computer program that causes a computer with screen and audio output means to perform the following steps.
A display step that displays a given problem on the above screen,
Answer step, in which the subject is instructed by voice by the above voice output means and is made to answer.
Obtain the answer result that the subject answered, judge whether it is correct or incorrect, store the score, age and gender information in the recording medium, and substitute the score, age and gender information into the predetermined formula to obtain the predicted score. , Storage step,
A determination step in which the stored predicted score is compared with a predetermined threshold value to determine the possibility of future mild cognitive impairment.
2. 2. 1. The computer program according to 1, wherein the audio output means is noise canceling headphones.
3. 3. In the above display step, the above-mentioned problems to be displayed on the above-mentioned screen are number forward singing, number reverse singing, immediate memory, remote memory, Stroop task, and graphic recognition.
The computer program according to 1 or 2, wherein the predetermined formula in the storage step is the following formula for predicting the occurrence of mild cognitive impairment.
Predictive score for mild cognitive decline = forward score of numbers x (-0.503) + reverse score of numbers x (-0.540) + immediate memory score x (-0.056) + remote memory score x (-0.314) + Stroop task score x (-0.155) + figure recognition score x (-0.307) + gender (male: -0.233, female: 0) + age x (0.00036) + constant (-3.105)
4. The computer program according to any one of 1 to 3, wherein in the storage step, when the predicted score is obtained by the predetermined formula, the answer time is also acquired, and the determination result is weighted by the answer time and corrected. ..
5.1 A device for determining the possibility of dementia dysfunction in which the computer program described above is stored.
It has a screen and audio output means,
A display means for displaying a predetermined problem on the above screen,
Answering means, in which the subject is instructed by voice by the above-mentioned voice output means and is made to answer.
The answer result obtained by the subject is obtained, the correctness is judged, the storage means for storing the judgment result in the recording medium, and the stored result are substituted into a predetermined formula, and the substitution result is compared with a predetermined threshold value. A device for determining the possibility of dementia dysfunction, which comprises a determination means step for determining the possibility of mild cognitive impairment in the future.

The computer program of the present invention can easily propose and provide a device for determining the possibility of occurrence of dementia dysfunction, which can easily determine the possibility of occurrence of mild cognitive impairment (MCI), and the computer program of the present invention can provide a device for determining the possibility of dementia dysfunction. The occurrence possibility determination device can easily determine the possibility of occurrence of mild cognitive impairment (MCI).

FIG. 1 is a schematic diagram of a computer used in the present invention. FIG. 2 is a schematic diagram showing a flow sheet of the computer program of the present invention of the present invention. 3 (a) to 3 (f) are explanatory views showing an example of a problem displayed on a computer screen using the computer program of the embodiment shown in FIG. 2. FIG. 4 is an explanatory diagram showing another problem. FIG. 5 is a chart showing the ROC curve in Example 1. FIG. 6 is a chart showing the ROC curve in Example 2.

1: Computer, 11: Memory, 13: CPU, 15: Storage medium, 20: Input device, 30: Screen, 40: Audio output means

Hereinafter, the present invention will be described in more detail.
First, the computer program of the present invention (hereinafter, may be simply referred to as a "program") will be described, and then the dementia function decline possibility determination device (hereinafter, abbreviated as "determination device") of the present invention will be described. The program of the present embodiment is for conducting a predetermined test on a subject and determining the possibility of future dementia dysfunction based on the result.
The computer program of the present invention causes a computer having the screen and audio output means shown in FIG. 1 to perform the following steps shown in FIG.
Display step S1 to display a predetermined problem on the above screen,
Answer step S2, in which the subject is instructed by voice by the above voice output means to answer.
Obtain the answer result that the subject answered, judge whether it is correct or incorrect, store the score, age and gender information in the recording medium, and substitute the score, age and gender information into the predetermined formula to obtain the predicted score. , Storage step S3,
A determination step S4 for determining the possibility of future mild cognitive impairment by comparing the stored predicted score with a predetermined threshold value.
Hereinafter, with respect to this embodiment, the computer will be described first, and then each step will be described.

〔Computer〕
Specifically, as shown in FIG. 1, the computer 1 used in the present embodiment has a central processing unit (CPU) 13, a memory 11 as a temporary storage area, and a non-volatile computer such as a hard disk or a solid state device. An ordinary personal computer including the storage medium 15 can be used without particular limitation. Further, although not particularly shown, the computer in the present embodiment preferably has a communication device and is capable of communication via a network. By communicating, it is possible to connect to a server that has a database located on the network and set it to obtain updated data from the database at any time.
Further, the computer is equipped with an image input device such as a keyboard, a mouse and a camera, an audio input device such as a microphone, and an input device 20 such as a communication input device using a communication device such as Bluetooth (registered trademark), and appropriately necessary data and data are provided. Set to enter information. Further, a screen (display) 30 for displaying the evaluation result is provided, and the result is appropriately displayed in a desired form. In the present embodiment, the screen 30 is a touch panel having a built-in so-called touch sensor, and the answer and operation described later can be performed by directly touching the screen. Further, by appropriately connecting to a printer (not shown) and outputting the information, necessary information, for example, a determination result can be output.
In this embodiment, an audio output means 40, specifically, an external output means such as a speaker or a headphone is provided. The audio output means is preferably so-called noise canceling headphones. That is, the audio output means 40 may be built in a computer or may be an external output means such as headphones connected via an earphone jack of the computer or via a communication device such as Bluetooth (registered trademark).
In the present embodiment, the program of the present embodiment is stored in this computer, and the computer is made to function as a display means, a response means, a storage means, and a determination means described later, and to function as a determination device.
Further, in the present embodiment, a mobile terminal such as a so-called smartphone or tablet terminal, which also has a screen as an input means, can be preferably used, and these are also included in the "computer" in the present invention.
<Other members (devices)>
The computer of the present embodiment may include various devices in addition to the above-mentioned devices, if necessary.

[Preliminary step S0]
In the computer program of the present embodiment, a question (screen) formed by storing predetermined questions for performing a predetermined test together with their answers in the computer or a server connected to the computer via a network. It is preferable to have a preliminary step that constitutes a database having the displayed question data and the question voice) and the answer data output corresponding to this question data. In addition, in this database, in addition to subject information such as gender, age, pre-existing illness, years of education, correct answer rate of the above questions, etc., a large number of subjects were subjected to the tests stored in the program of this embodiment. The score, as well as the presence or absence of cognitive decline in the subject in the past, and the number of years (years and months) after the test was performed are also stored. Further, as described later, the threshold value is set based on the data stored in the database.

[Display step S1]
The display step S1 is a step of displaying a predetermined question on the screen in order to perform a predetermined test. It should be noted that the display step S1 and the answer step S2 cannot be completely separated depending on the question to be asked, and the display step S1 and the answer step S2 may be confused. Therefore, in the explanation of this step, the answer step S2 may be described as appropriate.
Here, the problem to be displayed on the screen includes a multi-regional cognitive function test, and the specific problem categories are 1. Singing numbers, 2. Reverse numbers, 3. Immediate memory, 4. Remote memory, 5. Stroop task, 6. Figure recognition can be mentioned. These trials have criteria-related validity with a correlation coefficient of 0.51 with the Dementia Screening Test (MMSE). These are examples, and other problems may be added or the illustrated problems may be deleted. Explain the screen display, the purpose of the question, and the answer method for each.
When singing numbers in order, one number from 0 to 9 is randomly selected and displayed in the center of the screen. The displayed number is erased from the screen after a certain period of time (about 1 second) has elapsed. This is repeated, and at first, a 3-digit number (displaying the number 3 times indicates a 3-digit number) is displayed on the screen. In the answer step S2 described later, the numbers 0 to 9 are displayed at the bottom of the screen as a one-row table with the numbers in the squares, and three blank squares are displayed in a one-row table format in the middle of the screen (). Blank squares increase according to the number of digits in the question). Respondents answer by selecting (tapping) the numbers in the order displayed at the beginning. The selected number is displayed in the middle cell. As you answer correctly, the number of digits displayed on the screen increases from 3 digits to 5 digits, 5 digits to 7 digits, and finally up to 8 digits (5 in Fig. 3 (a)). In response to the numbers read aloud, up to the third number is displayed in the middle square).
As shown in FIG. 3B, the reverse singing of numbers has the same screen configuration and display of problematic numbers as the forward singing of numbers. That is, in the reverse singing of numbers, the display step S1 is the same as the singing of numbers in order. However, when answering (answer step S2), the numbers displayed on the screen are selected (tapped) in the reverse order of the displayed order.
Immediate memory randomly displays 10 words on the screen. Words are displayed on the screen one word at a time for memory (not shown). The display time is preferably about 1 second per word (up to this point is the display step S1). Then, in the answer step S2, as shown in FIG. 3C, 10 dummy words and 10 words actually displayed on the screen, a total of 20 words, are displayed on the screen. In this embodiment, 10 words displayed for memory are tapped to answer. At this time, the tapped word is set so that the color changes (in the present embodiment, it changes from white to green). Instruct the students to remember the words displayed by voice so that the words displayed in the immediate memory will be answered again in the remote memory, which is the final item of the examination.
In the stroop task, as shown in FIG. 3D, in the display step S1, the word indicating the color is displayed in a color different from the color meaning the word (in the present embodiment, a large “red” is displayed in the center. , The color is shown in blue), and the word indicating the color is displayed in the lower table. Then, in the answer step S2, the subject is made to select and tap the color of the character displayed in the center from the lower table according to the voice instruction to answer.
In the figure recognition, as shown in FIG. 3 (e), in the display step S1, a figure formed by arranging a plurality of cubes is displayed, and numbers are displayed in the lower table. Then, in the answer step S2, the subject is made to answer by selecting the number of cubes constituting the figure from the numbers shown in the lower table and tapping the subject.
In the remote storage, the words are displayed in a tabular format in the display step S1 as shown in FIG. 3 (f). Then, in the answer step S2, the word displayed in the immediate memory is selected again from the words displayed in the table format and tapped to make the answer.

[Answer step S2]
This step is a step in which the subject is instructed by voice by the above-mentioned voice output means, and the answer column is displayed as necessary to make the subject answer. Further, as described in the column of the display step S1 described above, the screen display in the display step S1 and the screen display in the response step S2 may be different, and in that case, the screen as described above in the response step S2. Display. That is, in the answer step S2, not only the voice output but also the display on the screen may be performed.
Here, in the present embodiment, the audio output means is so-called noise canceling headphones. Here, noise canceling headphones are headphones that can reduce ambient noise and provide clear sound. Normally, ambient noise is collected by a microphone built into the headphones, and the noise is collected. These headphones are equipped with a function to eliminate noise by detecting the frequency of the headphone and generating a sound with the opposite phase of the detected frequency. Here, the headphones include so-called earphone type headphones such as so-called canal type headphones. As such noise canceling headphones, commercially available ones can be used without particular limitation.
In this step, the timing and contents of execution differ depending on the category of the problem displayed in the above-mentioned display step S1. In the following, the contents set to execute this step corresponding to the problem category will be described. In this step, the question voice corresponding to the problem displayed by the voice output is output from the computer. At this time, the question voice is randomly selected from the question voice stored in the above database and output, and the question is completed. When the question is completed, the subject will answer. Explain the completion of questions for each type of nuclear question.
In ordering numbers, the instructional wording of the problem (in this embodiment, "Please select and touch the numbers displayed on the screen from the columns below in the order in which they are displayed") is output by voice. Complete the questions.
In the case of reverse numbers, the instruction wording in question (in this embodiment, "select and touch the numbers displayed on the screen from the column below in the reverse order of the displayed order") is output by voice. And complete the question.
In immediate memory, after outputting all the words that are sequentially displayed for memory, the instruction word in question (in this embodiment, "all the words displayed on the screen earlier from the table displayed next". Please touch ") to complete the question.
In the Stroop task, the instruction wording of the question (in this embodiment, "select the color of the character to be displayed next and touch it") is output by voice to complete the question.
In the figure recognition, the instruction wording of the problem (in this embodiment, "Next, select the number of cubes used in the figure from the column below and touch it") is output by voice to complete the question. ..
In the remote memory, the instruction wording of the problem (in this embodiment, "Please select and touch the subword displayed on the screen again from the column below") is output by voice to complete the question.
Further, in the present embodiment, the question is displayed and the answer is stored (a storage step described later), and the age and gender of the subject are acquired. This step can be performed in this answer step by displaying the subject information input screen and having the subject input the age and gender prior to answering the question.
Since it is necessary to confirm the correctness of the question in the storage step, the question is stored in the storage medium so that it can be reconfirmed as a question in which category and which question was asked. To.
Then, when the question is completed as described above, the subject taps the number or word displayed on the screen corresponding to each of the above questions in response to the displayed screen and the output question voice. Answer by doing. When the answer is confirmed or a predetermined answer time is set according to each question type, in that case, even if the answer is not answered after the lapse of the answer time, the answer is completed and the process proceeds to the storage step S3.

[Storage step S3]
In this step, the answer result obtained by the subject is obtained, the correctness is judged, the score is calculated, the score, age, and gender are stored in the recording medium, and the score, age, and gender information is expressed in a predetermined formula. It is a step to obtain a predicted score by substituting.
First, the answer result is acquired. Execution of this acquisition is performed for each problem. That is, when multiple questions are asked in the same category, the answer result is acquired for each question.
Specifically, in the ordering of numbers, the numbers are read aloud, the subject taps the answer, and when the answer is completed (or the set answer time has elapsed) until the final question, the answered number is acquired. Also, the answer time (the time from the output of the question voice to the touch) is acquired. At this time, the acquisition may be temporarily stored in the memory of the computer and then stored in the recording medium of the computer, or may be stored in the recording medium of the computer each time the tap is tapped. Reverse-song of numbers is the same as forward-song of numbers. In immediate memory, when the subject taps all the words (or all 10 words when they are read aloud) and completes the answer (or the set answer time has elapsed), the answered word is acquired. do. Also, the answer time (the time from the output of the question voice to the completion of the touch) is acquired. At this time, the acquisition is stored in the recording medium of the computer. In the Stroop task, when the subject taps a word and completes the answer (or the set answer time has elapsed), the answered word is acquired. Also, the answer time (the time from the output of the question voice to the completion of the touch) is acquired. At this time, the acquisition is stored in the recording medium of the computer. In the figure recognition, when the subject taps the number and completes the answer (or the set answer time has elapsed), the answered word is acquired. Also, the answer time (the time from the output of the question voice to the completion of the touch) is acquired. At this time, the acquisition is stored in the recording medium of the computer. In remote memory, when the subject taps all the words (or all 10 words when they are read aloud) and completes the answer (or the set answer time has elapsed), the answered word is acquired. ..
Next, it is determined whether or not the subject's answer is correct by comparing the obtained answer with the answer to the question that is temporarily stored in the storage medium.
Then, the score of the subject obtained from the determined result is calculated, and the correct answer or the incorrect answer of each question and the score are stored in the storage medium.
Then, the obtained score is substituted into the following formula for predicting the occurrence of mild cognitive impairment, which is prepared in advance. Further, the age and gender of the subject acquired in the answer step S2 at this time are also substituted into the following prediction formula. Specifically, the obtained score, age, and gender information are substituted to calculate the predicted score for mild cognitive decline. Then, the obtained predicted score is stored in the recording medium.
Predictive score for mild cognitive decline = forward score of numbers x (-0.503) + reverse score of numbers x (-0.540) + immediate memory score x (-0.056) + remote memory score x (-0.314) + Stroop task score x (-0.155) + figure recognition score x (-0.307) + gender (male: -0.233, female: 0) + age x (0.00036) + constant (-3.105)
Note: For gender, substitute -0.233 for males and 0 for females.
The display step S1, the answer step S2, and the storage step S3 are all performed for each problem. In the present embodiment, the display step S1 and the answer step S2 are looped for each question type, and the storage step S3 is set to store the result based on the answer data obtained in the answer step S2. ing.

[Determination step S4]
This step is a step of comparing the stored predicted score with a predetermined threshold value to determine the possibility of the occurrence of mild cognitive impairment in the future. Here, "future" means within two years after the subject is asked to answer the above-mentioned answer (by conducting the test).
For the above-mentioned predetermined threshold value, the ROC curve in which dementia dysfunction occurs within 2 years is obtained based on the data in the above-mentioned database, and the threshold value based on the ROC curve obtained according to a conventional method (for example, Youden's index) is calculated. (Refer to Examples for specific numerical values). This is used as the threshold of the predicted score in the database. The threshold value of the predicted score in the following examples is 0.0772.
At the time of judgment, the predicted score of the subject is first calculated. That is, when all the problems are completed, all the correctness and the age and gender (the age and gender can be stored at any stage of the storage step, and in some cases, it should be stored in the display step and the pre-step. (Also possible) is stored, so the stored results (all correctness, age, and gender) are substituted into a predetermined prediction formula to calculate the prediction score.
The judgment is made by comparing the subject's predicted score obtained here with the above-mentioned predicted score as the threshold value, and if the subject's predicted score is less than the threshold value, "decrease in cognitive function in the near future (within 2 years)". Is likely to occur. "
The determination result in this step is stored in the storage medium in association with personal information such as the subject's name, age, and gender, and is displayed on the computer screen.

[Correction of storage step S3 and determination step S4]
Further, in this step, the answer result obtained by having the subject answer is acquired, the correctness is determined, the determination result is obtained, and the answer time is also acquired, and the determination result is weighted by the answer time and corrected. The score can also be stored in a recording medium.
That is, since the response time of the subject is also acquired in the response step S2 at this time, whether or not the response time is early in the storage step S3, that is, when compared with the average value of the response time and earlier than the average value, is the case. The score is weighted when it is the same as the average value and later than the average value. In that case, the score is corrected by multiplying the score by a predetermined coefficient as a weighting of the response time. Then, it is also possible to store the obtained corrected score in a recording medium and use the corrected score to calculate the above-mentioned predicted score. Here, as a predetermined coefficient, for example, the weighting coefficient may be 3 if it is earlier than the average value, 2 if it is the same as the average value (within ± 1), 1 if it is later than the average value, and so on. can.

(Other steps)
In the computer program of the present embodiment, other steps can be carried out without departing from the spirit of the present invention. Further, in the present embodiment, in addition to the above-mentioned problems, the following additional problems can be additionally executed.
Additional issue: Trail making test (TMT)
As shown in Fig. 4, the entire screen is displayed with hiragana characters "A, I, U, E, O, Ka, Ki, Ku" and "1, 2, 3, 4, 5, 6, 7". Display randomly in. The subject alternately selects hiragana and numbers in order. On the screen, the selected letters and numbers are displayed so that they are connected by a line. For example, in the example shown in FIG. 4, when “A → 1 → I → 2 → U → 3 → E → 4 → O” is selected, each hiragana and a number are connected by a line as shown in FIG.
〔Device〕
Next, a device for determining the possibility of dementia dysfunction, in which the computer program of the present embodiment is stored, will be described.
The device for determining the possibility of dementia dysfunction of the present embodiment is configured by the computer shown in FIG.
That is, it is composed of a computer 1 in which the above-mentioned computer program is stored, and has a screen 30 and an audio output means 40. A display means for displaying a predetermined problem stored in the storage medium 15 on the screen 30 is configured by the CPU 13, the memory 11, the storage medium 15, and the screen 30, and the CPU 13, the memory 11, the storage medium 15, and the screen 30 are configured. The answering means for instructing the subject by voice and making an answer is configured by the voice output means 40 and the answer means, and the answer result which made the subject answer is acquired by the CPU 13, the memory 11, the storage medium 15, and the screen 30. A storage means for determining correctness and invalidity and storing the determination result in the recording medium 15 is configured, and the stored result is stored in the storage medium by the CPU 13, the memory 11, the storage medium 15, and the screen 30 in the above-mentioned equation. A determination means for determining the possibility of mild cognitive decline in the future (within 2 years) is configured by substituting and comparing the substitution result with the above-mentioned determination criteria which is a predetermined threshold value.

〔Example of use〕
The device for determining the possibility of dementia dysfunction, in which the computer program of the present embodiment is stored, is used as follows.
That is, an icon (which corresponds to the start button of the computer program of the present embodiment, which can be set as such an icon or as a function of the computer program of the present embodiment), which is not particularly shown, is displayed on the computer screen. do.
When the subject taps this icon, the computer program is executed and the problem start screen (not shown) is displayed. On this start screen, an input window for inputting the above personal information of the subject and a start button are displayed. By inputting personal information in the input window and pressing the start button, the display step S1 is started. Then, as shown in FIG. 2, the process proceeds to the answer step S2 for each question, and by completing the answer, the process proceeds to the storage step S3. The execution of each of the steps S1 to S3 is executed until all the problems are completed. Then, in a state where all the problems are completed, the process proceeds to the next determination step S4. The judgment step S4 can be set to automatically shift when all the problems are completed, and the judgment button is set to be displayed at the end of the problem, and the judgment button is tapped. It may be set to make a judgment at times.
In this way, the determination step S4 is performed, and the determination result is displayed on the screen (not shown).

[Action effect]
The computer program of the present embodiment and the device for determining the possibility of dementia dysfunction are configured as described above and can be used as described above.
The subject can answer by looking at the problem displayed on the screen and listening to the voice output, and can perform a smooth answering work even if the elderly person does not have the help of an assistant. .. Then, it is possible to easily determine the possibility of dementia function decline in the future (within 2 years) simply by answering some questions using a computer having a touch panel as a screen.
In addition, when noise canceling headphones are used, malfunctions of the subject are particularly reduced, accurate answer data (correct / incorrect and answer time) can be obtained, and the possibility of dementia function deterioration can be determined more accurately. can do.
From these facts, the computer program of this embodiment and the device for determining the possibility of dementia dysfunction enable cognitive function tests without the need for staff trained in community medical examinations and events for the elderly. Has the advantage of becoming.
In addition, it is possible to evaluate cognitive function on a home PC or smartphone without going to a medical institution.
Therefore, it is expected to be used in situations where it is necessary to easily estimate cognitive function, such as in medical settings and local health and welfare services.

The present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the spirit of the present invention.
For example, the database described above can be set to be updated sequentially. In that case, the threshold value is updated as the amount of data stored in the database increases, and it becomes possible to make a judgment with a threshold value capable of making a more accurate judgment.

Hereinafter, the present invention will be specifically described with reference to Examples, but the present invention is not limited thereto.
[Example 1] (Example of confirming the certainty of determination using the program of the present invention)
Criteria for the dementia dysfunction possibility determination device shown in FIGS. 1 and 2 for 773 elderly people (average age 72.6 years (65-97 years)), 332 men, and 441 women living in Tokyo. The relevant validity was examined. As a result, a moderate correlation (correlation coefficient 0.51) with MMSE, which is widely used as a cognitive function test, was shown. In addition, the ability to discriminate suspected dementia (MMSE <24) was examined using the ROC curve. As a result, the curve shown in FIG. 5 was obtained, and the area under the curve (AUC) was 0.85, the sensitivity was 0.81, and the specificity was 0.77. From this, it was found that by using the program and the apparatus of the present invention, the dementia dysfunction is determined with the same ability to discriminate the dementia dysfunction as the MMSE.
[Example 2] (Example of setting threshold value)
Using the dementia dysfunction possibility determination device shown in FIGS. 1 and 2 for 455 elderly people living in Tokyo (median age 72 years (65-89 years), 173 men, 282 women). The test was conducted, and the predictive ability of MCI occurrence within 2 years of the test was examined by the ROC curve based on the measured data of the presence or absence of MCI occurrence 2 years after the test. As a result, the curve shown in FIG. 6 was obtained, and the area under the curve (AUC) was 0.80, the sensitivity was 0.81, and the specificity was 0.76. From the obtained results, the threshold was calculated by Youden's index. This was used as the threshold for the predicted score.

Claims (5)

A computer program that causes a computer with screen and audio output means to perform the following steps.
A display step that displays a given problem on the above screen,
Answer step, in which the subject is instructed by voice by the above voice output means and is made to answer.
Obtain the answer result that the subject answered, judge whether it is correct or incorrect, store the score, age and gender information in the recording medium, and substitute the score, age and gender information into the predetermined formula to obtain the predicted score. , Storage step,
A determination step in which the stored predicted score is compared with a predetermined threshold value to determine the possibility of future mild cognitive impairment. The computer program according to claim 1, wherein the audio output means is noise canceling headphones. In the above display step, the above-mentioned problems to be displayed on the above-mentioned screen are number forward singing, number reverse singing, immediate memory, remote memory, Stroop task, and graphic recognition.
The computer program according to claim 1 or 2, wherein the predetermined formula in the storage step is the following formula for predicting the occurrence of mild cognitive impairment.
Predictive score for mild cognitive decline = forward score of numbers x (-0.503) + reverse score of numbers x (-0.540) + immediate memory score x (-0.056) + remote memory score x (-0.314) + Stroop task score x (-0.155) + figure recognition score x (-0.307) + gender (male: -0.233, female: 0) + age x (0.00036) + constant (-3.105) The invention according to any one of claims 1 to 3, wherein in the storage step, when the predicted score is obtained by the predetermined formula, the answer time is also acquired, and the determination result is weighted by the answer time and corrected. Computer program. A device for determining the possibility of dementia dysfunction in which the computer program according to claim 1 is stored.
It has a screen and audio output means,
A display means for displaying a predetermined problem on the above screen,
Answering means, in which the subject is instructed by voice by the above-mentioned voice output means and is made to answer.
The answer result obtained by the subject is obtained, the correctness is judged, the storage means for storing the judgment result in the recording medium, and the stored result are substituted into a predetermined formula, and the substitution result is compared with a predetermined threshold value. A device for determining the possibility of dementia dysfunction, which comprises a determination means step for determining the possibility of mild cognitive impairment in the future.

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