JP2021003476A - Evaluation apparatus, evaluation program, and evaluation system - Google Patents

Abstract

To highly accurately evaluate the progress of cognitive impairment.SOLUTION: An evaluation apparatus 10 accepts an instruction, acquires an index indicating a physical balance of an examinee for each of before and after receiving the instruction, measures the recovery time until the acquired index returns to the index before receiving the instruction, and evaluates the progress of cognitive impairment in the examinee using the measured recovery time and the index.SELECTED DRAWING: Figure 6

Description

The present invention relates to an evaluation device, an evaluation program, and an evaluation system.

Patent Document 1 includes an application execution unit that executes a stereoscopic vision program for generating a left-eye image and a right-eye image corresponding to the left and right eyes of the observer, and the application execution unit. An information processing terminal provided with a display unit that displays the left-eye image and the right-eye image generated by the stereoscopic viewing program at locations corresponding to the left and right eyes, and a user interface that accepts user operations. It is an early detection / prevention program for early detection or prevention of mild dementia by using the early detection / prevention program, in which the information processing terminal is connected to the left eye image and the right eye image. The stereoscopic image generation step of generating a stereoscopic image area for displaying a stereoscopic image configured by generating a convergence angle and a parallax between them, and the position or orientation in the virtual space constructed in the stereoscopic image area change. A plurality of objects are displayed, and the plurality of objects are rotated at an arbitrary speed around an arbitrary center of gravity position installed in the virtual space, and the color of the objects is changed at an arbitrary timing and time length. Recognition that records the time difference between the object operation step, the timing and time length when the color of the object changes, the user operation with respect to the user interface, and the accuracy of the user operation as test results of spatial recognition ability and situation judgment ability. An early detection prevention program for mild dementia is disclosed, which comprises performing a force measurement step and a process including.

Patent Document 2 describes a load sensor that detects a load acting on a measurement surface on which a examiner puts his / her foot in a standing position, a center of gravity detection device that detects the position of the center of gravity of the examiner by a detection signal of the load sensor, and the like. A pressure distribution sensor having a plurality of pressure detection units arranged on the measurement surface, a foot pressure area detection device that detects the foot pressure action area of the examiner by the detection signal of the pressure distribution sensor, and the foot in the displacement direction of the center of gravity. A reference width dimension setting device that sets the reference width dimension of the pressure action region based on the detection signal of the foot pressure action region detected by the foot pressure region detection device, and the foot set by the reference width dimension setting device. The center of gravity displacement amount calculation device for obtaining the displacement amount of the center of gravity position of the examiner detected by the center of gravity detection device and the center of gravity displacement amount calculation device for obtaining the displacement amount in the width direction with respect to the reference width dimension of the pressure action region. A balance capacity measuring device is disclosed, which comprises a display device for externally displaying a result based on the displacement amount of the center of gravity position.

Patent Document 3 describes an information transmission unit that works on at least one of the visual and auditory senses of a examiner to transmit information to the examiner, a measurement unit that measures the reaction of the examiner to which the information is transmitted, and the above. A plurality of different feature amounts are calculated based on the results of the measurement unit, and a control unit for determining whether or not the examiner has dementia based on the feature amounts is provided. It is provided with a sound collecting unit that collects the sound emitted by the examiner, and the control unit has at least one acoustic feature amount that is an acoustic feature amount of the sound emitted by the examiner, and the examiner. A dementia test system is disclosed, which determines whether or not the examiner has dementia based on at least one linguistic feature amount which is a linguistic feature amount of the emitted voice. ..

Japanese Patent No. 6229867 JP-A-2016-209546 Japanese Unexamined Patent Publication No. 2018-15139

Routine tests, such as a doctor's interview and the Mini Mental State Examination (MMSE), may be performed to determine if the examiner is suspected of having cognitive impairment.

However, since the judgment of cognitive impairment by interview tends to be made based on the experience and subjectivity of the doctor, the judgment result may vary.

In addition, because there is a wave in the cognitive level of things due to cognitive impairment, even if the examiner actually has cognitive impairment, the consciousness is clear during the MMSE test, and the cognitive level of things is healthy. It may be difficult to make a correct judgment when the level is at the same level as the cognitive level.

The present invention is an evaluation capable of accurately evaluating the progress of cognitive impairment as compared with the case of evaluating the progression of cognitive impairment of a examiner based on the correct answer rate of a question used for grasping cognitive ability. It is an object of the present invention to provide an apparatus, an evaluation program, and an evaluation system.

The evaluation device according to the first aspect includes a reception unit that receives an instruction, an acquisition unit that acquires an index indicating the physical balance of the examiner before and after receiving the instruction at the reception unit, and the instruction. Using the measuring unit that measures the recovery time until the index returns to the index before receiving the instruction, the recovery time measured by the measuring unit, and the index acquired by the acquisition unit are used. Further, an evaluation unit for evaluating the progress of cognitive impairment of the examiner is provided.

The evaluation device according to the second aspect includes a reception unit that receives an instruction, an acquisition unit that acquires an index indicating the physical balance of the examiner before and after receiving the instruction at the reception unit, and the acquisition unit. The progress of cognitive impairment of the examiner using the measurement unit that measures the amount of sway of the body of the examiner before and after receiving the instruction from the index acquired by the unit and the amount of sway measured by the measurement unit. It is equipped with an evaluation unit that evaluates the degree.

The evaluation device according to the third aspect is the evaluation device according to the first aspect, wherein the instruction is an instruction to shake the body of the examiner, and the evaluation unit is obtained from the recovery time and the index. The progress of the cognitive impairment of the examiner is evaluated by using the recovery rate of returning to the posture before the examiner's body is shaken.

In the evaluation device according to the third aspect, the evaluation device according to the fourth aspect evaluates the evaluation unit so that the faster the recovery rate, the lower the degree of progression of the cognitive impairment of the examiner.

The evaluation device according to the fifth aspect is the evaluation device according to the second aspect, in which the examination is performed when the examiner is shown an image affecting the examiner's sense of balance with respect to the amount of body agitation of the examiner. The first sway amount representing each sway amount of the head or foot of the person and the second sway amount representing each sway amount of the head or foot of the examiner when the image is not shown are included. The evaluation unit determines that the smaller the difference between the first sway amount and the preset first reference sway amount and the difference between the second sway amount and the preset second reference sway amount, the more the examiner's Evaluate so that the degree of progression of cognitive impairment is low.

The evaluation device according to the sixth aspect is set from the physical balance of each person belonging to the group in which the first reference sway amount and the second reference sway amount are not recognized in the evaluation device according to the fifth aspect. Will be done.

The evaluation device according to the seventh aspect is the evaluation device according to the fifth or sixth aspect, wherein the evaluation unit has a difference between the first sway amount and the second sway amount and a preset reference difference. The smaller the difference, the lower the degree of progression of the cognitive impairment of the examiner.

In the evaluation device according to the eighth aspect, in the evaluation device according to the seventh aspect, the reference difference is based on the difference between the first sway amount and the second sway amount of each person belonging to the group in which no cognitive impairment is observed. Set.

In the evaluation device according to any one of the first to eighth aspects, the evaluation device according to the ninth aspect further measures the completion time of the operation required by the instruction, and the evaluation unit further measures the completion time of the operation requested by the instruction. However, the shorter the completion time, the lower the degree of progression of the cognitive impairment of the examiner.

The evaluation device according to the tenth aspect is the evaluation device according to any one of the first to ninth aspects, and the examination is performed before the evaluation unit acquires the physical balance of the examiner at the acquisition unit. An initial test is performed to evaluate whether a person is suitable for a cognitive function test, and if the test result of the initial test does not meet the predetermined criteria, the degree of progression of cognitive impairment to the examiner Stop the evaluation.

The evaluation device according to the eleventh aspect is the evaluation device according to the tenth aspect, the initial examination includes a visual acuity test and a hearing test, and the evaluation unit includes the above-mentioned predetermined standard for at least one of the visual acuity test and the hearing test. If the above is not satisfied, the evaluation of the progress of cognitive impairment for the examiner is stopped.

The evaluation device according to the twelfth aspect outputs the progress of the cognitive impairment of the examiner evaluated by the evaluation unit in chronological order in the evaluation device according to any one of the first to eleventh aspects. It has an output unit.

The evaluation program according to the thirteenth aspect is a program for causing the computer to function as each part of the evaluation device according to any one of the first to twelfth aspects.

The evaluation system according to the fourteenth aspect includes a measuring device for measuring the physical condition of the examiner and an evaluation device according to any one of the first to twelfth aspects.

According to the first aspect, the second aspect, the thirteenth aspect, and the fourteenth aspect, as compared with the case of evaluating the progress of cognitive impairment of the examiner based on the accuracy rate of the question used for grasping the cognitive ability. It has the effect of being able to accurately evaluate the degree of progression of cognitive impairment.

According to the third aspect, there is an effect that the physical balance of the examiner can be obtained by shaking the body of the examiner.

According to the fourth aspect, there is an effect that the recovery speed of the posture against the agitation of the body can be used for the evaluation of the progress of the cognitive impairment.

According to the fifth aspect, it is possible to accurately evaluate the progress of cognitive impairment as compared with the case of evaluating the progression of cognitive impairment without showing the examiner an image that disturbs the sense of balance. Have.

According to the sixth aspect, there is an effect that the physical balance of the examiner can be evaluated based on the physical balance of a person belonging to the group in which no cognitive impairment is observed.

According to the seventh aspect, there is an effect that the difference in the amount of agitation depending on the presence or absence of a load that affects the sense of balance can be used for evaluating the degree of progression of cognitive impairment.

According to the eighth aspect, there is an effect that the difference in the amount of agitation in the examiner can be evaluated based on the difference in the amount of agitation of a person belonging to the group in which no cognitive impairment is observed.

According to the ninth aspect, there is an effect that the completion time of the instructed motion can be used for evaluating the progress of cognitive impairment.

According to the tenth aspect, it has an effect that it is possible to determine whether or not the degree of progression of cognitive impairment in the examiner can be evaluated before acquiring an index indicating the physical balance of the examiner.

According to the eleventh aspect, there is an effect that the evaluation of the progress of cognitive impairment for a examiner who does not understand the instructions can be stopped.

According to the twelfth aspect, it has an effect that it is possible to output training results useful for improving cognitive impairment.

It is a figure which shows the configuration example of the evaluation system. It is a figure which shows an example of the state during the examination of a examiner. It is a figure which shows the locus example of the sway of the foot in a examiner. It is a figure which shows an example of the load applied to the examiner. It is a figure which shows the locus example of the sway of the head in a examinee. It is a figure which shows the functional configuration example of the evaluation apparatus. It is a figure which shows the example of the composition of the main part of an electric system in an evaluation apparatus. It is a flowchart which shows an example of the evaluation process which concerns on 1st Embodiment. It is a figure which shows an example of the menu screen which concerns on 1st Embodiment. It is a figure which shows an example of the graph of the center of gravity movement distance. It is a figure which shows an example of the figure used in the figure recognition inspection. It is a figure which shows an example of the image used in the emotion recognition test. It is a figure which shows an example of the image used in the memory test. It is a flowchart which shows the modification of the evaluation process which concerns on 1st Embodiment. It is a figure which shows an example of the Randold ring used in the initial inspection. It is a flowchart which shows an example of the evaluation process which concerns on 2nd Embodiment. It is a figure which shows an example of the menu screen which concerns on 2nd Embodiment. It is a figure which shows an example of the graph of the cognitive score.

Hereinafter, the present embodiment will be described with reference to the drawings. It should be noted that the same code is given throughout the drawings to the configurations and processes having the same function, and duplicate description is omitted.

<First Embodiment>
FIG. 1 is a diagram showing a configuration example of the evaluation system 100 according to the present embodiment. The evaluation system 100 includes an evaluation device 10 for evaluating the progress of cognitive impairment of a examiner who is screened for cognitive impairment, and a measuring device 20 for measuring the cognitive status and physical condition of the examiner. Reference numeral 20 is connected by a communication line 2.

The communication line 2 may be a wireless line or a wired line, and may be a dedicated line or a public line to which an unspecified number of devices are connected, such as the Internet. There are no restrictions on the types of wireless lines that can be applied, and for example, wireless LAN (Local Area Network), Bluetooth (registered trademark), and the like are used.

The measuring device 20 uses the foot pressure sensor 21, the HMD (Head Mounted Display) 22, the motion sensor 23, and the microphone 24 to collect measurement data representing the cognitive and physical conditions of the examiner. Then, the measuring device 20 transmits the collected measurement data to the evaluation device 10 through the communication line 2.

FIG. 2 is a diagram showing a state of screening of a examiner who is screened for cognitive impairment by the evaluation system 100. As shown in FIG. 2, the examiner stands on the foot pressure sensor 21 formed in the shape of a sheet with the HMD 22 attached to the head to be examined for cognitive impairment. In addition, motion sensors 23 are attached to both arms of the examiner.

The foot pressure sensor 21 measures the position of the sole of the foot of the examiner and the pressure applied to the sole of the foot by a pressure sensor provided inside. Further, by measuring the change in the pressure applied to the sole of the foot of the examiner in chronological order by the foot pressure sensor 21, the locus 4 of the sway of the foot of the examiner as shown in FIG. 3 can be obtained. The X-axis in FIG. 3 indicates the amount of sway along the anteroposterior direction of the examiner, and the anteroposterior direction of the examiner is a direction orthogonal to the straight line connecting both shoulders of the examiner as shown in FIG. To say. Further, the Y-axis in FIG. 3 indicates the amount of sway along the left-right direction of the examiner, and the left-right direction of the examiner is a direction along a straight line connecting both shoulders of the examiner as shown in FIG. That is, the direction perpendicular to the X-axis.

The HMD 22 is a device including a display device such as a liquid crystal display or an organic EL (Electro Luminescence) display and displaying an image to a examiner. By wearing the HMD22, the examiner blocks the view of the surroundings by the HMD22 and sees only the image displayed on the HMD22. That is, the HMD 22 allows the examiner to experience a virtual reality (VR) that causes the examiner to have the illusion that he / she exists in the world in the image displayed by the HMD 22.

Therefore, as shown in FIG. 4, for example, when the image of the rotating spiral 6 is displayed on the HMD 22, the examiner is drawn into the world in the image, and the examiner feels the balance of the examiner, for example, the body is out of balance and staggers. Changes will occur. Hereinafter, showing an image that affects the sense of balance of the examiner on the HMD 22 is referred to as "loading the examiner".

Further, an acceleration sensor is attached to the HMD 22, and the HMD 22 measures the movement of the head of the examiner who is viewing the image by the acceleration sensor. Further, by measuring the movement of the examiner's head in chronological order with the acceleration sensor, the locus 4 of the head sway of the examiner as shown in FIG. 5 can be obtained. The Z-axis in FIG. 5 indicates the amount of shaking of the head along the vertical direction of the examiner, and the vertical direction of the examiner is the direction from the examiner's head to the feet as shown in FIG. That is, it refers to the vertical direction.

Further, as shown in FIG. 2, a microphone 24 is attached to the HMD 22 to convert the answer given by the examiner to the question into voice data. The microphone 24 does not necessarily have to be attached to the HMD 22, and when the HMD 22 to which the microphone 24 is not attached is used, the microphone 24 may be prepared separately.

The motion sensor 23 is a sensor that measures the movement of the examiner's arm. For example, an acceleration sensor is used, but a displacement sensor may also be used. The motion sensor 23 measures the movement of the arm when the examiner answers the question with a gesture.

On the other hand, FIG. 6 is a diagram showing a functional configuration example of the evaluation device 10. As shown in FIG. 6, the evaluation device 10 includes each functional unit of the reception unit 11, the acquisition unit 12, the measurement unit 13, the response determination unit 14, the evaluation unit 15, and the output unit 16.

The reception unit 11 receives instructions from medical staff such as doctors and nurses. The instruction received by the reception unit 11 includes, for example, an inspection start instruction.

The acquisition unit 12 acquires an index indicating the physical balance of the examiner before and after receiving the instruction at the reception unit 11. Before accepting the instruction, when the received instruction is an inspection start instruction, in addition to the period before the reception unit 11 accepts the inspection start instruction, the inspection specified after receiving the inspection start instruction is actually performed. The period until it starts to start is also included. Therefore, after receiving the instruction means the period after the start of the prescribed inspection.

In addition, to acquire an index indicating the physical balance of the examiner means to acquire the measurement data indicating the physical balance of the examiner corresponding to the content of the instructed examination from the measuring device 20, and also to measure with the measuring device 20. By analyzing the measured data, it means to acquire the data showing the physical balance of the examiner corresponding to the contents of the instructed examination.

The details of the test contents for evaluating the progress of cognitive impairment and the index showing the physical balance of the examiner corresponding to the test contents will be described later. The index acquired by the acquisition unit 12 is called a "balance index".

The measuring unit 13 measures the physical characteristics based on the physical balance of the examiner by using the balance index acquired by the acquiring unit 12. Details of the physical characteristics measured by the measuring unit 13 will be described later.

When the content of the instructed test is a test for examining the cognitive ability of the examiner, the answer determination unit 14 recognizes the examiner's answer to the question asked by the medical staff and determines the correct answer rate of the question. ..

The evaluation unit 15 evaluates the progress of the cognitive impairment of the examiner using at least one of the physical characteristics measured by the measurement unit 13 and the correct answer rate of the question determined by the answer determination unit 14. When the balance index acquired by the acquisition unit 12 is required for the evaluation of the degree of cognitive impairment, the evaluation unit 15 adds the balance index to evaluate the degree of cognitive impairment of the examiner. The details of the evaluation method of the progress of cognitive impairment in the evaluation unit 15 will be described later.

The output unit 16 outputs the progress of the cognitive impairment of the examiner evaluated by the evaluation unit 15 so that at least one of the medical staff and the examiner can confirm it. The method of outputting the progress of cognitive impairment may be any method as long as at least one of the medical staff and the examiner can confirm the progress of cognitive impairment. For example, in addition to displaying on a display device, printing by an image forming unit and voice Notification by, and storage in a storage device that can be read by at least one of the medical staff and the examiner is used.

Next, an example of the configuration of a main part of the electric system in the evaluation device 10 will be described.

FIG. 7 is a diagram showing an example of a main component configuration of an electric system in the evaluation device 10. The evaluation device 10 is configured by using, for example, a computer 30.

The computer 30 includes a CPU (Central Processing Unit) 31 that is responsible for each functional unit related to the evaluation device 10, a ROM (Read Only Memory) 32 that stores an evaluation program that causes the computer 30 to function as each functional unit shown in FIG. 6, and a CPU 31. A RAM (Random Access Memory) 33, a non-volatile memory 34, and an input / output interface (I / O) 35 used as a temporary work area of the computer are provided. Then, the CPU 31, ROM 32, RAM 33, non-volatile memory 34, and I / O 35 are each connected via the bus 36.

The non-volatile memory 34 is an example of a storage device in which the stored information is maintained even if the power supplied to the non-volatile memory 34 is cut off. For example, a semiconductor memory is used, but a hard disk may be used. The non-volatile memory 34 does not necessarily have to be built in the computer 30, and may be a portable storage device that is attached to and detached from the computer 30 such as a memory card.

For example, a communication unit 37, an input unit 38, and a display unit 39 are connected to the I / O 35.

The communication unit 37 includes a communication protocol that is connected to the communication line 2 and performs data communication with an external device connected to the communication line 2. The CPU 31 controls the measuring device 20 connected to the communication line 2 through the communication unit 37.

The input unit 38 is a device that receives an instruction from a medical worker and notifies the CPU 31, and for example, a button, a touch panel, a keyboard, a mouse, and the like are used.

The display unit 39 is a device that displays information processed by the CPU 31, and for example, a liquid crystal display, an organic EL display, a projector that projects an image on a screen, or the like is used.

The unit connected to the I / O 35 is not limited to each unit shown in FIG. 7, and even if another unit such as an image forming unit that forms an image on paper or a speaker that outputs sound is connected. Good. Further, the evaluation device 10 does not acquire the measurement data from the measurement device 20 through the communication line 2, but may acquire the measurement data via a semiconductor memory such as a memory card or a USB (Universal Serial Bus) memory, for example. Good.

Next, the operation of the evaluation device 10 will be described.

FIG. 8 is a flowchart showing an example of the evaluation process executed by the CPU 31 of the evaluation device 10 when the inspection start instruction is received. The evaluation program that defines the evaluation process is stored in advance in, for example, the ROM 32 of the evaluation device 10. The CPU 31 of the evaluation device 10 reads the evaluation program stored in the ROM 32 and executes the evaluation process.

The inspection start instruction is given by, for example, a medical worker operating a menu screen 40 as shown in FIG. 9 displayed on the display unit 39.

The menu screen 40 includes a selection area 42 for selecting an examination to be performed, a measurement button 44 for notifying the CPU 31 of an instruction to start the selected examination, and a result display field 46 for quantifying and displaying the progress of cognitive impairment.

In the selection area 42, the names of the inspection items to be evaluated by the evaluation device 10 are displayed. In the case of the example of FIG. 9, the sway test (both legs), the sway test (one leg), the sway difference test, and the movement of the center of gravity are displayed. It supports tests, posture recovery tests, figure recognition tests, emotion recognition tests, and memory tests. When the medical staff selects "All in One", all the inspection items supported by the evaluation device 10 are carried out. On the other hand, when the medical staff selects the "selection mode", only the individually selected test items are carried out.

Hereinafter, as an example, the operation of the evaluation device 10 when "All in One" is selected will be described.

In step S10, the CPU 31 carries out a two-foot standing sway test corresponding to the "sway test (both feet)" selected on the menu screen 40.

The two-legged sway test is a test in which the examiner is asked to stand on both feet on the foot pressure sensor 21 with the eyes open and to maintain the upright state so as not to shake the body as much as possible for a specified period. .. The two-legged sway test measures the examiner's basic physical balance.

First, the CPU 31 controls the HMD 22 so as not to display an image that puts a load on the examiner, and the head collected by the HMD 22 is based on the position of the examiner's head immediately before starting the two-leg standing sway test. The amount of displacement of the examiner's head obtained from the acceleration of the part, that is, the amount of head sway is measured over a specified period. If the period for maintaining the upright state is too short or too long, the measurement accuracy of the amount of sway of the head tends to decrease. Therefore, it is preferable to set it in the range of 30 seconds or more and 90 seconds or less, for example. .. In the present embodiment, as an example, the period for maintaining the upright state is set to 60 seconds.

The amount of sway in the head of the examiner is represented by the sway width in the anteroposterior direction, the sway width in the left-right direction, and the total sway movement distance. The sway width of the head in the front-rear direction is represented by the width of the locus 4 in the X-axis direction in FIG. The left-right sway width of the head is represented by the width of the locus 4 in the Y-axis direction in FIG. The total swaying movement distance of the head is represented by the length from the start point to the end point of the locus 4 in FIG.

The acceleration of the head collected by the HMD 22 is an example of an index indicating the physical balance of the examiner, and the amount of shaking of the head is an example of the physical characteristics of the examiner based on the physical balance.

The CPU 31 performed a two-legged sway test in advance for each healthy person belonging to the group of people without cognitive impairment (hereinafter referred to as "healthy person"), and the head of the head obtained from the healthy person group. A value indicating the degree of progression of cognitive impairment (hereinafter referred to as "score") is calculated from the amount of sway in the head of the examiner using a statistic representing the amount of sway.

The score calculated from the amount of head sway of the examiner is called the "both legs standing sway score". In particular, the two-legged sway score when the examiner is not loaded is called the "two-legged sway score when there is no load", and the two-legged sway score when the examiner is loaded is called "load". It is called "both legs standing upset score in the presence state".

As statistics showing the amount of head sway obtained from the healthy subject group, the sway width in the anterior-posterior direction, the sway width in the left-right direction, and the sway width in the left-right direction, respectively, measured without applying a load to each of the healthy subjects. The mean and standard deviation for each of the total swaying distances are used. The average value and standard deviation of each of them are stored in advance in the non-volatile memory 34.

The anterior-posterior sway width in the examiner's head is D _H1 , the left-right sway width is D _H2 , and the total sway movement distance is _{DH 3,} and the anteroposterior sway width in the head measured from the healthy subject group is average value M _H1, the average value in the lateral direction of the upset width M _H2, the average value M _H3 total upset distance traveled, the standard deviation sigma _H1 in the longitudinal direction of the upset width, the standard deviation in the lateral direction of the upset width Assuming that the standard deviations of σ _H2 and the total swaying distance are σ _H3 , the standing sway score Y _HA of both feet under no load is expressed by Eq. (1).

Here, Y _Hi (i = 1 to 3) is standardized data in which the amount of head sway of the examiner is corrected by the mean value M _{Hi of the} amount of head sway of the healthy subject group and the standard deviation σ _Hi. .. The standardized data Y _H1 is the standardized data for the anteroposterior sway width of the head in the examiner, and the standardized data Y _H2 is the standardized data and the standardized data Y for the lateral sway width of the head in the examiner. _H3 represents the standardized data for the total swaying distance of the head in the examiner, respectively.

The mean value M _H1 of the anteroposterior sway width in the head, the average value MH ₂ of the sway width in the left-right direction, and the average value _{MH 3} of the total sway movement distance measured from the healthy subject group under no load are , Corresponds to the first reference sway amount according to the present embodiment.

Next, the CPU 31 re-executes the above-mentioned two-leg standing sway test in a state where the HMD 22 is controlled so as to display an image that puts a load on the examiner, and calculates the two-foot standing sway score Y _HB under the load. To do. The formula for calculating the two-legged sway score Y _HB under load follows formula (1) in which "Y _HA " is read as "Y _HB ".

When calculating the two-legged sway score Y _HB under load, the CPU 31 uses a load on each of the healthy subjects as a statistic representing the amount of head sway obtained from the healthy subject group. The two-leg standing sway score Y _HB under load is calculated using the average value and standard deviation for each of the measured sway width in the anteroposterior direction, the sway width in the left-right direction, and the total sway movement distance in the head. That is, the mean values _MH1 , _MH2 , _MH3 , and the standard deviations σ _H1 , σ _H2 , and σ _H3 measured from the healthy subject group are statistics measured under a load on each of the healthy subjects. The quantity is used.

The mean value M _H1 of the anterior-posterior sway width in the head, the average value M _H2 of the left-right sway width, and the average value M _{H 3} of the total sway movement distance measured from the healthy subject group under load are , Corresponds to the second reference sway amount according to the present embodiment.

The CPU 31 sets the final both-foot standing sway score Q ₁ using the average value Y _HM of the two-foot standing sway score Y _HA in the unloaded state and the two-foot standing sway score Y _{HB in} the loaded state, and stores it in the RAM 33. To do.

The larger the mean Y _HM , the more difficult it is for the examiner to maintain the same posture than the healthy person. Thus, CPU 31 in accordance with the average value Y _HM increases, the feet standing upset score Q ₁ is set to be lower. Specifically, classified into N sections in accordance with a possible range average value Y _HM is the magnitude of the average value Y _HM, including the smallest average value Y _HM from fraction containing the largest average value Y _HM The values of "0", "1", ..., "N-1" are associated with each category in order toward the category. CPU31 sets the value associated with the segment that contains the calculated average value Y _HM as both feet standing upset score Q _1.

By calculating the two-foot standing sway score Q ₁ using both the two-foot standing sway score Y _HA in the unloaded state and the two-foot standing sway score Y _HB in the loaded state, which were calculated in different states with respect to the load. one score Y _HA or, as compared with the case of setting both feet standing upset score Q ₁ from Y _HB, so that the upset amount of examined person's head is evaluated accurately.

If the degree of influence of the two-foot standing sway score Y _HA in the unloaded state and the two-foot standing sway score Y _{HB in} the loaded state is different from the progress of the cognitive impairment, the CPU 31 will perform both feet in the unloaded state. The two-foot standing sway score Q ₁ may be set based on the weighted average of the standing sway score Y _HA and the two-foot standing sway score Y _HB under load.

In step S20, the CPU 31 carries out a one-leg standing sway test corresponding to the "sway test (one leg)" selected on the menu screen 40.

The one-leg standing sway test is a test in which the examiner is asked to stand on one leg on the foot pressure sensor 21 with the eyes open and maintain an upright state so as not to shake the body as much as possible for a specified period. .. In the one-leg standing sway test, the state of physical balance due to the work of the cerebellum and trunk of the examiner is measured.

First, the CPU 31 collects with the foot pressure sensor 21 based on the position of the sole of the foot of the examiner immediately before starting the one-leg standing sway test in a state where the HMD 22 is controlled so as not to display an image that puts a load on the examiner. The amount of displacement of the examiner's foot obtained from the change in pressure applied to the sole of the examiner's foot, that is, the amount of sway of the foot is measured over a specified period.

In the case of standing on one leg, it is more difficult to maintain the upright state than standing on both legs. Therefore, it is preferable to set the period for maintaining the upright state on one leg to be shorter than the period for maintaining the upright state on both legs. In the present embodiment, as an example, the period for maintaining an upright state while standing on one leg is set to 30 seconds.

The amount of sway at the feet of the examiner is represented by the width of sway in the anteroposterior direction, the width of sway in the left-right direction, and the total sway movement distance, similar to the amount of sway in the head. The width of the sway in the front-back direction of the foot is represented by the width of the locus 4 in the X-axis direction in FIG. The left-right sway width of the foot is represented by the width of the locus 4 in the Y-axis direction in FIG. The total swaying movement distance of the feet is represented by the length from the start point to the end point of the locus 4 in FIG.

The pressure applied to the sole of the foot collected by the foot pressure sensor 21 is an example of an index indicating the physical balance of the examiner, and the amount of sway of the foot is an example of the physical characteristics of the examiner based on the physical balance.

The CPU 31 performs a one-leg standing sway test in advance for each healthy person belonging to the healthy person group, and uses a statistic representing the amount of foot sway obtained from the healthy person group to sway the feet of the examiner. Calculate the score corresponding to the quantity.

The score calculated from the amount of sway at the feet of the examiner is called the "one-leg standing sway score". In particular, the one-leg standing sway score when the examiner is not loaded is called the "one-leg standing sway score when there is no load", and the one-leg standing sway score when the examiner is loaded is called "load". One-legged upset score in the presence state ".

As a statistic showing the amount of sway of the feet obtained from the healthy person group, the sway width in the anteroposterior direction, the sway width in the left-right direction, and the total sway movement of the feet measured without applying a load to each of the healthy people. The mean and standard deviation for each of the distances is used. The average value and standard deviation of each of them are stored in advance in the non-volatile memory 34.

Upset width D _F1 in the longitudinal direction of the examinee feet, the left-right direction of the upset width D _F2, and the total upset and moving distance D _F3, the average of the longitudinal upset width of feet which are respectively measured from a healthy person group values M _F1, average value M _F2 of the right and left direction of the upset width, the average value M _F3 total upset distance traveled, the standard deviation sigma _F1 in the longitudinal direction of the upset width, the standard deviation in the lateral direction of the upset width sigma If the standard deviation of _F2 and the total sway movement distance is σ _F3 , the one-leg standing sway score Y _{FA under} no load is expressed by Eq. (2).

Here, Y _Fi (i = 1 to 3) is standardized data obtained by correcting the amount of sway at the feet of the examiner with the mean value M _{Fi of the} amount of sway at the feet of the healthy subject group and the standard deviation σ _Fi . The standardized data Y _F1 is the standardized data for the anteroposterior sway width of the feet of the examiner, the standardized data Y _F2 is the standardized data for the lateral sway width of the feet of the examiner, and the standardized data Y _F3 is. , Represents the standardized data for the total swaying distance of the examinee.

Next, the CPU 31 re-executes the one-leg standing sway test described above in a state where the HMD 22 is controlled so as to display an image that puts a load on the examiner, and calculates the one-leg standing sway score Y _FB under load. To do. The formula for calculating the one-leg standing sway score Y _FB under load is based on formula (2) in which "Y _FA " is read as "Y _FB ".

When calculating the one-leg standing sway score Y _FB under load, the CPU 31 measures the sway of the feet obtained from the healthy person group as a statistic with a load applied to each of the healthy people. The one-leg standing sway score Y _FB under load is calculated using the average value and standard deviation for each of the anteroposterior sway width, the left-right sway width, and the total sway movement distance at the feet. That is, the mean values M _F1 , M _F2 , M _F3 , and the standard deviations σ _F1 , σ _F2 , and σ _F3 measured from the healthy subject group are statistics measured under a load on each of the healthy subjects. The quantity is used.

CPU31 sets the final leg standing upset score Q ₂ using the average value Y _FM of standing on one leg upset score Y _FB under load present state and standing on one leg upset score Y _FA with no load condition, stored in the RAM33 To do.

Similar to the mean value Y _HM , the larger the mean value Y _FM , the more difficult it is for the examiner to maintain the same posture as the healthy person. Therefore, the CPU 31 is set so that the one-leg standing sway score Q ₂ decreases as the average value Y _FM increases. Specifically, it classified into N sections in accordance with the range that can take the average value Y _FM to the magnitude of the average value Y _FM, including the smallest average value Y _FM from fraction containing the largest average value Y _FM The values of "0", "1", ..., "N-1" are associated with each category in order toward the category. The CPU 31 sets a value associated with the category including the calculated average value Y _FM as the one-leg standing sway score Q ₂ .

As for the one-leg standing sway score Q ₂ , the CPU 31 uses the weighted average of the one-leg standing sway score Y _FA in the unloaded state and the one-leg standing sway score Y _{FB in} the loaded state, as in the case of the two-leg standing sway score Q _1. Based on this, one leg standing sway score Q ₂ may be set.

In step S30, the CPU 31 performs the sway difference inspection selected on the menu screen 40.

The sway difference test is a test that evaluates the degree of progression of cognitive impairment based on the change in the amount of sway between when the examiner is loaded and when the examiner is not loaded. The change in the amount of sway in the head and the feet It is carried out by paying attention to the change in the amount of sway.

The CPU 31 acquires the amount of sway of the examiner's head in the unloaded state and the amount of sway of the examiner's head in the state of being loaded, which was measured in step S10. The amount of sway of the examiner's head in the unloaded state corresponds to the first sway amount according to the present embodiment, and the amount of sway of the examiner's head in the state of applying the load is , Corresponds to the second amount of sway according to the present embodiment.

Of the acquired head sway amount of the examiner, the CPU 31 first determines the difference between the sway width D _H1 in the anteroposterior direction when no load is applied and the sway width D _H1 in the anteroposterior direction when a load is applied. ("Back-and-forth sway difference Δ _H1 ") is calculated.

Further, the CPU 31 acquires the average value Δ _MH1 of the anteroposterior sway difference in the head of the healthy person, which is calculated in advance from the amount of sway of the head of each healthy person belonging to the healthy person group. The average value _ΔMH1 of the anteroposterior sway difference in the head of a healthy person corresponds to the reference difference according to the present embodiment, and is stored in, for example, the non-volatile memory 34.

On top of that, CPU 31 calculates the difference delta _.DELTA.H1 the average delta _MH1 before and after shaking the difference in the head before and after upset difference delta _H1 and healthy subjects in the head of the examined person. The higher the probability that cognitive impairment is observed in the examiner, the more likely the anteroposterior sway difference Δ _H1 in the examiner's head deviates from the average value Δ _MH1 of the anterior-posterior sway difference in the head of a healthy person. Therefore, the CPU 31 sets the score Y _ΔH1C so that the smaller the difference _{ΔΔH1, the} lower the degree of progression of the cognitive impairment of the examiner is evaluated.

Specifically, classified into N partitions the range of difference delta _.DELTA.H1 can take depending on the magnitude of the difference delta _.DELTA.H1, toward the fraction containing the smallest difference delta _.DELTA.H1 from fraction containing the largest difference delta _.DELTA.H1 The values of "0", "1", ..., "N-1" are associated with each category in this order. CPU31 sets the value associated with the segment that contains the calculated difference delta _.DELTA.H1 as the score _Y ΔH1C.

Then, CPU 31, among the upset of the head of the acquired examined person, and upset the width D _H2 in the horizontal direction in a state where no intensive, the left and right direction under load sway width D _H2 ( _Legend of "left-right sway difference Δ _H2 "), and calculate the difference Δ Δ _H2 between the left-right sway difference Δ _H2 in the examiner's head and the average value Δ _MH2 of the left-right sway difference in the head of a healthy person. .. The average value _ΔMH2 of the lateral sway difference in the head of a healthy person corresponds to the reference difference according to the present embodiment, and is stored in, for example, the non-volatile memory 34.

The higher the probability that cognitive impairment is observed in the examiner, the more likely the left-right sway difference Δ _H2 in the examiner's head deviates from the average value Δ _MH2 of the left-right sway difference in the head of a healthy person. Thus, CPU 31, as the degree of progress of cognitive impairment examined person as the difference delta _{[Delta] H2} is small is evaluated low, setting the score Y _{Derutaeichi2C} by applying the classification as described in the configuration of the score Y _{Derutaeichi1C} the difference delta _{[Delta] H2} To do.

Next, the CPU 31 determines the difference between the total swaying movement distance D _{H3 in} the unloaded state and the total swaying moving distance D _H3 in the loaded state among the acquired amount of swaying of the examiner's head. calculated (referred to as "total upset the difference Δ _H3"), we calculate the difference _Δ ΔH3 between the average value Δ _MH3 of the total upset the difference in the head of the total upset the difference Δ _H3 and a healthy person in the head of the examined person. The average value _ΔMH3 of the total sway difference in the head of a healthy person corresponds to the reference difference according to the present embodiment, and is stored in, for example, the non-volatile memory 34.

The higher the probability that cognitive impairment is observed in the examiner, the more likely the total sway difference Δ _H3 in the examiner's head deviates from the average value Δ _MH3 of the total sway difference in the head of a healthy person. Thus, CPU 31, as the degree of progress of cognitive impairment examined person as the difference delta _Derutaeichi3 small is evaluated low, setting the score Y _{Derutaeichi3C} by applying the classification as described in the configuration of the score Y _{Derutaeichi1C} the difference delta _Derutaeichi3 To do.

Further, the CPU 31 acquires the amount of sway of the examiner's feet when the load is not applied and the amount of sway of the examiner's feet when the load is applied, which are measured in step S20. The amount of sway at the feet of the examiner in the unloaded state corresponds to the first amount of sway according to the present embodiment, and the amount of sway at the feet of the examiner under the load is the book. It corresponds to the second amount of sway according to the embodiment.

Then, CPU 31 in a similar procedure to that set a score Y _{Derutaeichi1C} from the difference delta _.DELTA.H1 the average delta _MH1 before and after shaking the difference in the head before and after upset difference delta _H1 and healthy subjects in the head of the examined person, The score Y _ΔF1C is set from the difference Δ _{ΔF1 between the} anteroposterior sway difference Δ _F1 at the feet of the examiner and the average value Δ _MF1 of the anteroposterior sway difference at the feet of a healthy person.

Further, CPU 31 is a set of score Y _{Derutaeichi2C} from the difference delta _{[Delta] H2} between the average value delta _MH2 left and right sway difference in the head of the left and right sway difference delta _H2 and healthy subjects in the head of the examined person approaches the same manner, The score Y _ΔF2C is set from the difference _ΔΔF2 between the left-right sway difference Δ _F2 at the feet of the examiner and the average value Δ _MF2 of the left-right sway difference at the feet of a healthy person.

Further, CPU 31 is a set of score Y _{Derutaeichi3C} from the difference delta _Derutaeichi3 the average delta _MH3 total upset difference in the head of the total upset difference delta _H3 and healthy subjects in the head of the examined person approaches the same manner, setting the score Y _Derutaefu3C from the difference delta _.DELTA.f3 the average delta _MF3 total upset difference in the total upset difference delta _F3 healthy subjects feet in screening's feet.

The mean value Δ _MF1 of the anteroposterior sway difference at the feet of a healthy person, the mean value Δ _MF2 of the lateral sway difference at the feet of a healthy person, and the healthy person used to set the score Y _ΔF1C , the score Y _ΔF2C , and the score Y _ΔF3C , respectively. The mean value _ΔMF3 of the total sway difference at the feet of the above corresponds to the reference difference according to the present embodiment, and is stored in, for example, the non-volatile memory 34.

CPU31 is score Y _{Derutaeichi1C,} sets the score Y _{Derutaeichi2C,} score Y _{Derutaeichi3C,} score Y _Derutaefu1C, score Y _Derutaefu2C, and the average value of the score Y _Derutaefu3C as the final upset difference score Q _3.

If the degree of _influence of the score Y _ΔH1C , the score Y _ΔH2C , the score Y _ΔH3C , the score Y _ΔF1C , the score Y _ΔF2C , and the score Y _{ΔF3C on} the degree of progression of cognitive impairment is different, the CPU 31 uses a weight according to the degree of influence. based on the weighted average which had, it may be set to upset the difference score Q _3. Further, using agitation difference score Q ₃ of necessarily score Y _{Derutaeichi1C} set, the score Y _{Derutaeichi2C,} score Y _{Derutaeichi3C,} score Y _Derutaefu1C, score Y _Derutaefu2C, and it is not necessary to use each score Score Y _Derutaefu3C, at least one score it may be set to upset the difference score Q ₃ Te.

In step S40, the CPU 31 carries out the center of gravity movement inspection selected on the menu screen 40.

The center-of-gravity movement test is a test for evaluating the progress of cognitive impairment of a medical examiner by measuring how long the examiner can perform the movement instructed by the medical staff.

As the movement instructed by the medical staff, a movement that allows the examiner to grasp the physical balance ability is preferable. In the present embodiment, the medical staff instructs the operation of moving the center of gravity of the examiner in the front-rear direction and the operation of moving the center of gravity in the left-right direction.

In the case of an action that moves the center of gravity of the examiner in the anteroposterior direction, the medical staff may, for example, "tilt the center of gravity forward", "return the center of gravity", "tilt the center of gravity backward", or "tilt the center of gravity backward". Give instructions to the examiner, such as "Please return." For each instruction, the CPU 31 measures the completion time from the time when the instruction is given to the completion of the instructed operation. For measuring the time, for example, a timer function built in the CPU 31 is used.

When the instructed operation is completed, the position of the center of gravity obtained from the change in the pressure of the sole of the foot measured by the foot pressure sensor 21 tends to stay within a predetermined range for a specified time or longer. Therefore, the CPU 31 is the examiner. It may be determined whether or not the examiner has completed the instructed operation based on the change in the position of the center of gravity in.

The completion times of the operations for each instruction of "tilt the center of gravity _forward ", "return the center of gravity", "tilt the center of gravity backward", and "return the center of gravity" are t _fb1 and t _fb2 , respectively. , T _fb3 , and t _fb4 , the reaction time t _fb when the examiner moves in the anteroposterior direction is expressed by Eq. (3).

On the other hand, in the case of the action of moving the center of gravity of the examiner to the left and right, the medical staff, for example, "tilt the center of gravity to the right", "return the center of gravity", "tilt the center of gravity to the left", " Give instructions to the examiner, such as "Please return the center of gravity." For each instruction, the CPU 31 measures the completion time from the time when the instruction is given to the completion of the instructed operation.

"Please tilt to the right of the center of gravity", "Please return the center of gravity", "Please tilt to the left of the center of gravity", "Please return the center of gravity" of each _t rll the completion time of the operation for each instruction, t _rl2 , if t _RL3, and t _RL4, the reaction time t _rl when the examined person moves in the lateral direction is expressed by equation (4).

The CPU 31 calculates the total reaction time t of the examiner as the sum of the reaction time t _fb when the examiner moves in the front-back direction and the reaction time t _rl when the examiner moves in the left-right direction. The higher the probability that a cognitive impairment is observed in the examiner, the longer it takes to understand the instruction and the lower the physical balance ability, so that the total reaction time t tends to be longer. Thus, CPU 31, as the degree of progress of cognitive impairment examined person as the total reaction time t is short is evaluated low, setting the center of gravity moving score Q _4.

Specifically, the range that the total reaction time t can take is classified into N categories according to the length of the total reaction time t, and the category including the longest total reaction time t and the shortest total reaction time t are included. The values of "0", "1", ..., "N-1" are associated with each category in order toward the category. CPU31 sets the value associated with the segment that contains the total reaction time t calculated as the centroid moving score Q _4.

In the center-of-gravity movement test, it is not always necessary to calculate the total reaction time t of the movement of moving the center of gravity in the front-rear direction and the movement of moving the center of gravity in the left-right direction, and the center-of-gravity movement score Q is obtained from the reaction time for either movement. ₄ may be set.

In step S50, the CPU 31 carries out the posture recovery test selected on the menu screen 40.

The posture recovery test is a test that evaluates the progress of cognitive impairment of the examiner from the recovery speed when the examiner's body is shaken from the outside regardless of the examiner's intention and the examiner returns to the posture before the upset. Is.

In the present embodiment, for example, a method of vibrating the sheet-shaped foot pressure sensor 21 laid at the feet of the examiner to shake the examiner's body is used, but the examiner's body is pressed with a predetermined force. May be good.

First, the CPU 31 controls to vibrate the foot pressure sensor 21 in a state where the acceleration of the examiner's head measured by the acceleration sensor attached to the HMD 22 is collected before the foot pressure sensor 21 is vibrated. Further, the CPU 31 measures the elapsed time from the time when the foot pressure sensor 21 is vibrated.

Due to the sudden vibration of the foot pressure sensor 21, the examiner riding on the foot pressure sensor 21 loses his / her physical balance. Therefore, the examiner reflexively takes the position before the foot pressure sensor 21 vibrates (““ Trying to return to the original position). During this period, the CPU 31 also collects the acceleration of the examiner's head from the HMD 22 to calculate the position of the center of gravity of the examiner, and sets the moving distance of the center of gravity based on the position of the center of gravity of the examiner immediately before vibrating the foot pressure sensor 21. Get every time. The moving distance of the center of gravity is an example of an index showing the physical balance of the examiner according to the present embodiment.

Then, the CPU 31 determines whether or not the examiner has returned to the original posture, and measures the recovery time from the vibration of the foot pressure sensor 21 until the examiner returns to the original posture.

As described in the center-of-gravity movement test in step S40, when the examiner returns to the original posture, the position of the examiner's center of gravity is defined within a predetermined range from the position of the center of gravity immediately before the foot pressure sensor 21 is vibrated. Shows a tendency to stay for more than an hour. Therefore, when the CPU 31 detects a state in which the moving distance of the center of gravity stays within a predetermined distance for a predetermined time or more, the CPU 31 may determine that the examiner has returned to the original posture and measure the recovery time of the examiner. ..

FIG. 10 is a diagram showing an example of a graph of the movement distance of the center of gravity obtained by the posture recovery test. The vertical axis of the graph of FIG. 10 represents the distance of movement of the center of gravity, and the horizontal axis represents time.

The CPU 31 calculates the recovery speed when the examiner returns to the original posture by using the measured recovery time and the moving distance of the center of gravity of the examiner. Specifically, assuming that the center of gravity movement distance is g _hp and the time is t _g , the CPU 31 calculates the recovery speed of the examiner by differentiating the center of gravity movement distance g _hp by the time t _g .

The higher the probability that the examiner will have cognitive impairment, the slower the instantaneous force to restore the posture, and the slower the recovery speed tends to be. Thus, CPU 31, as in the degree of progress of cognitive impairment examined person as the recovery rate of the examined person is fast is evaluated low, sets the posture recovery score Q _5.

Specifically, the range in which the recovery speed of the examiner can be taken is classified into N categories according to the speed, and "0", in order from the category including the slowest recovery speed to the category including the fastest recovery speed, The values of "1", ..., "N-1" are associated with each category. CPU31 sets the value associated with the segment that contains the recovery speed of the calculated examined person as a posture recovery score Q _5.

In step S60, the CPU 31 carries out the figure recognition inspection selected on the menu screen 40.

The figure recognition test is a test for evaluating the progress of cognitive impairment of a examiner from the ability to display a specific figure and grasp the characteristics of the figure, for example.

First, the CPU 31 controls the HMD 22 so as to display a specific figure. In response to this, the examiner answers the question using the figure displayed on the HMD 22.

FIG. 11 is a diagram showing an example of a figure displayed on the HMD 22, and a question such as "Please copy this figure exactly as it is" is asked to the displayed figure. The question may be displayed on the HMD 22 together with the graphic, the CPU 31 may notify by synthetic voice from a speaker (not shown), or the medical staff may notify by voice. The question to the examiner is also an example of the instruction according to this embodiment.

The examiner answers by the answer method according to the content of the question. For example, in the case of the above-mentioned question, since it is necessary to copy the figure, the examiner moves his arm to draw the figure in the air. Since the motion sensor 23 is attached to the examiner's arm, the figure drawn by the examiner is recognized by the CPU 31 from the movement of the arm measured by the motion sensor 23, and the answer result is obtained.

In the case of a question asking for a voice answer, such as "What is the name of this figure?", The examiner will answer aloud. The voice uttered by the examiner is converted into voice data by the microphone 24, and the CPU 31 performs a known voice recognition process on the voice data to obtain an answer result.

The non-volatile memory 34 stores in advance the correct answer to the question to be performed in the graphic recognition test, and the CPU 31 determines that the higher the similarity between the answer result of the examiner and the correct answer to the question, the higher the degree of cognitive impairment of the examiner. as will be Dislike, to set the figure recognition score Q _6.

Specifically, the range in which the similarity can be taken is classified into N categories according to the value, and "0", "" in order from the category containing the lowest similarity to the category containing the highest similarity. The values of "1", ..., "N-1" are associated with each category. CPU31 sets the value associated with the segment that contains the similarity correct answer to the examined person answers results and questions as a figure recognition score Q _6.

In step S70, the CPU 31 carries out the emotion recognition test selected on the menu screen 40.

The emotion recognition test is a test that evaluates the progress of cognitive impairment of a examiner from the imagination of imagining what kind of emotions and thoughts a person appearing in a story or video has.

First, the CPU 31 controls the HMD 22 so as to display an illustration or a photograph (referred to as an “image”) showing a person to be recognized for emotions. In response, the examiner answers the question asked for the image displayed on the HMD 22. As described in the figure recognition test in step S60, the answer to the question may be performed by a gesture by the movement of the arm or verbally.

FIG. 12 is a diagram showing an example of an image displayed on the HMD 22 in the emotion recognition test.

FIG. 12A is an image showing facial expressions showing various emotions, and a question such as "Which face is laughing?" Is asked. These questions primarily test the examiner's visual cognitive abilities.

FIG. 12B is an image showing one frame of the story, and a question such as "This is the story of Mt. Kamuriki. Why is the grandmother breaking the branch?" Is asked. These questions primarily test the examiner's comprehension of social norms.

FIG. 12C is an image showing one frame of a social event, and a question such as "Why is this child crying?" Is asked. These questions primarily test the examiner's responsiveness to well-being.

The non-volatile memory 34 stores in advance the correct answer to the question to be performed in the emotion recognition test, and the CPU 31 evaluates the progress of the cognitive impairment of the examiner to be lower as the correct answer rate to the question is higher. to set the recognition score Q _7.

Specifically, the correct answer rate is classified into N categories, and "0", "1", ..., "N" are ordered from the category containing the lowest correct answer rate to the category containing the highest correct answer rate. The value of -1 "is associated with each category. CPU31 sets the value associated with the segment that contains the examinee accuracy rate as emotion recognition score Q _7.

In step S80, the CPU 31 performs the memory test selected on the menu screen 40.

The memory test is a test for evaluating the progress of cognitive impairment of a examiner based on the memory ability of the examiner.

First, the CPU 31 controls the HMD 22 so as to display an image used for determining the memory ability of the examiner. In response, the examiner answers the question asked for the image displayed on the HMD 22. As described in the figure recognition test in step S60, the answer to the question may be performed by a gesture by the movement of the arm or verbally.

FIG. 13 is a diagram showing an example of an image displayed on the HMD 22 in the memory test. A plurality of articles are drawn in the image shown in FIG. 13, and the CPU 31 controls to stop the display of the image after displaying the image on the HMD 22 for a predetermined period (for example, 30 seconds). .. Then, a question such as "Please tell me what you remember from the items included in the image above" is asked.

The non-volatile memory 34 stores in advance the correct answer to the question to be performed in the memory test, and the CPU 31 has the correct answer rate to the question (in this case, the ratio of the number of articles remembered by the examiner to all the articles). is as progress of higher examinee cognitive disorders is evaluated low, to set the memory score Q _8.

Specifically, the correct answer rate is classified into N categories, and "0", "1", ..., "N" are ordered from the category containing the lowest correct answer rate to the category containing the highest correct answer rate. The value of -1 "is associated with each category. CPU31 sets the value associated with the segment that contains the examinee accuracy rate as memory score Q _8.

In the figure recognition test, the emotion recognition test, and the memory test, the score was set using the similarity between the answer result of the examiner and the correct answer to the question, or the correct answer rate, but the CPU 31 started after the question was asked. The score of each test may be corrected by using the response time required for the examiner to respond.

As the degree of cognitive impairment of the examiner increases, the comprehension, judgment, and memory ability of the examiner deteriorates as compared with that of the healthy person. Therefore, the answering time to the question tends to be longer. Therefore, CPU 31 may, for example be a correct answer rate, etc. are the same as in progress of about examinee cognitive impairment response times of the examined person becomes longer be appreciated, figure recognition score Q _6, emotions set recognition score Q _7, and memory score Q ₈ may be corrected.

Further, the CPU 31 also measures at least one of the amount of sway in the examiner's head and the amount of sway in the examiner's feet in the graphic recognition test, the emotion recognition test, and the memory test, and the larger the measured amount of sway. as it appreciated that the degree of progress of cognitive impairment of the examined person, figure recognition score Q ₆ set, may be corrected emotion recognition score Q _7, and memory score Q _8.

In step S90, the CPU 31 calculates a cognitive score J that comprehensively represents the degree of progress of the cognitive impairment of the examiner by using the scores of the respective test items performed in steps S10 to S80.

Cognitive Score J is (5) feet standing upset score Q ₁ as shown in the expression standing on one leg upset score Q _2, upset difference score Q _3, movement of the center of gravity score Q _4, posture recovery score Q _5, figure recognition score Q ₆ It is calculated by the weighted sum of the emotion recognition score Q _7, and memory score Q _8.

Here, k _i is a constant representing the weight of each score Q _i . Of each score Q _i , the score having a greater influence on the cognitive score J is multiplied by the larger weight k _i to the score Q _i to calculate the cognitive score J.

Since each score Q _i indicates that the degree of cognitive impairment of the examiner is lower as the value is larger, the cognitive score J calculated by Eq. (5) also indicates that the cognitive impairment of the examiner is higher as the value is larger. It indicates that the progress is low.

The formula for calculating the cognitive score J is not limited to formula (5). For example, the cognitive score J may be calculated based on the deviation from the average value of the score based on the average value of the scores in each test item of each healthy person belonging to the healthy person group.

Specifically, if the average value of each score in the healthy subject group corresponding to each score Q _i of the examiner is score Q _Mi , the cognitive score J is score Q _{i as} shown in equation (6). And the score Q _Mi may be calculated as the weighted sum of the difference ΔQ _i .

Since it is estimated that the degree of cognitive impairment of the examiner increases as each score Q _i deviates from the score Q _Mi , the value of the cognitive score J is large when the cognitive score J is calculated by the equation (6). The more the examiner has a higher degree of cognitive impairment.

In this embodiment, for convenience of explanation, an example of calculating the cognitive score J using the equation (5) will be described.

In step S100, the CPU 31 controls the display unit 39 so that the cognitive score J calculated in step S90 is displayed in the result display column 46 of the menu screen 40 shown in FIG. As a result, the CPU 31 ends the evaluation process shown in FIG.

The doctor finally determines whether or not the examiner has cognitive impairment with reference to the cognitive score J displayed in the result display column 46.

As described above, according to the evaluation system 100 according to the present embodiment, not only the correct answer rate of the question used for grasping the cognitive ability but also the physical balance of the examiner before and after receiving the instruction is taken into consideration. Evaluate the progress of cognitive impairment in the examiner.

<Modified example of the first embodiment>
In each of the above-mentioned test items, the examiner may at least provide information based on sight and hearing, regardless of the degree of cognition, because he / she may answer questions by looking at images or move his / her body according to verbal instructions. It is assumed that you have the ability to process.

Therefore, the evaluation device 10 has the ability of the examiner to process information based on sight and hearing before acquiring the physical balance of the examiner, that is, the examiner has a cognitive function using the evaluation system 100. It is preferable to carry out an initial test to evaluate whether the person is suitable for the test.

FIG. 14 is a flowchart showing a modified example of the evaluation process executed by the CPU 31 of the evaluation device 10 when the inspection start instruction is received. The evaluation program that defines the evaluation process is stored in advance in, for example, the ROM 32 of the evaluation device 10. The CPU 31 of the evaluation device 10 reads the evaluation program stored in the ROM 32 and executes the evaluation process.

The flowchart shown in FIG. 14 is different from the flowchart shown in FIG. 8 in that steps S2 and S4 are added, and other processing is the same as the flowchart shown in FIG.

In step S2, the CPU 31 performs an initial examination on the examiner. In the initial examination, a visual acuity test and a hearing test are performed to determine whether the visual and auditory senses of the examiner have a function capable of correctly receiving each examination item performed in the subsequent steps S20 to S80. Is done.

First, the CPU 31 controls the HMD 22 so as to display the Randold ring as shown in FIG. On the other hand, the examiner answers the direction in which the Randold ring displayed on the HMD 22 is missing and measures the visual acuity.

The examiner may answer by moving his arm, such as pointing in the direction where the Randold ring is missing, or by verbally, such as "right." When the examiner responds with a gesture, the CPU 31 recognizes the direction pointed by the examiner from the movement of the arm measured by the motion sensor 23. Further, when the examiner answers verbally, the answer is converted into voice data by the microphone 24, and the CPU 31 performs a known voice recognition process on the voice data to recognize the direction in which the examiner answered. ..

As a result, the CPU 31 determines whether or not the visual acuity of the examiner is equal to or higher than the reference visual acuity. The reference visual acuity is set to the lowest visual acuity that is considered capable of recognizing the image displayed on the HMD 22.

Further, the CPU 31 generates some instruction by synthetic voice, outputs the generated instruction from a speaker (not shown), and determines whether or not the instruction is heard. For example, the CPU 31 outputs an instruction such as "Can you hear this narration? If you can hear it, press the" Yes "button on the screen" while gradually increasing the volume from a low volume. In this case, the CPU 31 causes the HMD 22 to display the button displayed as "Yes".

If the examiner understands the content of the instruction, moves his hand and presses the "Yes" button displayed in the virtual space, the examiner has the understanding ability to understand the content of the instruction and there is no problem with hearing. You can see that. The CPU 31 determines whether or not the examiner's hearing is equal to or higher than the reference hearing depending on how much the volume is raised before the examiner presses the "Yes" button. The reference hearing is set to the lowest hearing that is considered to be able to hear the voiced instructions.

By carrying out the initial examination, it is used for evaluation of the progress of cognitive impairment of the examiner (hereinafter, also referred to as "evaluation of cognitive function") such as HMD22, motion sensor 23, microphone 24, and speaker (not shown). You can also confirm that the equipment is not out of order.

In step S4, the CPU 31 determines whether or not the cognitive function of the examiner can be evaluated according to the examination items to be performed thereafter. Specifically, when the visual acuity of the examiner is equal to or higher than the standard visual acuity, the hearing of the examiner is equal to or higher than the standard visual acuity, and the examiner performs an operation or an answer as instructed, the CPU 31 uses the evaluation system 100. It is judged that the cognitive function of the examiner can be evaluated using.

If the cognitive function of the examiner cannot be evaluated, the evaluation process shown in FIG. 14 is stopped without executing each process of steps S10 to S100. On the other hand, when the cognitive function of the examiner can be evaluated, each process of steps S10 to S100 already described is executed to evaluate the cognitive function of the examiner.

As described above, according to the modified example of the evaluation system 100 according to the present embodiment, the initial examination is performed before the examiner evaluates the cognitive function, and the examiner is suitable for the examination of the cognitive function using the evaluation system 100. If not, the evaluation of cognitive function is stopped. Therefore, the reliability of the evaluation result is improved as compared with the case where the cognitive function of the examiner is evaluated without performing the initial examination.

<Second Embodiment>
In the first embodiment, an example of evaluating the progress of cognitive impairment of a examiner using the evaluation system 100 has been described, but the use of the evaluation system 100 is not limited to this.

The test items carried out by using the evaluation system 100 include test items that move the examiner's body according to instructions and test items that ask the examiner to think. Thinking and moderate exercise are expected to lead to maintenance and improvement of cognitive ability, and are therefore effective as training for cognitive function.

In the second embodiment, an example will be described in which the evaluation system 100 is used to motivate the examiner to continue training that leads to improvement of cognitive function.

The functional configuration of the evaluation device 10 and the main configuration of the electrical system according to the present embodiment are the functional configuration example of the evaluation device 10 according to the first embodiment shown in FIG. 6 and the third configuration shown in FIG. 7, respectively. It is the same as the configuration example of the main part of the electric system of the evaluation device 10 according to the first embodiment.

FIG. 16 is a flowchart showing an example of the evaluation process executed by the CPU 31 of the evaluation device 10 when the training start instruction is received. As described in the first embodiment, the evaluation program that defines the evaluation process is stored in advance in, for example, the ROM 32 of the evaluation device 10. The CPU 31 of the evaluation device 10 reads the evaluation program stored in the ROM 32 and executes the evaluation process.

The training start instruction is given, for example, by the medical worker operating the menu screen 40A as shown in FIG. 17 displayed on the display unit 39. The menu screen 40A shown in FIG. 17 differs from the menu screen 40 according to the first embodiment shown in FIG. 9 in that a history button 48 is added, and other contents are the same as the menu screen 40. ..

It is assumed that the medical staff or the examiner operates the menu screen 40 to select the inspection items to be performed in advance.

In step S200, the CPU 31 selects any one of the inspection items that has not yet been selected from the inspection items for which the execution instruction has been received through the menu screen 40A. The inspection item for which the implementation instruction is received through the menu screen 40A is referred to as an "instruction inspection item", and the inspection item selected by the CPU 31 in step S200 is referred to as a "selection inspection item".

In step S210, the CPU 31 implements a selective inspection item. The contents of the inspection items to be carried out are the same as the contents of each inspection item described in the first embodiment.

In step S220, the CPU 31 determines whether or not there is an unexecuted inspection item that has not yet been selected in step S200 among the instruction inspection items.

If there are unselected inspection items, the process proceeds to step S200, and any one of the unselected inspection items is selected. That is, by executing steps S200 to S220, each of the indicated inspection items is executed, and a score is set for each indicated inspection item.

On the other hand, if it is determined in the determination process of step S220 that all the instruction inspection items have been selected, the process proceeds to step S230.

In step S230, the CPU 31 calculates the cognitive score J, which comprehensively represents the progress of the cognitive impairment of the examiner, according to the equation (5), using the score for each instruction test item. In this case, the CPU 31 sets the score of the inspection item for which the execution was not instructed to "0" and calculates the cognitive score J. The CPU 31 stores the calculated cognitive score J in the non-volatile memory 34 in association with the instruction test item and the calculated date and time information of the cognitive score J.

In step S240, the CPU 31 controls the display unit 39 so that the cognitive score J calculated in step S230 is displayed in the result display column 46 of the menu screen 40A shown in FIG.

When the history button 48 is pressed by the medical staff or the examiner, the CPU 31 acquires the cognitive score J of the instruction test item performed in the past from the non-volatile memory 34, and the acquired cognitive score J is displayed in chronological order. Control is performed so that the graph shown along the line is displayed on the display unit 39.

FIG. 18 is a diagram showing an example of a graph of the cognitive score J displayed on the display unit 39. The horizontal axis of the graph shown in FIG. 18 represents the date and time when the inspection item was performed using the evaluation device 10, and the vertical axis represents the cognitive score J. Since the graph shown in FIG. 18 shows the result of daily training as a change in the cognitive score J, the examiner can grasp the result of the training as a numerical value.

In addition, when the examiner does not carry out the same test item every day but carries out different test items depending on the day, for example, the CPU 31 makes the cognitive score J on the day when the same indicated test item is carried out non-volatile. A graph obtained from the memory 34 and showing the acquired cognitive score J in chronological order may be displayed on the display unit 39. As a result, the evaluation process shown in FIG. 16 is completed.

As described above, according to the evaluation system 100 according to the present embodiment, the cognitive score J calculated from the performed inspection items is output in chronological order. Therefore, the evaluation system 100 motivates the examiner to continue training.

Although the present invention has been described above using each embodiment, the present invention is not limited to the scope described in each embodiment. Various changes or improvements can be made to each embodiment without departing from the gist of the present invention, and the modified or improved forms are also included in the technical scope of the present invention. For example, the order of processing may be changed without departing from the gist of the present invention.

In each embodiment, an embodiment in which the evaluation process is realized by software has been described as an example, but the process equivalent to each flowchart shown in FIGS. 8, 14 and 16 is applied to, for example, an ASIC (Application Specific Integrated Circuit). It may be implemented and processed by hardware. In this case, the speed of the evaluation process can be increased as compared with the case where the evaluation process is realized by software.

Further, in each of the above-described embodiments, the mode in which the evaluation program is installed in the ROM 32 has been described, but the present invention is not limited to this. The evaluation program according to the present invention can also be provided in a form recorded on a computer-readable storage medium. For example, the evaluation program according to the present invention may be provided in the form of being recorded on an optical disk such as a CD (Compact Disc) -ROM or a DVD (Digital Versatile Disc) -ROM. Further, the information processing program according to the present invention may be provided in a form recorded in a semiconductor memory.

Further, the evaluation device 10 may acquire the evaluation program according to the present invention from the external device through the communication line 2.

2 communication line, 4 locus, 10 evaluation device, 11 reception unit, 12 acquisition unit, 13 measurement unit, 14 answer judgment unit, 15 evaluation unit, 16 output unit, 20 measurement device, 21 foot pressure sensor, 22 HMD, 23 movement Sensor, 24 microphone, 30 computer, 31 CPU, 32 ROM, 33 RAM, 34 non-volatile memory, 37 communication unit, 38 input unit, 39 display unit, 40 (40A) menu screen, 42 selection area, 44 measurement button, 46 Result display field, 48 history buttons, 100 evaluation system

Claims (14)

The reception department that accepts instructions and
An acquisition unit that acquires an index indicating the physical balance of the examiner before and after receiving the instruction at the reception unit, and an acquisition unit.
A measuring unit that measures the recovery time until the index after receiving the instruction returns to the index before receiving the instruction.
An evaluation unit that evaluates the progress of cognitive impairment of the examiner using the recovery time measured by the measurement unit and the index acquired by the acquisition unit.
Evaluation device equipped with. The reception department that accepts instructions and
An acquisition unit that acquires an index indicating the physical balance of the examiner before and after receiving the instruction at the reception unit, and an acquisition unit.
A measurement unit that measures the amount of body sway of the examiner before and after receiving the instruction from the index acquired by the acquisition unit, and a measurement unit.
An evaluation unit that evaluates the degree of cognitive impairment of the examiner using the amount of agitation measured by the measurement unit, and an evaluation unit.
Evaluation device equipped with. The instruction is an instruction that upsets the body of the examiner.
The evaluation unit evaluates the progress of cognitive impairment of the examiner by using the recovery time and the recovery speed of returning to the posture before the examiner's body is shaken, which is obtained from the index. Evaluation device. The evaluation device according to claim 3, wherein the evaluation unit evaluates so that the faster the recovery rate, the lower the degree of progression of the cognitive impairment of the examiner. The amount of sway of the body of the examiner is the first amount of sway representing the amount of sway of the head or feet of the examiner when the examiner is shown an image affecting the sense of balance of the examiner. A second amount of sway, which represents the amount of sway of the head or feet of the examiner when the image is not shown, is included.
In the evaluation unit, the smaller the difference between the first sway amount and the preset first reference sway amount and the difference between the second sway amount and the preset second reference sway amount, the more the examiner The evaluation device according to claim 2, wherein an evaluation is performed so that the degree of progression of cognitive impairment is low. The evaluation device according to claim 5, wherein the first reference sway amount and the second reference sway amount are set from the physical balance of each person belonging to a group in which cognitive impairment is not observed. The evaluation unit evaluates that the smaller the difference between the first sway amount and the second sway amount and the preset reference difference, the lower the degree of progression of the cognitive impairment of the examiner. The evaluation device according to claim 5 or 6. The evaluation device according to claim 7, wherein the reference difference is set from the difference between the first sway amount and the second sway amount of each person belonging to the group in which no cognitive impairment is observed. The measuring unit further measures the completion time of the operation requested by the instruction.
The evaluation device according to any one of claims 1 to 8, wherein the evaluation unit evaluates so that the shorter the completion time, the lower the degree of progression of the cognitive impairment of the examiner. Before the acquisition unit acquires the physical balance of the examiner, the evaluation unit carries out an initial examination for evaluating whether the examiner is a person suitable for the examination of cognitive function, and the initial examination is performed. The evaluation device according to any one of claims 1 to 9, wherein the evaluation of the degree of progression of cognitive impairment to the examiner is stopped when the test result of the above does not satisfy the predetermined criteria. The initial tests include a visual acuity test and a hearing test,
The evaluation device according to claim 10, wherein the evaluation unit stops the evaluation of the degree of cognitive impairment for the examiner when at least one of the visual acuity test and the hearing test does not satisfy the predetermined criteria. The evaluation device according to any one of claims 1 to 11, further comprising an output unit that outputs the degree of cognitive impairment of the examiner evaluated by the evaluation unit in chronological order. An evaluation program for causing a computer to function as each part of the evaluation device according to any one of claims 1 to 12. A measuring device that measures the physical condition of the examiner,
The evaluation device according to any one of claims 1 to 12.
Evaluation system including.