JP2017217052A - Dementia diagnosis support apparatus, operation method and operation program thereof, and dementia diagnosis support system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a dementia diagnosis support apparatus capable of making it clear which one of a plurality of core symptoms of dementia is developed in a subject in a simple diagnosis test of dementia, an operation method and an operation program thereof, and a dementia diagnosis support system.SOLUTION: A dementia diagnosis support server 12 provides a simple diagnosis test for dementia. Questions include a complex question on two of dysmnesia, aphasia, and agnosia. The complex question is composed of a first complex question CQ1 for determining presence or absence of dysmnesia, and presence or absence of aphasia, a second complex question CQ2 for determining presence or absence of aphasia, and presence or absence of agnosia, and a third complex question CQ3 for determining presence or absence of dysmnesia, and presence or absence of agnosia. Based on the answers to the complex questions CQ1-CQ3, it is determined which one of dysmnesia, aphasia, and agnosia is developed in a subject S.SELECTED DRAWING: Figure 6

Description

  The present invention relates to a dementia diagnosis support apparatus, an operation method and an operation program thereof, and a dementia diagnosis support system.

  Conventionally, a simple diagnostic test for dementia has been conducted, in which subjects with dementia are presented and answered, the suspicion of suffering from dementia is determined based on the response, and the determination result is displayed to the subject. Has been. Various proposals have been made to automate the presentation of problems, acceptance of responses, determination based on responses, and display of determination results, which are the steps of such tests, by a computer.

  For example, in Patent Document 1, there is a problem that asks whether a stored word can be reproduced immediately (word reproduction) or a question that asks whether the words presented in the word reproduction can be recalled over time (word recording). ) And the like are presented to the subject, and a dementia diagnosis support apparatus that discriminates suspicion of suffering from Alzheimer-type dementia based on the answer is described. Patent Document 2 discloses whether or not the display color of the color word and the color represented by the color word are the same color in the test text including the color word color-coded in a predetermined color, and the content of the test text. A dementia diagnosis support device is described that presents a question to the subject and determines the degree of dementia of the subject based on the answer.

  By the way, the core symptoms of dementia include memory impairment and cognitive dysfunction. Memory impairment is the most popular core symptom to be synonymous with dementia. Cognitive dysfunction includes aphasia, agnosia, executive dysfunction, and the like. Aphasia literally suffers from memory problems because it literally obscures the name of the object. Disapproval means that the situation obtained through sensory organs such as eyes and ears cannot be correctly grasped. The execution function is a function necessary to independently and effectively achieve a series of actions with a purpose, and the execution function disorder refers to a state in which the execution function is hindered.

  The problem of word reproduction and word memorization described in Patent Document 1 is to determine the presence or absence of memory impairment and the presence or absence of cognitive dysfunction aphasia. Further, the problem of whether or not the display color of the color word and the color represented by the color word described in Patent Document 2 are the same color and the content of the test sentence is the presence or absence of memory impairment and cognitive impairment. This is to determine the presence or absence of aphasia, disapproval, and executive function failure. As described above, the problems presented to the subject include many complex problems that simultaneously determine the presence or absence of a plurality of core symptoms including memory impairment.

Japanese Patent No. 3515988 JP 2005-046289 A

  However, in the complex problem, when the answer of the subject in question is an incorrect answer, it cannot be distinguished which of the plurality of core symptoms caused the incorrect answer. For this reason, it is not known which of a plurality of core symptoms appear in the subject.

  The present invention relates to a dementia diagnosis support apparatus capable of clarifying which one of a plurality of core symptoms of dementia appears in a subject in a simple diagnosis test for dementia, its operation method and operation An object is to provide a program and a dementia diagnosis support system.

  In order to solve the above-mentioned problem, the dementia diagnosis support apparatus of the present invention provides an output of a problem in the dementia diagnosis support apparatus that provides a subject with a simple diagnosis test for dementia composed of problems related to dementia. A problem output control unit to be controlled, an answer reception unit that receives an answer to the problem, a determination unit that determines which of the core symptoms of dementia appears in the subject based on the response, and a determination A determination result output control unit for controlling the output of the determination result by the unit, and the problem includes a composite problem related to two of the core symptoms of memory impairment, first cognitive dysfunction, and second cognitive dysfunction The composite problem includes a first composite problem for determining presence / absence of memory impairment and first cognitive dysfunction, a second composite problem for determining presence / absence of first cognitive dysfunction and presence / absence of second cognitive dysfunction, Memory impairment and second cognition And a third composite problem of determining the presence or absence of intolerance.

  When the answer to each of the first composite problem, the second composite problem, and the third composite problem is a correct answer, the determination unit has all of the memory impairment, the first cognitive impairment, and the second cognitive impairment. If the answer to the first complex problem, the second complex problem, and the third complex problem is an incorrect answer, all of the memory impairment, the first cognitive impairment, and the second cognitive impairment It is preferable to determine that it has appeared.

  The discriminating unit discriminates that the first cognitive dysfunction appears when each answer of the first complex problem and the second complex problem is an incorrect answer and the answer of the third complex problem is a correct answer, and the second If each answer of the complex problem and the third complex problem is an incorrect answer and the answer of the first complex problem is a correct answer, it is determined that the second cognitive dysfunction appears, and the first complex problem and the third complex problem If each answer of the question is an incorrect answer and the answer of the second composite question is a correct answer, it is preferable to determine that a memory failure has occurred.

  The first cognitive dysfunction and the second cognitive dysfunction are preferably any two of aphasia, agnosia, or executive dysfunction.

  When one of the first cognitive dysfunction and the second cognitive dysfunction is aphasia, the compound problem is caused by causing the subject to memorize a specific word and then among a plurality of words including the specific word. From the above, it is preferable to include one that allows a specific word to be selected.

  When one of the first cognitive dysfunction and the second cognitive dysfunction is agnostic, the compound problem is caused by causing the subject to remember a specific graphic, and then from among a plurality of graphics including the specific graphic, It is preferable to include one that allows a specific figure to be selected.

  If one of the first cognitive dysfunction and the second cognitive dysfunction is agnostic, the compound problem is to cause the subject to remember multiple pairs of human faces and names, A face of a specific person is presented from a set of names, and a name corresponding to the face of the specific person presented is selected from the names of a plurality of persons, and / or multiple subjects After remembering the face / name pairs of the person, present the name of the specific person from the face / name pairs of the persons, and then present the specific person from the faces of the persons It is preferable that a face corresponding to the name is selected.

  When the first cognitive dysfunction and the second cognitive dysfunction are aphasia and disapproval, the composite problem presents an illustration representing a specific word to the subject, and from among a plurality of words including the specific word, It is preferable to include one that allows a specific word to be selected.

  When one of the first cognitive dysfunction and the second cognitive dysfunction is executive dysfunction, the composite problem may include a question that asks the keyword after having the subject read a sentence including a plurality of keywords. preferable.

  When the first cognitive dysfunction and the second cognitive dysfunction are aphasia and executive dysfunction, the composite problem presents the subject with multiple phrases that become one sentence if rearranged, and rearranges the phrases in the correct order, In addition, it is preferable to include a phrase that allows a phrase to be selected in a specific order when rearranged in the correct order.

  When the first cognitive dysfunction and the second cognitive dysfunction are agnosia and executive dysfunction, the composite problem preferably includes a question of topographic cognitive function and / or a question of left and right orientation.

  Preferably, the problem includes one that presents the subject with illustrations representing a plurality of articles and allows the user to select one illustration in a different category from the other illustrations.

  The operation method of the dementia diagnosis support apparatus of the present invention controls the output of a problem in the operation method of the dementia diagnosis support apparatus that provides a subject with a simple diagnosis test of dementia composed of problems related to dementia. A problem output control step; an answer reception step for receiving an answer to the problem; a determination step for determining which of a plurality of core symptoms of dementia appears in the subject based on the answer; and A determination result output control step for controlling the output of the determination result, and the problem includes a composite problem relating to two of the core symptoms of memory impairment, first cognitive impairment, and second cognitive impairment The problems are a first composite problem that determines the presence or absence of memory impairment and the presence or absence of the first cognitive dysfunction, and a second composite problem that determines the presence or absence of the first cognitive dysfunction and the presence or absence of the second cognitive dysfunction. The presence or absence of memory disorders and and a third composite problem of determining the presence or absence of the second cognitive impairment.

  The operation program of the dementia diagnosis support apparatus of the present invention controls the output of a problem in the operation program of the dementia diagnosis support apparatus that provides a subject with a simple diagnosis test of dementia composed of problems related to dementia. By a problem output control function, an answer reception function that accepts an answer to a problem, a discrimination function that determines which of the core symptoms of dementia appears in the subject based on the answer, and a discrimination function The determination result output control function for controlling the output of the determination result is caused to be executed by a computer, and the problem is a complex problem related to two of the core symptoms of memory failure, first cognitive dysfunction, and second cognitive dysfunction The composite problem includes a first composite problem for determining the presence or absence of memory impairment and the presence or absence of a first cognitive dysfunction, and a second for determining the presence or absence of first cognitive dysfunction and the presence or absence of second cognitive dysfunction. And if a problem, and a presence or absence of memory impairment and a third composite problem of determining the presence or absence of the second cognitive impairment.

  The dementia diagnosis support system of the present invention is connected to a dementia diagnosis support device that provides a subject with a simple diagnosis test for dementia composed of problems related to dementia via a network. In the dementia diagnosis support system comprising an answer terminal operated by the subject, the dementia diagnosis support device includes a problem output control unit that controls the output of the problem to the answer terminal, and the answer from the answer terminal A response receiving unit that receives the response, a determination unit that determines which of the core symptoms of dementia appears in the subject based on the response, and an output of the determination result by the determination unit to the response terminal A determination result output control unit for controlling, and the problem includes a composite problem related to two of memory impairment, a first cognitive dysfunction, and a second cognitive dysfunction, which are core symptoms. A first composite problem for determining the presence or absence of harm and the presence or absence of a first cognitive dysfunction; a second composite problem for determining the presence or absence of a first cognitive dysfunction and the presence or absence of a second cognitive dysfunction; 2 It is comprised with the 3rd compound problem which discriminate | determines the presence or absence of cognitive dysfunction.

  According to the present invention, the first composite problem for determining the presence or absence of memory impairment and the presence or absence of the first cognitive dysfunction, the second composite problem for determining the presence or absence of the first cognitive dysfunction and the presence or absence of the second cognitive dysfunction, memory Output to the subject a third composite problem for determining the presence or absence of the disorder and the presence or absence of the second cognitive dysfunction, and based on the answers to the first to third composite problems, the memory disorder, the first cognitive dysfunction, the first 2 Since it is determined which of cognitive dysfunction is present in the subject, it is clear which of several core symptoms of dementia is present in the subject in a simple diagnostic test for dementia It is possible to provide a dementia diagnosis support apparatus, an operation method and an operation program thereof, and a dementia diagnosis support system.

It is a figure which shows a dementia diagnosis support system. It is a block diagram which shows the computer which comprises an answering terminal and a dementia diagnosis support server. It is a block diagram which shows the function part of CPU of an answering terminal. It is a block diagram which shows each function part of CPU of a dementia diagnosis support server. It is a figure which shows problem information. It is a figure which shows discrimination information. It is a figure which shows log | history information. It is a figure which shows another example of log | history information. It is a figure which shows the problem display screen of the problem which discriminate | determines the presence or absence of aphasia and the presence or absence of a recognition. It is a figure which shows the problem display screen of the problem which discriminate | determines the presence or absence of a memory failure and the presence or absence of aphasia. It is a figure which shows the problem display screen of the problem which discriminate | determines the presence or absence of a memory failure and the presence or absence of a disapproval. It is a figure which shows the problem display screen of the problem which discriminate | determines the presence or absence of a memory failure and the presence or absence of a disapproval. It is a figure which shows the discrimination | determination result display screen when two of the 1st-3rd compound questions are incorrect answers and the remaining one is a correct answer. It is a figure which shows the discrimination | determination result display screen when one of the 1st-3rd compound questions is an incorrect answer and the remaining two are correct answers. It is a flowchart which shows the process sequence of a dementia diagnosis support server. It is a figure which shows another example of the problem display screen of the problem which discriminate | determines the presence or absence of a memory failure, and the presence or absence of a recognition failure. It is a figure which shows another example of the problem display screen of the problem which discriminate | determines the presence or absence of a memory failure, and the presence or absence of a recognition failure. It is a figure which shows another example of the problem display screen of the problem which discriminate | determines the presence or absence of a memory failure, and the presence or absence of a disapproval. It is a figure which shows the problem information of 2nd Embodiment. It is a figure which shows the problem display screen of the problem which discriminate | determines the presence or absence of an aphasia and the presence or absence of an execution function failure. It is a figure which shows the problem display screen of the problem which discriminate | determines the presence or absence of a memory failure and the presence or absence of an execution function failure. It is a figure which shows the problem display screen of the problem which discriminate | determines the presence or absence of a memory failure and the presence or absence of an execution function failure. It is a figure which shows the problem information of 3rd Embodiment. It is a figure which shows the problem display screen of the question which asks a topographical recognition function. It is a figure which shows the problem display screen of the question which asks right and left orientation. It is a figure which shows another example of the problem display screen of the problem which asks right and left orientation. It is a figure which shows another example of the problem display screen of the problem which asks right and left orientation. It is a figure which shows the problem display screen of the problem which discriminate | determines the presence or absence of a disapproval. It is explanatory drawing of the aspect which determines the correctness of the 1st-3rd compound problem finally used for discrimination | determination according to the correctness of the 1st-3rd compound problem of multiple sets. It is a scoring table for each compound problem. It is explanatory drawing of the aspect which outputs the score which shows the grade of a core symptom as a discrimination | determination result.

[First embodiment]
In FIG. 1, a dementia diagnosis support system 10 includes a reply terminal 11 and a dementia diagnosis support server 12 corresponding to a dementia diagnosis support apparatus. The dementia diagnosis support server 12 provides the subject S with a simple diagnosis test for dementia including problems related to dementia. The reply terminal 11 and the dementia diagnosis support server 12 are connected to each other via a network 13 such as a WAN (Wide Area Network) such as the Internet or a public communication network. In consideration of information security, a virtual private network (VPN) is constructed for the network 13 and a communication protocol with a high security level such as HTTPS (Hypertext Transfer Protocol Secure) is used.

  The answering terminal 11 and the dementia diagnosis support server 12 are configured by installing a control program such as an operating system and various application programs (hereinafter abbreviated as AP) based on a computer such as a server computer, a personal computer, or a workstation. The

  The answer terminal 11 is a tablet computer having a touch panel 14, for example. The answering terminal 11 is deployed in the waiting room 16 of the medical facility 15 and is operated by the subject S. The touch panel 14 displays various screens according to the operation of the subject S. The screen has an operation function by GUI (Graphical User Interface).

  The subject S is a patient who has visited the medical facility 15. The subject S can take a simple diagnostic test in the waiting room 16 during the waiting time of medical treatment by the dementia diagnosis support system 10.

  The dementia diagnosis support server 12 is installed in the data center 17. The data center 17 provides the medical facility 15 with various services such as management and distribution of medical data such as electronic medical records and medical images, reception of medical appointments, and diagnosis support for specific diseases.

  The dementia diagnosis support server 12 transmits a problem related to dementia constituting the simple diagnosis test to the answering terminal 11. The answer terminal 11 transmits the answer of the problem by the subject S to the dementia diagnosis support server 12. The dementia diagnosis support server 12 determines which of the core symptoms of dementia appears in the subject S based on the response from the response terminal 11 and transmits the determination result to the response terminal 11. To do.

  The dementia diagnosis support server 12 has a problem display screen 60 (see FIGS. 9 to 12) and a determination result display screen 70 (see FIG. 9) that can be viewed on the web browser of the answering terminal 11 as one form of output of the problem and the determination result. 13 and FIG. 14), and outputs this to the answering terminal 11.

  The dementia diagnosis support server 12 outputs the screens 60 and 70 in the form of screen data for web distribution created by a markup language such as XML (Extensible Markup Language). Instead of XML, other data description languages such as JSON (JavaScript (registered trademark) Object Notation) may be used. The dementia diagnosis support server 12 outputs various screens in addition to the screens 60 and 70 to the answering terminal 11 in the form of screen data for web distribution.

  In FIG. 1, only one answer terminal 11 is depicted, but a plurality of answer terminals 11 may be provided. There may also be a plurality of medical facilities 15 that are provided with various services from the data center 17.

  In FIG. 2, the computers constituting the answering terminal 11 and the dementia diagnosis support server 12 have the same basic configuration, and are respectively a storage device 30, a memory 31, a CPU (Central Processing Unit) 32, a communication unit 33, And an input / output device 34. These are interconnected via a data bus 35.

  The storage device 30 is a hard disk drive built in a computer constituting the answering terminal 11 or the like, or connected through a cable or a network, or a disk array in which a plurality of hard disk drives are connected. The storage device 30 stores a control program such as an operating system, various APs, and various data associated with these programs.

  The memory 31 is a work memory for the CPU 32 to execute processing. The CPU 32 loads the program stored in the storage device 30 into the memory 31 and executes processing according to the program, thereby comprehensively controlling each part of the computer. The communication unit 33 is a network interface that controls transmission of various information via the network 13. The input / output device 34 is the above-described touch panel 14 in the case of the answering terminal 11 and a display and an operation unit (not shown) in the case of the dementia diagnosis support server 12.

  In the following description, each part of the computer constituting the answering terminal 11 has a subscript “A”, and each part of the computer constituting the dementia diagnosis support server 12 has a subscript “B”. To distinguish.

  In FIG. 3, when the web browser is activated, the CPU 32A of the answering terminal 11 functions as the browser control unit 40 in cooperation with the memory 31 and the like. The browser control unit 40 controls the operation of the web browser. The browser control unit 40 receives screen data of various screens from the dementia diagnosis support server 12. The browser control unit 40 reproduces various screens displayed on the web browser based on the screen data and displays them on the touch panel 14.

  Further, the browser control unit 40 receives various operation instructions input from the touch panel 14 by the subject S through various screens. The operation instructions include an instruction to access the dementia diagnosis support server 12 and an instruction to select answer options. The browser control unit 40 issues a request corresponding to the operation instruction to the dementia diagnosis support server 12.

  The access instruction to the dementia diagnosis support server 12 includes input of a subject ID (Identification Data) that is identification information of the subject S. When there is an access instruction, the browser control unit 40 issues an access request including the input subject ID and a pre-registered facility ID to the dementia diagnosis support server 12. The facility ID is identification information of the medical facility 15. Further, the subject ID is a patient ID given to the subject S at the medical facility 15, for example.

  The answer option selection instructions include answer option selection instructions that include the correct and incorrect answers for each question, as well as instructions for selecting “not sure” answer options to indicate that the answer is unknown. There is. When there is an instruction to select an answer option, the browser control unit 40 issues a registration request including information on the selected answer option, that is, an answer, to the dementia diagnosis support server 12. Similar to the access request, the registration request includes the facility ID and the subject ID.

  In FIG. 4, the storage device 30B of the dementia diagnosis support server 12 stores an operation program 45 as an AP. The operation program 45 is an AP for causing a computer constituting the dementia diagnosis support server 12 to function as a dementia diagnosis support apparatus. In addition to the operation program 45, problem information 46, discrimination information 47, and history information 48 are stored in the storage device 30B.

  When the operation program 45 is activated, the CPU 32B of the dementia diagnosis support server 12 functions as the output control unit 50, the reception unit 51, the determination unit 52, and the information management unit 53 in cooperation with the memory 31 and the like.

  The output control unit 50 corresponds to a problem output control unit, and has a problem output control function for controlling the output of the problem to the answering terminal 11. More specifically, the output control unit 50 generates screen data of the problem display screen 60 for web distribution, and outputs this to the answer terminal 11 that is the access source. Each time the output control unit 50 outputs the problem display screen 60 for each problem, the output control unit 50 outputs to the reception unit 51 that the problem display screen 60 has been output.

  The accepting unit 51 corresponds to an answer accepting unit and has an answer accepting function for accepting an answer included in a registration request from the answer terminal 11. The accepting unit 51 outputs the accepted answer to the information managing unit 53. In addition, the reception unit 51 measures an elapsed time after receiving the fact that the problem display screen 60 is output from the output control unit 50. The reception unit 51 stops measuring elapsed time when an answer is received.

  Each time the reception unit 51 receives a response, the reception unit 51 outputs a message indicating that the response has been received to the output control unit 50. When the output control unit 50 receives a response from the reception unit 51, the output control unit 50 outputs a problem display screen 60 for the next problem.

  The accepting unit 51 accepts an access request. The accepting unit 51 outputs an access request to the output control unit 50 and the information management unit 53. When receiving an access request from the receiving unit 51, the output control unit 50 starts outputting the problem display screen 60.

  The discriminating unit 52 has a discriminating function for discriminating which of a plurality of core symptoms of dementia appears in the subject S based on the answer. The determination unit 52 outputs the determination result to the output control unit 50.

  The output control unit 50 corresponds to a discrimination result output control unit, and also has a discrimination result output control function for controlling the output of the discrimination result. More specifically, the output control unit 50 generates screen data of the determination result display screen 70 for web distribution, and outputs this to the answer terminal 11 that is the access source.

  The information management unit 53 manages each information of the problem information 46, the discrimination information 47, and the history information 48. The information management unit 53 registers the answer from the reception unit 51 in the history information 48. Further, the information management unit 53 outputs the problem information 46 to the output control unit 50 and the reception unit 51 (only the output control unit 50 is shown), and the discrimination information 47 and the history information 48 to the discrimination unit 52, respectively.

  In FIG. 5, the problem information 46 registers a problem, its contents, a time limit, and the like. Here, for convenience of explanation, the contents indicate combinations of core symptoms that can be identified by the problem. Actually, answer options, question sentences or instruction sentences, illustrations necessary for the question, information for generating the question display screen 60 such as a screen layout thereof, and correct answers are registered. A plurality of types of answer choices, question sentences or instructions, illustrations, and correct answers are prepared so that the subject S takes a simple diagnostic test a plurality of times so that the contents are different each time. In addition, for answer choices, question sentences, and instruction sentences, expressions excluding Japanese-specific expressions are used in order to facilitate translation into other languages.

  The time limit is a restriction on the elapsed time from the output of each problem. If the answer to the problem is not accepted even when the elapsed time exceeds the time limit, the accepting unit 51 outputs a timeout message to the information managing unit 53. In addition to the above, in the contents, the order of outputting each question (question order) is registered. The output control unit 50 outputs the question display screen 60 for each question to the answering terminal 11 according to the order registered in the question information 46. In the first embodiment, the second composite problem CQ2 is output first, then the first composite problem CQ1 is output, and finally the third composite problem CQ3 is output.

  The problem includes a complex problem involving two of memory impairment, a core symptom of dementia, aphasia corresponding to the first cognitive dysfunction, and agnosis corresponding to the second cognitive dysfunction. The composite problem includes a first composite problem CQ1, a second composite problem CQ2, and a third composite problem CQ3. The first combined problem CQ1 is for determining the presence or absence of a memory failure and the presence or absence of aphasia, and 60 seconds is registered as the time limit. The second composite problem CQ2 is for determining the presence or absence of aphasia and the presence or absence of recognition. The third composite problem CQ3 is for determining whether or not there is a memory failure and whether or not there is a disapproval. The second complex problem CQ2 and the third complex problem CQ3 are both registered with a time limit of 10 seconds.

  The discrimination information 47 corresponds to eight patterns (discrimination patterns 1 to 8) of correctness (correct answer and wrong answer) of each of the complex questions CQ1 to CQ3 and the discrimination patterns 1 to 8, for example, as shown in the table of FIG. This is a summary of the determination results (whether there is a failure). The discriminating unit 52 discriminates which of a plurality of core symptoms of dementia appears in the subject S according to the discrimination information 47.

  Here, the correct answer includes a case where the answer is literally correct and a case where the error rate is lower than the set rate in the case of multiple answers or multiple questions. In addition, the wrong answer is literally when the answer is incorrect, when “I don't know” is selected as the answer option, and when the answer is not accepted by the accepting unit 51 within the time limit (timeout). In the case of multiple answers or multiple questions, the case where the error rate is equal to or higher than the set rate is included. Note that the setting rate can be changed by the doctor of the medical facility 15 or the administrator of the data center 17.

  The discrimination pattern 1 is a case where each answer of each of the complex questions CQ1 to CQ3 is a correct answer (“correct”). In this case, as shown in the lower part of the right / wrong column, it can be seen that neither the memory failure nor the aphasia is caused by the first compound problem CQ1 (“memory: none aphasia: none”), and the second compound problem CQ2 is aphasic and agnostic. (“Aphasia: none, disapproval: none”), and the third composite problem CQ3 reveals that neither memory failure nor disapproval exists (“memory: none, disapproval: none”). In the case of the discrimination pattern 1, the discrimination unit 52 discriminates that all of memory failure, aphasia, and disapproval do not appear (“none”).

  On the other hand, the discrimination pattern 2 is a case where each answer of each of the complex questions CQ1 to CQ3 is an incorrect answer (“wrong”). In this case, as shown in the lower part of the right / wrong column, it can be seen that both the memory failure and the aphasia are caused by the first compound question CQ1 ("memory: yes aphasia: yes"), and the second compound question CQ2 is aphasic and agnostic. (“Aphasia: yes, disapproval: yes”), and the third composite problem CQ3 shows that both memory failure and agnosia are present (“memory: yes, misidentification: yes”). In the case of the discrimination pattern 2, the discrimination unit 52 discriminates that all of memory failure, aphasia, and disapproval appear (“Yes”).

  The discrimination patterns 3 to 5 are cases where two of the complex questions CQ1 to CQ3 are wrong answers and the remaining one is a correct answer. In the case of these discrimination patterns, the discriminating unit 52 concludes that the two complex problems that were wrong answers that are both faulty are the core symptoms appearing in the subject S.

  More specifically, in the case of the discrimination pattern 3 in which each answer of the first compound question CQ1 and the second compound question CQ2 is an incorrect answer and the answer of the third compound question CQ3 is a correct answer, the discriminating unit 52 The aphasia that was found to be impaired in both the first composite problem CQ1 and the second composite problem CQ2 was determined as the core symptom appearing in the subject S. That is, in the case of the discrimination pattern 3, the discriminating unit 52 discriminates that an aphasia appears, and discriminates that a memory failure and a disapproval do not appear.

  In the case of the discrimination pattern 4 in which each answer of the second composite question CQ2 and the third composite question CQ3 is an incorrect answer and the answer of the first composite question CQ1 is a correct answer, the discriminator 52 determines that the second composite question was an incorrect answer. It is determined that the disapproval that both the problem CQ2 and the third complex problem CQ3 are disabled is a core symptom appearing in the subject S. That is, in the case of the discrimination pattern 4, the discriminating unit 52 discriminates that the disapproval appears, and discriminates that the memory failure and the aphasia do not appear.

  In the case of the discrimination pattern 5 in which each answer of the first composite question CQ1 and the third composite question CQ3 is an incorrect answer and the answer of the second composite question CQ2 is a correct answer, the discriminator 52 determines the first composite that was an incorrect answer. The memory impairment that is determined to be impaired in both the problem CQ1 and the third composite problem CQ3 is determined as the core symptom that appears in the subject S. That is, in the case of the discrimination pattern 5, the discrimination unit 52 discriminates that a memory failure has occurred, and discriminates that aphasia and disapproval have not occurred.

  The discrimination patterns 6 to 8 are cases where one of the complex questions CQ1 to CQ3 is an incorrect answer and the remaining two are correct answers. These discrimination patterns 6 to 8 are contradictory patterns that are not possible originally. For example, in the case of the discriminant pattern 6, since the answer to the first composite problem CQ1 is an incorrect answer, this result leads to “Yes” for both memory failure and aphasia, but the second composite problem CQ2 and the second The answers to the three complex questions CQ3 are both correct, leading to an aphasic “none” from the second complex question CQ2, and a memory failure “none” from the third complex problem CQ3, which contradict each other. Therefore, in the case of these discrimination patterns, the discrimination unit 52 does not determine whether or not the core symptom appears in the subject S as in the case of other discrimination patterns, and is a compound problem that is an incorrect answer. In the case of the symptom, the symptom is determined to be a core symptom that is suspected of appearing in the subject S ("suspect").

  More specifically, in the case of the discrimination pattern 6 in which the answer to the first composite question CQ1 is an incorrect answer and each answer of the second composite question CQ2 and the third composite question CQ3 is a correct answer, the discriminator 52 The memory failure and aphasia determined to be faulty in the first composite problem CQ1 are determined as the core symptoms that are suspected of appearing in the subject S, and it is determined that the disapproval does not appear.

  In the case of the discrimination pattern 7 in which the answer to the second composite question CQ2 is an incorrect answer and each answer of the first composite question CQ1 and the third composite question CQ3 is a correct answer, the discriminator 52 determines that the second composite question CQ2 is an incorrect answer. The aphasia and the agnosia determined to be faulty in the problem CQ2 are determined as the core symptoms that are suspected of appearing in the subject S, and it is determined that the memory fault does not appear.

  In the case of the discrimination pattern 8 in which the answer to the third composite question CQ3 is an incorrect answer and each answer of the first composite question CQ1 and the second composite question CQ2 is a correct answer, the discriminator 52 determines that the answer is the third composite The memory failure and the agnosis determined to be disabled in the problem CQ3 are determined as the core symptoms that are suspected of appearing in the subject S, and it is determined that the aphasia does not appear. In the case of discrimination patterns 6 to 8, the discrimination result may be indefinite without determining which of the core symptoms appears in the subject S.

  7 and 8, the history information 48 is a history of simple diagnostic tests for each subject S. The history information 48 is associated with the facility ID of the medical facility 15 where the subject S has undergone the simple diagnostic test, the subject ID, and the date and time (start date) of the simple diagnostic test. When the subject S has received a plurality of simple diagnostic tests, history information 48 for each execution date and time is stored.

  The history information 48 includes columns for each of the complex questions CQ1 to CQ3, their answers, and correct / incorrect columns. The information management unit 53 registers the response from the reception unit 51 in the response column. Further, the information management unit 53 determines whether the answer is correct by collating the answer from the reception unit 51 with the correct answer registered in the problem information 46, and registers the determined correct / incorrect in the correct / incorrect column. The discriminating unit 52 obtains correct / incorrect information of answers necessary for discrimination from the history information 48 and performs discrimination.

  When “I don't know” is selected as the answer option, the information management unit 53 displays “2” in the answer column as illustrated in the bottom column (“5” column) of the second composite question CQ2 in FIG. Register "I don't know" and register the wrong answer in the right / wrong column. When the time-out is input from the reception unit 51, the information management unit 53 displays the answer column as illustrated in the bottom column (column “5”) of the third composite problem CQ3 in FIG. Register "Timeout" and register the wrong answer in the right / wrong column.

  7 and 8 illustrate a case where a plurality of answers or a plurality of questions are prepared for each of the complex questions CQ1 to CQ3. That is, five answers or questions are prepared for each of the complex questions CQ1 to CQ3.

  In this case, for example, 50% is set as the setting rate for determining the correctness of each of the complex problems CQ1 to CQ3. Accordingly, the correctness of each of the complex questions CQ1 to CQ3 in the case of the history information 48A in FIG. 7 is one because there is one wrong answer and the wrong answer rate is 20%, which is lower than the set rate 50%. It corresponds to 1. On the other hand, in the case of the history information 48B in FIG. 8, there are four wrong answers for the first mixed question CQ1 and the second mixed question CQ2, the wrong answer rate is 80%, a set rate of 50% or more, and the third mixed question CQ3. Since there is only one wrong answer and the error rate is 20%, which is lower than the set rate of 50%, the correctness of the first composite problem CQ1 and the second composite problem CQ2 is incorrect, and the correctness of the third composite problem CQ3 is correct. This corresponds to the discrimination pattern 3.

  9 to 12 are examples of the problem display screen 60. The question display screen 60 displays a question sentence such as “What is this?”, Answer options such as “mandarin oranges, bananas, apples,...”, And illustrations depending on the problem. In the answer choices, a button 61 that does not know is prepared to indicate that the answer is unknown. The problem display screen 60 is provided with a help button 62 that is operated when displaying an operation guide or the like of the problem display screen 60.

  FIG. 9 shows a problem display screen 60A for the second composite problem CQ2. The question display screen 60A displays answer choices of five words such as a question sentence “What is this?”, “Mikan”, “Apple”, “Momo”, and an illustration of “Apple”. . In other words, the second composite problem CQ2 presents an illustration representing a specific word to the subject S when the first cognitive dysfunction and the second cognitive dysfunction are aphasia and agnosia, and includes a plurality of specific words including the specific word. A specific word can be selected from the individual words. The question display screen 60A has a common question sentence and is output five times in total with different illustrations and answer options.

  FIG. 10 is a problem display screen 60B of the first complex problem CQ1 that is given next to the second complex problem CQ2. On the question display screen 60B, when answering the choice of 25 words such as the question sentence “Please select the five you remembered earlier”, “Apple”, “Bicycle”, “Sunflower”, etc. Each option of “correction” to be operated and “decision” to be operated when an answer is transmitted is displayed.

  The question display screen 60B presents illustrations to the subject S on the question display screen 60A of the second composite question CQ2, and the subject S has selected five words that indicate the words represented by the illustrations. , 25 answer options are selected. For this reason, the answer choices on the question display screen 60B always include the words of the five illustrations presented to the subject S in the second composite question CQ2. In other words, the first compound problem CQ1 is a case where one of the first cognitive dysfunction and the second cognitive dysfunction is aphasic, and after the subject S remembers the specific word, the specific word is A specific word is selected from a plurality of words.

  11 and 12 are problem display screens 60C-1 and 60C-2 for the third composite problem CQ3. The question display screen 60C-1 shown in FIG. 11 displays the instruction sentence “Please remember the lower figure.” And a figure in which a square and an equilateral triangle overlap. The question display screen 60C-2 shown in FIG. 12 displays a question sentence “Please select the same figure as the current figure.” And answer options for four figures including the figure shown in FIG. In other words, the third composite problem CQ3 includes a specific graphic after causing the subject S to remember a specific graphic when one of the first cognitive dysfunction and the second cognitive dysfunction is agnostic. A specific figure can be selected from a plurality of figures.

  The problem display screens 60C-1 and 60C-2 are displayed as a set, and after the problem display screen 60C-1 is displayed for a predetermined time, the problem display screen 60C-2 is displayed immediately. In the set of problem display screens 60C-1 and 60C-2, the instruction sentence and the question sentence are common, and the figure and answer options to be learned by the subject S are changed and output five times in total. In addition, as for the figure to show, the thing which two figures overlap so that it may illustrate is preferable. Further, the graphic to be presented may be a planar graphic or a three-dimensional graphic as illustrated.

  FIG. 13 is a discrimination result display screen 70A in the case of the discrimination patterns 3 to 5 in which two of the complex questions CQ1 to CQ3 are wrong answers and the remaining one is a correct answer, and more specifically, in the case of the discrimination pattern 3. On the other hand, FIG. 14 shows a discrimination result display screen 70B in the case of discrimination patterns 6 to 8 in which one of the complex questions CQ1 to CQ3 is an incorrect answer and the remaining two are correct answers. is there. The discrimination result display screens 70A and 70B are provided with a retry button 71 that is operated when the simple diagnostic test is started again from the beginning, and an end button 72 that is operated when the simple diagnostic test is ended.

  In FIG. 13, in the case of the discrimination patterns 3 to 5, the core symptom that the discrimination unit 52 discriminates as appearing in the subject S, such as “You seem to have an aphasic disorder.” A message indicating that it appears to the subject S with a high probability and a message prompting the subject S to receive a doctor's examination such as “Please consult with the doctor in charge” are displayed.

  On the other hand, in the case of the discrimination patterns 6 to 8 in FIG. 14, the test is performed by the discrimination unit 52 such as “You may have memory and aphasia, but the possibility is low.” A message indicating that there is a suspicion that the core symptom that has appeared in the subject S is suspected to have appeared in the subject S, although the probability is relatively low, and “Please be careful in the future.” A message prompting the subject S to pay attention to his / her health condition will be displayed. In this way, it is possible to know at a glance whether the probability of the occurrence of the core symptom is relatively high or low by changing the output mode of the discrimination result between the discrimination patterns 3 to 5 and the discrimination patterns 6 to 8. .

  Note that a message indicating that all the core symptoms have not appeared is displayed on the discrimination result display screen 70 in the case of the discrimination pattern 1 in which each of the answers to the complex questions CQ1 to CQ3 is a correct answer. In addition, all the core symptoms appear on the discrimination result display screen 70 in the case of the discrimination pattern 2 in which each answer of each of the complex questions CQ1 to CQ3 is an incorrect answer, and it is subject to immediate medical examination. A message prompting the examiner S is displayed.

  Hereinafter, the operation of the above configuration will be described with reference to the flowchart of FIG. In the waiting room 16 of the medical facility 15, the subject S waiting for medical treatment operates a response terminal 11 provided in the waiting room 16 to start a web browser in order to receive a simple diagnostic test, and diagnoses dementia on the web browser. The access screen of the support server 12 is displayed. On this access screen, the subject S inputs his / her subject ID and gives an access instruction. Thereby, an access request including the input subject ID and facility ID is transmitted to the dementia diagnosis support server 12, and access to the dementia diagnosis support server 12 is completed. Note that the initial setting such as the input of the subject ID may be performed with the cooperation of a family member of the subject S or a third party such as a nurse.

  In response to the access from the answering terminal 11, the problem display screen 60 is output from the output control unit 50 to the answering source answering terminal 11 in the dementia diagnosis support server 12 (step S100, problem output control step). In the answering terminal 11, a problem display screen 60 is displayed on the touch panel 14. In the first embodiment, a problem display screen 60A for the second composite problem CQ2 is output first, followed by a problem display screen 60B for the first composite problem CQ1, and finally a problem display screen 60C for the third composite problem CQ3. The In addition, before the question display screen 60, a practice screen for making the subject S accustomed to the operation of the answering terminal 11 is output, and the physical condition of the subject S (whether he can sleep well or feel that he has forgotten something recently) Etc.) or a screen asking about the family structure.

  The subject S selects a desired answer option on the question display screen 60. When the correct answer is not known, the button 61 that is not known is selected. Thereby, the registration request including the answer is transmitted to the dementia diagnosis support server 12.

  In the dementia diagnosis support server 12, a registration request including an answer from the answer terminal 11 is accepted by the accepting unit 51 (step S110, answer accepting step). The answer is output from the reception unit 51 to the information management unit 53. If the elapsed time after the problem is output exceeds the time limit and the response is not received by the reception unit 51 within the time limit, a message indicating timeout is output from the reception unit 51 to the information management unit 53.

  The response is associated with the subject ID and the like by the information management unit 53 and registered in the history information 48 (step S120). The processes from step S100 to step S120 are repeated until all questions are output (NO in step S130).

  When all the questions have been output (YES in step S130), the determination unit 52 determines which of the core symptoms of dementia appears in the subject S (step S140, determination step). ).

  In the case of the discrimination pattern 1 in which each answer of each of the complex questions CQ1 to CQ3 is a correct answer, it is discriminated that all of memory failure, aphasia, and disapproval have not appeared. On the other hand, in the case of the discrimination pattern 2 in which each answer of each of the complex questions CQ1 to CQ3 is an incorrect answer, it is determined that all of memory failure, aphasia, and disapproval have appeared.

  In the case of the discrimination pattern 3 in which each answer of the first compound question CQ1 and the second compound question CQ2 is an incorrect answer and the answer of the third compound question CQ3 is a correct answer, it is determined that an aphasia appears. In the case of the discrimination pattern 4 in which each answer of the second compound question CQ2 and the third compound question CQ3 is an incorrect answer and the answer of the first compound question CQ1 is a correct answer, it is determined that a disapproval has appeared. In the case of the discrimination pattern 5 in which the answers to the first compound question CQ1 and the third compound question CQ3 are incorrect answers and the answer to the second compound question CQ2 is a correct answer, it is determined that a memory failure has occurred.

  In the case of the discrimination pattern 6 in which the answer to the first compound question CQ1 is an incorrect answer and each answer of the second compound question CQ2 and the third compound question CQ3 is a correct answer, it is determined that there is a suspicion that memory failure and aphasia appear. Is done. In the case of the discrimination pattern 7 in which the answer to the second compound question CQ2 is an incorrect answer and each answer of the first compound question CQ1 and the third compound question CQ3 is a correct answer, it is determined that there is a suspicion that aphasia and disapproval have appeared. Is done. In the case of the discriminant pattern 8 in which the answer to the third complex question CQ3 is an incorrect answer and each answer of the first complex problem CQ1 and the second complex problem CQ2 is a correct answer, there is a suspicion that memory failure and disapproval have appeared. Determined. The core symptom appearing in the subject S can be discriminated with a relatively simple discrimination logic based on whether the answers to the complex questions CQ1 to CQ3 are correct.

  The determination result is output from the determination unit 52 to the output control unit 50. In the output control unit 50, a discrimination result display screen 70 is generated based on the discrimination result from the discrimination unit 52. The generated discrimination result display screen 70 is output from the output control unit 50 to the access source answering terminal 11 (step S150, discrimination result output control step). In the answering terminal 11, a discrimination result display screen 70 is displayed on the touch panel 14.

  A first compound problem CQ1 for determining the presence or absence of a memory failure and a presence or absence of aphasia; a second compound question CQ2 for determining the presence or absence of aphasia and the presence or absence of agnosis; Since the composite problem composed of the composite problem CQ3 is output, and based on the answer, it is determined which of the core symptoms of memory impairment, aphasia, or dementia of dementia appears in the subject S. It becomes possible to clarify which of these core symptoms appear in the subject S.

  The third composite question CQ3 for determining the presence / absence of memory failure and the presence / absence of disapproval is a graphic specific to the subject S exemplified in the problem display screens 60C-1 and 60C-2 in FIGS. It is not limited to the one that allows a specific figure to be selected from a plurality of figures including the specific figure after the memory is memorized.

  16 and 17 are other examples of the third composite problem CQ3. The question display screen 60D-1 shown in FIG. 16 includes a combination of faces and names of four persons such as an instruction sentence “Remember the faces and names of four persons”, “Yoshio”, “Waruo”, and the like. Is displayed. The question display screen 60D-2 shown in FIG. 17 includes a question sentence “Who is this person?”, The face of “Yoshio” among the four persons shown in FIG. 16, and 4 shown in FIG. Answer choices for the names of people are displayed. That is, the third composite problem CQ3 in this case is to remember a pair of faces and names of a plurality of persons in the subject S when one of the first cognitive dysfunction and the second cognitive dysfunction is agnostic. After that, the face of a specific person is presented from a set of faces and names of multiple persons, and the name corresponding to the face of the specific person presented is selected from the names of multiple persons. It asks the so-called disapproval of the appearance.

  The problem display screens 60D-1 and 60D-2 are displayed in the same set as the problem display screens 60C-1 and 60C-2, and immediately after the problem display screen 60D-1 is displayed for a predetermined time, the problem display screen 60D-2 is displayed. Is displayed. In addition, it is preferable that there are three or more persons as illustrated, and it is preferable that the number of persons is the same. Furthermore, it is preferable that the age of the person is the same.

  After the problem display screen 60D-1 shown in FIG. 16, the problem display screen 60D-3 shown in FIG. 18 may be displayed instead of the problem display screen 60D-2 shown in FIG. Displays the question sentence “Which is the girl?” And the answer options for the faces of the four persons shown in FIG. That is, the third composite problem CQ3 in this case is to remember a pair of faces and names of a plurality of persons in the subject S when one of the first cognitive dysfunction and the second cognitive dysfunction is agnostic. After that, the name of a specific person is presented from a set of faces and names of multiple persons, and the face corresponding to the name of the specific person presented is selected from the faces of multiple persons It is. Also according to the contents shown in FIGS. 16 to 18, it is possible to determine whether or not the subject S has a memory failure and whether or not he / she is disapproved.

[Second Embodiment]
In the first embodiment, the case where the first cognitive dysfunction is aphasia and the second cognitive dysfunction is disapproval, but the first cognitive dysfunction as in the second embodiment shown in FIGS. May be aphasic, and the second cognitive dysfunction may be the execution dysfunction.

  FIG. 19 shows problem information 80 of the second embodiment. In the second embodiment, as described above, the first cognitive dysfunction is aphasia, and the second cognitive dysfunction is execution dysfunction. In this case, the first composite problem CQ1 is for determining the presence or absence of memory failure and the presence or absence of aphasia, similar to the first composite problem CQ1 of the first embodiment, but the second composite problem CQ2 and the third composite problem The contents of CQ3 are different from those in the first embodiment. That is, the second composite problem CQ2 is for determining the presence or absence of aphasia and the execution function failure, and the third composite problem CQ3 is for determining the presence or absence of memory failure and the presence or absence of execution function failure. 60 seconds is registered as the time limit for the second composite problem CQ2, and 20 seconds is registered as the time limit for the third composite problem CQ3.

  FIG. 20 is a problem display screen 60E of the second composite problem CQ2 of the second embodiment. On the question display screen 60E, the answer to the multiple sentences such as the question sentence “Please rearrange so that it becomes the correct sentence and then select the third sentence.”, “I am”, “Inspect” The options are displayed. In other words, the second compound problem CQ2 of the second embodiment is a case where the first cognitive dysfunction and the second cognitive dysfunction are aphasia and execution dysfunction, and the subject S is provided with a plurality of phrases that become one sentence when rearranged. It is presented and the phrases are rearranged in the correct order, and the phrases that have a specific order when rearranged in the correct order are selected. Similar to the problem display screens 60A, 60C-1, and 60C-2 of the first embodiment, the problem display screen 60E is output a plurality of times by changing the order of question sentences and answer options.

  21 and 22 are problem display screens 60F-1 and 60F-2 for the third composite problem CQ3 of the second embodiment. On the problem display screen 60F-1 shown in FIG. 21, the instruction sentence “Please read the following sentence carefully. I will ask about the contents later.” And “On Sunday I went shopping with my brother Taro and the car. A text like "I went ..." is displayed. The question display screen 60F-2 shown in FIG. 22 displays answer choices such as a question sentence “What was the day of the week? Please select the correct one.”, “Monday”, and “Wednesday”. In other words, the third composite problem CQ3 of the second embodiment is to read a sentence including a plurality of keywords to the subject S when one of the first cognitive dysfunction and the second cognitive dysfunction is an execution dysfunction. After that, ask the keyword. In the case of the problem display screen 60F-2, the keyword is “Sunday”.

  The problem display screens 60F-1 and 60F-2 are displayed as a set, and after the problem display screen 60F-1 is displayed for a predetermined time, the problem display screen 60F-2 is displayed immediately. The question display screen 60F-2 is also output a plurality of times with different question sentences and answer options.

  Note that the discrimination information in this case may be obtained by replacing “disapproval” in the discrimination information 47 shown in FIG. In addition, the first complex question CQ1 is made up of a plurality of words including a specific number of words after the subject S remembers a specific number of words shown on the problem display screen 60B of FIG. 10 of the first embodiment. A word that allows a specific word to be selected from the words may be employed.

  According to the second embodiment, it becomes possible to clarify which of the core symptoms of memory impairment, aphasia, and dementia of executive dysfunction appears in the subject S.

[Third Embodiment]
In the third embodiment shown in FIGS. 23 to 27, the first cognitive dysfunction is disapproved, and the second cognitive dysfunction is set as an execution dysfunction.

  FIG. 23 shows the problem information 85 of the third embodiment. In the third embodiment, as described above, the first cognitive dysfunction is disapproval, and the second cognitive dysfunction is execution dysfunction. In this case, the first combined problem CQ1 is for determining whether or not there is a memory failure and whether or not there is a disapproval, similar to the third combined problem CQ3 of the first embodiment. Similar to the third combined problem CQ3 of the embodiment, the presence or absence of a memory failure and the presence or absence of an execution function failure are determined, but the contents of the second combined problem CQ2 are different from those of the above embodiments. That is, the second composite problem CQ2 is for determining whether or not there is a disapproval and whether or not there is an execution function failure. 60 seconds is registered as the time limit for the second complex problem CQ2.

  FIG. 24 is a problem display screen 60G of the second composite problem CQ2 of the third embodiment. On the question display screen 60G, there is an illustration of a map with a question sentence “Go to the east from the intersection just north of the house and push the second intersection.” And a map showing the house and direction mark and multiple intersections. Is displayed. In other words, the second composite problem CQ2 of the third embodiment asks the regional cognitive function when the first cognitive dysfunction and the second cognitive dysfunction are agnosia and executive dysfunction. The question display screen 60G is also output a plurality of times while changing the contents of the question sentence or the position of the house illustration.

  The map illustration is preferably a schematic illustration as illustrated. In addition, as a question to ask a geological cognitive function, the content which asks for the route from a starting point to an arrival point, or the positional relationship of two points on a map may be sufficient.

  Note that the discrimination information in this case may be replaced by “disappointment” and “disapproval” in the discrimination information 47 shown in FIG. In addition, the first combined problem CQ1 is identified after the subject S remembers a specific figure as shown in the problem display screens 60C-1 and 60C-2 in FIGS. 11 and 12 of the first embodiment. What makes it possible to select a specific figure from among a plurality of figures including the above-described figure may be employed. Or what inquires about the disapproval of the appearance shown on the problem display screens 60D-1 to 60D-3 of FIGS. As the third complex question CQ3, the subject S shown in the problem display screens 60F-1 and 60F-2 in FIGS. 21 and 22 is read by the subject S and then the keyword is asked. do it.

  As the second composite problem CQ2 of the third embodiment, instead of or in addition to the question of the topographical cognitive function shown on the question display screen 60G of FIG. Good.

  FIG. 25 is another example of the second composite problem CQ2 of the third embodiment. In FIG. 25, the question display screen 60H displays a question sentence “Which hand is left or right?”, “Right hand”, “left hand” answer choices, and hand illustrations. In other words, the second composite problem CQ2 in this case asks the right and left orientations when the first cognitive dysfunction and the second cognitive dysfunction are disapproval and executive dysfunction. The problem display screen 60H is also output a plurality of times with different hand illustrations.

  As illustrated, the illustration of the hand is preferably an illustration in which the thumb and the tip of another finger are in contact with each other or an illustration in which the hand is held. Illustrations of eyes, ears, and feet may be used instead of hands.

  The problem of asking the right and left orientation may be the contents shown in FIGS. In the problem display screen 60I-1 shown in FIG. 26, an instruction sentence “Please select right for ○, left for ●” and indicates which button should be pressed according to the displayed mark. Instructions and illustrations are displayed. On the problem display screen 60I-2 shown in FIG. 27, a question sentence “Please select one”, “◯” or “●” mark, and left and right buttons are displayed. The problem display screen 60I-2 is output a plurality of times while changing the mark after the problem display screen 60I-1 is displayed for a predetermined time.

  According to the third embodiment, it becomes possible to clarify which of the core symptoms of dementia of memory impairment, agnosia, and executive dysfunction appears in the subject S.

  In addition to the problems illustrated in the above embodiments, a problem having the contents shown in FIG. 28 may be output.

  In FIG. 28, the question display screen 60J has answer options of illustrations representing five articles such as a question sentence “Only one different friend. Please select it.”, “Sunflower”, “banana” and the like. Is displayed. Four of the five illustrations belong to the same category, and one has a different category. Here, since “mandarin orange”, “banana”, “peach”, and “cucumber” are the same “fruit” category, a correct answer is obtained when “sunflower” in the “flower” category is selected. That is, the problem on the problem display screen 60J is to present the subject S with illustrations representing a plurality of articles and to select one illustration in a category different from other illustrations.

  According to the problem of the contents shown in FIG. 28, it is possible to determine purely the presence or absence of disapproval. Therefore, for example, when it is determined that there is a suspicion that the disapproval appears in the subject S as in the determination patterns 7 and 8 of the first embodiment, the problem of the contents shown in FIG. 28 is output. From the answer, it can be determined whether or not the disapproval really appears.

[Fourth Embodiment]
Prepare a plurality of complex problem sets each consisting of one question of the first complex problem CQ1, the second complex problem CQ2, and the third complex problem CQ3, and according to the correctness of the answers to each complex problem CQ1 to CQ3 The correctness / incorrectness of the answers to the composite questions CQ1 to CQ3 used for the determination may be finally determined.

  For example, as shown in FIG. 29, among the first to third sets, the first set is correct for the first combined problem CQ1, the second combined problem CQ2 and the third combined problem CQ3 are incorrect (discrimination pattern 4), When the second composite problem CQ2 is positive and the first composite problem CQ1 and the third composite problem CQ3 are erroneous (discrimination pattern 5), the second and third sets have a plurality of discrimination patterns 5 and a plurality of discrimination patterns 5. Ultimately determine which of the core symptoms are present in the subject.

[Fifth Embodiment]
Further, instead of or in addition to the determination method such as presence or absence of a disorder, a score indicating the degree of the core symptom may be calculated and output as a determination result. In this case, as shown in the table 90 of FIG. 30, the scores corresponding to the correctness of the answers to the complex questions CQ1 to CQ3 are set in advance. Specifically, the first composite question CQ1 has 5 answers, and when all 5 answers are correct, the score is 0, when 4 answers are correct, the score is 20,... A score of 100 is given for all incorrect answers.

  In the second composite problem CQ2 and the third composite problem CQ3, scores are assigned to the five questions when the answer is an incorrect answer. The scores of the second composite problem CQ2 and the third composite problem CQ3 are obtained by integrating the scores of the questions. For this reason, the scores of the second composite question CQ2 and the third composite question CQ3 are 100, which is the highest when all the answers to each question are wrong answers, and the lowest 0 when all the answers to each question are correct answers. It becomes.

  In the second composite question CQ2, the score is weighted by the question, such that the first question and the second question have a score of 30, the third question has a score of 20, and the fourth and fifth questions have a score of 10. The same applies to the third composite problem CQ3. The weighting of the score is performed according to, for example, the accuracy of determination for each question. The accuracy of discrimination is an index determined in consideration of whether or not it is effective for discriminating the degree of each core symptom based on a huge amount of past medical knowledge about dementia. For this reason, a relatively high score is assigned to a question with relatively high discrimination accuracy, and a relatively low score is assigned to a question with relatively low discrimination accuracy.

  For example, as a combined problem for determining the presence or absence of memory failure and the presence or absence of recognition, the subject S shown in FIG. 11 and FIG. 12 is made to remember a specific figure, and then from among a plurality of figures including the specific figure. When a question is asked to select a specific figure and one that asks for the disapproval of the appearance shown in FIGS. 16 to 18, the score of the one that asks for the disapproval of the appearance that is considered to have a relatively high accuracy of discrimination is high. Set.

  Here, in the history information 48C shown in FIG. 31, one correct answer is given to the first complex question CQ1, the third to fifth questions of the second complex question CQ2 are incorrect, and the second and second questions of the third complex question CQ3. Consider the case where 5 questions are incorrect.

  In this case, according to Table 90 of FIG. 30, the score of the first composite problem CQ1 is 80, the score of the second composite problem CQ2 is 40, and the score of the third composite problem CQ3 is 30. The score of the memory failure is calculated from the scores of the first composite problem CQ1 and the third composite question CQ3 that are common in determining whether or not there is a memory failure. Here, the average value of the scores of the first composite problem CQ1 and the score of the third composite problem CQ3, that is, (80 + 30) / 2 = 55 is calculated as the score of the memory failure.

  Similarly, the score of the first cognitive dysfunction is the average of the scores of the first composite problem CQ1 and the second composite problem CQ2 that are common in determining whether or not there is the first cognitive dysfunction, that is, (80 + 40) / 2. = 60. Furthermore, the score of the second cognitive dysfunction is the average value of the scores of the second composite problem CQ2 and the third composite problem CQ3 that are common in determining whether or not there is the second cognitive dysfunction, that is, (40 + 30) / 2 = 35. In this case, the score of each core symptom is displayed on the discrimination result display screen 70.

  If the score is lower than the set score, it may be determined that there is no core symptom, and if the score is equal to or higher than the set score, it may be determined that there is a core symptom. When the setting score is 50, it is determined in the example of FIG. 31 that there is a memory impairment and a first cognitive dysfunction and no second cognitive dysfunction.

  Thus, if the score of each core symptom is output as a discrimination result, whether the core symptom is mild or severe can be intuitively understood by the magnitude of the score. In addition, even if it cannot be determined that the subject appears in the subject S, it is possible to identify a core symptom with a certain probability of appearing. Therefore, it is possible to find a subject S with mild cognitive impairment (MCI) that may be buried in the manner of discrimination such as presence or absence of disability.

  The score may be increased or decreased in accordance with the length of the answer time, which is the time taken for answering each question, the number of times the button 61 is not selected, the number of time-outs, etc. For example, when the answer time is longer than the set time, 5 is added to the calculated score, or when the number of selections of the button 61 that is not known is equal to or less than the set number, 5 is subtracted from the calculated score.

  In each of the above embodiments, the reply terminal 11 is arranged in the waiting room 16 of the medical facility 15. However, when prescription drugs are purchased at a pharmacy, a waiting time is generated in the same manner as before medical treatment. Therefore, in addition to or instead of the waiting room 16, the answering terminal 11 may be provided in the pharmacy. Similarly, the answering terminal 11 may be arranged at an accounting window of the medical facility 15 where a waiting time occurs.

  Further, the place where the subject S receives the simple diagnostic test is not limited to the medical facility 15. It is also possible to take a simple diagnostic test at home or at a place other than the medical facility 15. In this case, the answer terminal 11 may be a mobile terminal such as a smartphone owned by the subject S.

  Various modifications can be made to the hardware configuration of the computer constituting the dementia diagnosis support apparatus of the present invention. For example, the dementia diagnosis support apparatus can be configured by a plurality of computers separated as hardware for the purpose of improving processing capability and reliability. For example, the functions of the output control unit 50, the reception unit 51, and the determination unit 52 and the function of the information management unit 53 are distributed and carried by two computers. In this case, a dementia diagnosis support apparatus is constituted by two computers.

  In each of the above embodiments, the problem output control function and the determination result output control function are assigned to the output control unit 50 at one hand. However, these functions may be assigned to independent function units.

  Moreover, although each said embodiment illustrated the aspect which outputs each screen, such as the problem display screen 60 and the discrimination | determination result display screen 70, from the output control part 50 to the reply terminal 11 in the format of the screen data for web delivery, It is also possible to install an AP for displaying each screen on the answering terminal 11 and output a command for instructing the AP to display each screen from the output control unit 50.

  The operating program may be installed in the answering terminal, each function unit constructed in the dementia diagnosis support server may be built in the answering terminal, and the answering terminal may be operated as a dementia diagnosis supporting apparatus. In this case, the answering terminal may be a dedicated product specialized for the dementia diagnosis support system instead of a commercially available tablet computer.

  The installation location of the dementia diagnosis support server 12 is not limited to the data center 17. One dementia diagnosis support server 12 may be installed in each medical facility 15.

  As described above, the hardware configuration of the computer can be changed as appropriate according to required performance such as processing capability, safety, and reliability. Furthermore, not only the hardware but also the AP such as the operation program 45 can be duplicated or distributed and stored in a plurality of storage devices for the purpose of ensuring safety and reliability. .

  The discrimination result or / and the history information 48 may be configured to be viewable by the doctor in charge of the subject S or / and the family or caregiver of the subject S. In this case, the dementia diagnosis support server 12 receives the determination result from the client terminal operated by the doctor in charge of the subject S or the like and / or the distribution request for the history information 48, and determines the determination result to the client terminal that has received the distribution request. Or / and history information 48 is transmitted. Alternatively, the e-mail address of the doctor in charge may be registered in advance in the dementia diagnosis support server 12, and the determination result or / and the history information 48 may be automatically transmitted to the e-mail address of the doctor in charge.

  BGM (Background Music) may be output from the speaker of the answering terminal 11 during the execution of the simple diagnostic test. In addition, after displaying the discrimination result display screen 70, a questionnaire screen related to lifestyle habits such as whether to exercise moderately, read well, or go shopping may be displayed.

  The present invention can be appropriately combined with the above-described various embodiments and various modifications. Moreover, it is needless to say that various configurations can be adopted without departing from the gist of the present invention. Furthermore, the present invention extends to a storage medium for storing a program in addition to the program.

10 Dementia Diagnosis Support System 11 Answer Terminal 12 Dementia Diagnosis Support Server (Dementia Diagnosis Support Device)
13 Network 14 Touch Panel 15 Medical Facility 16 Waiting Room 17 Data Center 30, 30B Storage Device 31 Memory 32, 32A, 32B CPU
33 Communication Unit 34 Input / Output Device 35 Data Bus 40 Browser Control Unit 45 Operation Program 46, 80, 85 Problem Information 47 Discrimination Information 48, 48A-48C History Information 50 Output Control Unit (Problem Output Control Unit, Discrimination Result Output Control Unit)
51 Reception Department (Reply Reception Department)
52 Discrimination part 53 Information management part 60, 60A-60J Problem display screen 61 Button not understood 62 Help button 70, 70A, 70B Discrimination result display screen 71 Retry button 72 End button S Subject CQ1-CQ3 First to third composite Problem S100 ~ S150 Step

Claims (15)

In a dementia diagnosis support apparatus that provides a subject with a simple diagnosis test for dementia consisting of problems related to dementia,
A problem output controller for controlling the output of the problem;
An answer reception unit for receiving an answer to the problem;
Based on the answer, a determination unit that determines which of the core symptoms of dementia appears in the subject;
A discrimination result output control unit for controlling the output of the discrimination result by the discrimination unit;
The problem includes a complex problem related to two of the core symptoms of memory impairment, first cognitive dysfunction, and second cognitive dysfunction;
The composite problem is a first composite problem for determining the presence or absence of the memory disorder and the presence or absence of the first cognitive dysfunction;
A second composite problem for determining the presence or absence of the first cognitive dysfunction and the presence or absence of the second cognitive dysfunction;
A dementia diagnosis support apparatus comprising the presence / absence of the memory impairment and a third composite problem for determining the presence / absence of the second cognitive dysfunction. The determination unit determines that the memory failure, the first cognitive dysfunction, and the second when each of the answers of the first composite question, the second composite question, and the third composite question is a correct answer. Determine that all of cognitive impairment has not appeared,
If each of the answers to the first complex problem, the second complex problem, and the third complex problem is an incorrect answer, the memory disorder, the first cognitive dysfunction, and the second cognitive dysfunction The dementia diagnosis support apparatus according to claim 1, wherein it is determined that all appear. The determination unit determines that the first cognitive dysfunction appears when each answer of the first complex question and the second complex problem is an incorrect answer and the answer of the third complex problem is a correct answer. It is determined that
If each answer of the second complex question and the third complex problem is an incorrect answer and the answer of the first complex problem is a correct answer, it is determined that the second cognitive dysfunction appears,
The method according to claim 2, wherein when the answer of each of the first composite problem and the third composite problem is an incorrect answer and the answer of the second composite problem is a correct answer, it is determined that the memory failure has occurred. Dementia diagnosis support apparatus as described.   The dementia diagnosis support according to any one of claims 1 to 3, wherein the first cognitive dysfunction and the second cognitive dysfunction are any two of aphasia, agnosia, and executive dysfunction. apparatus.   When one of the first cognitive dysfunction and the second cognitive dysfunction is the aphasia, the compound problem includes the specific word after causing the subject to remember the specific word The dementia diagnosis support apparatus according to claim 4, wherein the dementia diagnosis support apparatus includes one that allows the specific word to be selected from a plurality of words.   When one of the first cognitive dysfunction and the second cognitive dysfunction is the disapproval, the composite problem includes a plurality of the specific graphic after the subject is made to remember the specific graphic. The dementia diagnosis support apparatus according to claim 4 or 5 including what makes said specific figure choose from among the figures. When one of the first cognitive dysfunction and the second cognitive dysfunction is the disapproval, the combined problem is caused by causing the subject to remember a plurality of person face and name pairs. Presenting a face of a specific person from a set of faces and names of a plurality of persons, and selecting a name corresponding to the presented face of the specific person from the names of the plurality of persons,
Or / and after causing the subject to remember a set of faces and names of a plurality of persons, presenting a name of a specific person from the set of faces and names of the plurality of persons, The dementia diagnosis support apparatus according to any one of claims 4 to 6, including a device that allows a face corresponding to the presented name of the specific person to be selected from the faces of the person.   When the first cognitive dysfunction and the second cognitive dysfunction are the aphasia and the agnosia, the combined problem presents an illustration representing a specific word to the subject, and includes a plurality of the specific words The dementia diagnosis support apparatus according to any one of claims 4 to 7, including a word that allows the specific word to be selected from a plurality of words.   When one of the first cognitive dysfunction and the second cognitive dysfunction is the executive dysfunction, the complex problem is that the subject is read after reading a sentence including a plurality of keywords. The dementia diagnosis support apparatus according to any one of claims 4 to 8, including a question.   When the first cognitive dysfunction and the second cognitive dysfunction are the aphasia and the executive dysfunction, the composite problem presents the subject with a plurality of phrases that become one sentence when rearranged, and in the correct order The dementia diagnosis support apparatus according to any one of claims 4 to 9, including an element that rearranges the phrases and allows the phrases to be selected in a specific order when rearranged in the correct order.   In the case where the first cognitive dysfunction and the second cognitive dysfunction are the disapproval and the executive dysfunction, the complex problem is a question of geological cognitive function, and / or a question of left and right orientation. The dementia diagnosis support apparatus according to any one of claims 4 to 10.   The dementia according to any one of claims 1 to 11, wherein the problem includes one in which an illustration representing a plurality of articles is presented to the subject and one illustration in a category different from other illustrations is selected. Diagnosis support device. In the operation method of the dementia diagnosis support apparatus that provides the subject with a simple diagnosis test of dementia composed of problems related to dementia,
A problem output control step for controlling the output of the problem;
An answer receiving step for receiving an answer to the problem;
Based on the answer, a determination step of determining which of a plurality of core symptoms of dementia appears in the subject;
A determination result output control step for controlling the output of the determination result in the determination step;
The problem includes a complex problem related to two of the core symptoms of memory impairment, first cognitive dysfunction, and second cognitive dysfunction;
The composite problem is a first composite problem for determining the presence or absence of the memory disorder and the presence or absence of the first cognitive dysfunction;
A second composite problem for determining the presence or absence of the first cognitive dysfunction and the presence or absence of the second cognitive dysfunction;
A method of operating a dementia diagnosis support apparatus comprising the presence / absence of the memory impairment and the third composite problem for determining the presence / absence of the second cognitive dysfunction. In the operation program of the dementia diagnosis support device that provides the subject with a simple diagnosis test of dementia consisting of problems related to dementia,
A problem output control function for controlling the output of the problem;
An answer acceptance function for accepting an answer to the problem;
Based on the answer, a discriminating function for discriminating which of a plurality of core symptoms of dementia appears in the subject,
A discrimination result output control function for controlling the output of the discrimination result by the discrimination function;
The problem includes a complex problem related to two of the core symptoms of memory impairment, first cognitive dysfunction, and second cognitive dysfunction;
The composite problem is a first composite problem for determining the presence or absence of the memory disorder and the presence or absence of the first cognitive dysfunction;
A second composite problem for determining the presence or absence of the first cognitive dysfunction and the presence or absence of the second cognitive dysfunction;
An operating program for a dementia diagnosis support apparatus comprising the presence / absence of the memory impairment and a third composite problem for determining the presence / absence of the second cognitive dysfunction. A dementia diagnosis support device that provides a subject with a simple diagnosis test for dementia composed of problems related to dementia, and is connected to the dementia diagnosis support device via a network and operated by the subject In a dementia diagnosis support system comprising an answering terminal,
The dementia diagnosis support device comprises:
A problem output control unit for controlling the output of the problem to the answering terminal;
An answer receiving unit for receiving an answer to the problem from the answering terminal;
Based on the answer, a determination unit that determines which of the core symptoms of dementia appears in the subject;
A determination result output control unit for controlling the output of the determination result by the determination unit to the answering terminal,
The problem includes a complex problem related to two of the core symptoms of memory impairment, first cognitive dysfunction, and second cognitive dysfunction;
The composite problem is a first composite problem for determining the presence or absence of the memory disorder and the presence or absence of the first cognitive dysfunction;
A second composite problem for determining the presence or absence of the first cognitive dysfunction and the presence or absence of the second cognitive dysfunction;
A dementia diagnosis support system comprising the presence / absence of the memory impairment and a third composite problem for determining the presence / absence of the second cognitive dysfunction.

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