KR20220045854A - Method and device to screen global cognitive decline for the elderly based on bio-impedance technology - Google Patents

Abstract

Disclosed are a method and a device for screening cognitive decline in the elderly using bio-impedance. According to one embodiment, the method for screening cognitive decline in the elderly using bio-impedance includes the steps of: obtaining bio-impedance information of a subject; and screening cognitive decline for the elderly for the subject, based on the bio-impedance information.

Description

Method and device for screening geriatric cognitive decline using bioimpedance

MMSE (Mini-Mental State Examination) is a questionnaire tool that can evaluate a user's cognitive function relatively simply in about 10 minutes. The cognitive decline accuracy of MMSE is not as high as that of the precision neuropsychological screening battery (SNSB (Seoul Neuropsychological Screening Battery), CERAD (the Consortium to Establish a Registry for Alzheimer's Disease), etc.), so it is generally used for screening dementia patients. .

The present invention relates to a method and apparatus for screening for cognitive decline in the elderly using bioimpedance, which improves the accuracy of assessment of cognitive decline in MMSE and enables MMSE to be used for more diverse purposes.

In recent years, as we enter an aging society, dementia and degenerative brain disease are emerging as major social problems, and there is a frequent need to simply identify the risk of degenerative cognitive decline and dementia for the elderly.

Since dementia cannot be cured after onset, recently, it is possible to develop a diagnostic tool that can diagnose the mild stage (mild cognitive impairment, MCI) or the asymptomatic stage, and prevent or manage it at the mild stage or asymptomatic stage. Drug/non-pharmaceutical management methods are being developed.

As a diagnostic tool for diagnosing dementia in Korea, a collection of precision neuropsychological tests (precise neuropsychological evaluation tools) such as the Seoul Neuropsychological Screening Battery (SNSB) or The Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) is used. there is.

This collection of detailed neuropsychological examinations (precise neuropsychological evaluation tool) has disadvantages in that the evaluation time is long (it takes about 2 hours), and since it has to be evaluated with an expert, it consumes a lot of professional manpower and time for evaluation.

Therefore, it is difficult to universally use the examination by the precision neuropsychological examination collection (precise neuropsychological evaluation tool), which requires a long time for evaluation and requires professional manpower. In addition, there is a need to establish a diagnostic system as a method of conducting detailed examinations on the selected risk groups.

The screening test tool should be easy and fast to measure, and even if repeated measurement within 2-3 months, there should be no learning effect to enable follow-up.

As a screening tool for dementia, the Simple Mental State Test (MMSE), a simple questionnaire, is the most widely used.

Since the MMSE is short and simple, it has limitations in that it is difficult to accurately test due to the learning effect during repeated tests within a short period of time.

In order to overcome such shortcomings of MMSE and to satisfy the requirements as a screening tool, it is necessary to develop biosignals that can be used to evaluate cognitive decline.

Recently, studies on the relationship between bioimpedance and cognitive function are emerging, and bioimpedance measurement has the advantage of being able to measure within a short time within minutes, and does not require a separate professional manpower for evaluation.

Accordingly, there is an urgent need for a new screening technology capable of diagnosing cognitive decline in the elderly using bioimpedance integratedly.

An embodiment of the present invention aims to provide a method and apparatus for screening for cognitive decline in the elderly using bioimpedance, which improves the accuracy of evaluation of cognitive decline in MMSE and enables MMSE to be used in more diverse applications.

Another object of an embodiment of the present invention is to provide a technique for screening for cognitive decline in the elderly by using bioimpedance information.

In addition, an embodiment of the present invention aims at diagnosing senile cognitive decline using the MMSE questionnaire.

In addition, an embodiment of the present invention aims to improve the accuracy of cognitive function evaluation compared to when MMSE is used alone through the MMSE questionnaire and bioimpedance data fusion technology.

In addition, an embodiment of the present invention aims to secure the accuracy of the MMSE level by using information such as age, height, weight, sex, etc., which are demographic risk factors, when bioimpedance is used alone.

In addition, an embodiment of the present invention aims to implement a biosignal-based geriatric cognitive decline screening technology that is easy and fast to measure and has no learning effect even if repeated measurement is performed.

In addition, an embodiment of the present invention aims to overcome the learning effect of the repeated test, which is the biggest drawback of MMSE, and to implement a new biosignal technology that can be utilized to evaluate cognitive decline.

In addition, an embodiment of the present invention does not require a separate professional manpower for cognitive function evaluation, and aims to simply screen for cognitive decline in the elderly.

According to an embodiment of the present invention, a method for screening geriatric cognitive decline using bioimpedance includes: obtaining bioimpedance information of a subject; And based on the bioimpedance information, it may include the step of screening (screening) geriatric cognitive decline for the subject.

In addition, according to an embodiment of the present invention, an apparatus for screening geriatric cognitive decline using bioimpedance includes: an interface for acquiring bioimpedance information of a subject; And based on the bioimpedance information, it can be configured to include a processor for screening the aging cognitive decline for the subject.

According to an embodiment of the present invention, it is possible to provide a method and apparatus for screening for cognitive decline in the elderly using bioimpedance, which improves the accuracy of assessment of cognitive decline in MMSE and enables MMSE to be used for more diverse purposes.

In addition, according to an embodiment of the present invention, it is possible to provide a technology for screening for cognitive decline in the elderly by using bioimpedance information.

In addition, according to an embodiment of the present invention, senile cognitive decline can be diagnosed using the MMSE questionnaire.

In addition, according to an embodiment of the present invention, through the MMSE questionnaire and bioimpedance data fusion technology, the accuracy of the cognitive function evaluation can be improved compared to when the MMSE is used alone.

In addition, according to an embodiment of the present invention, when bioimpedance is used alone, information such as age, height, weight, gender, which are demographic risk factors for dementia, can be integrated and used to ensure MMSE level accuracy.

In addition, according to an embodiment of the present invention, it is possible to implement a biosignal-based geriatric cognitive decline screening technology that is easy and fast to measure and has no learning effect even if repeated measurement is performed.

In addition, according to an embodiment of the present invention, it is possible to overcome the learning effect of the repeated test, which is the biggest drawback of MMSE, and to implement a new biosignal technology that can be utilized to evaluate cognitive decline.

In addition, according to an embodiment of the present invention, it is possible to simply screen for cognitive decline in the elderly without requiring a separate professional manpower for cognitive function evaluation.

1 is a block diagram illustrating the configuration of an aging-related cognitive decline screening apparatus using bioimpedance according to an embodiment of the present invention.
2 is a conceptual diagram of a screening technique for aging/degenerative cognitive decline according to an embodiment of the present invention.
3 is a diagram for illustrating improvement of correlation between K-MMSE + Bioimpedance - SNSB II field.
4 to 6 are diagrams for explaining a correlation analysis result regarding SNSB II.
7 is a diagram for comparing the correlation between MMSE questionnaire scores and SNSB II fields.
8 is a diagram for comparing the correlation between questionnaire scores for each MMSE field and SNSB II field.
9 is a flowchart illustrating an emotion evaluation method according to an embodiment of the present invention.

Hereinafter, embodiments will be described in detail with reference to the accompanying drawings. However, since various changes may be made to the embodiments, the scope of the patent application is not limited or limited by these embodiments. It should be understood that all modifications, equivalents and substitutes for the embodiments are included in the scope of the rights.

The terms used in the examples are used for the purpose of description only, and should not be construed as limiting. The singular expression includes the plural expression unless the context clearly dictates otherwise. In this specification, terms such as "comprise" or "have" are intended to designate that a feature, number, step, operation, component, part, or a combination thereof described in the specification exists, but one or more other features It should be understood that this does not preclude the existence or addition of numbers, steps, operations, components, parts, or combinations thereof.

Unless otherwise defined, all terms used herein, including technical or scientific terms, have the same meaning as commonly understood by one of ordinary skill in the art to which the embodiment belongs. Terms such as those defined in commonly used dictionaries should be interpreted as having a meaning consistent with the meaning in the context of the related art, and should not be interpreted in an ideal or excessively formal meaning unless explicitly defined in the present application. does not

In addition, in the description with reference to the accompanying drawings, the same components are given the same reference numerals regardless of the reference numerals, and the overlapping description thereof will be omitted. In describing the embodiment, if it is determined that a detailed description of a related known technology may unnecessarily obscure the gist of the embodiment, the detailed description thereof will be omitted.

1 is a block diagram illustrating the configuration of an aging-related cognitive decline screening apparatus using bioimpedance according to an embodiment of the present invention.

Referring to FIG. 1 , an apparatus for screening geriatric cognitive decline using bioimpedance (hereinafter abbreviated as 'senior cognitive decline screening device') 100 according to an embodiment of the present invention includes an interface 110, and a processor It can be configured to include (120).

First, the interface 110 obtains bioimpedance information of the subject. That is, the interface 110 may serve to receive bioimpedance information related to a biosignal sensed through an electrode attached to the subject, wired or wireless from the electrode.

The electrode may be attached to the surface of the subject's body, and may be a means for obtaining a biosignal, an EMG signal, or the like from the subject.

Bio-impedance information is information generated by applying a minute alternating current to the human body through electrodes and measuring the internal impedance in response to this, and is mainly used to analyze the body composition of the human body. can be utilized.

The processor 120, based on the bioimpedance information, screens geriatric cognitive decline for the subject. That is, the processor 120 may serve to evaluate the degree of senile cognitive decline for the subject based on the bio-signals input through the electrodes.

Here, screening refers to a search and screening method, and may refer to a population screening method for detecting the presence of geriatric cognitive decline diseases such as memory loss, behavioral disorders, dementia, and the like.

The bioimpedance information may include at least one of a phase angle, reactance, and impedance component of 5 kHz, 50 kHz, and 550 kHz, respectively.

More specifically, the bioimpedance information is, Ht ² /Xc5, Ht ² /Xc50, Ht ² /Xc250, Ht ² /Z(R)5, Ht ² /Z(R)50, Ht ² /Z(R) 250, Xc5/Ht ² , Xc50/Ht ² , Xc250/Ht ² , Z(R)5/Ht ² , Z(R)50/Ht ² , Z(R)250/Ht ² , Ht/Xc5, Ht/ Xc50, Ht/Xc250, Ht/Z(R)5, Ht/Z(R)50, Ht/Z(R)250, Xc5/Ht, Xc50/Ht, Xc250/Ht, Z(R)5/Ht, Z(R)50/Ht, Z(R)250/Ht, and PhA50/ECWR can be used as variables.

Here, the Ht is the height, the Xc is the reactance, the Z(R) is the impedance (resistance), the PhA is the phase angle, the ECWR is the extracellular water rate, the 5 is 5 kHz, the 50 is 50 kHz, the 250 may refer to 250 kHz.

The processor 120 may estimate the current state of the subject with respect to cognitive decline in the elderly through the above-described bioimpedance variable.

For example, the processor 120 compares the key and the variable 'Ht ² /Xc5' related to the impedance of 5 kHz with the key and the variable 'Ht ² /Xc250' related to the impedance of 250 kHz, indicating that the subject is in a low-grade cognitive decline state can be estimated

In another embodiment, the geriatric cognitive decline screening apparatus 100 may screen for geriatric cognitive decline by additionally using MMSE.

To this end, the interface 110 may receive a test result for the dementia screening test paper (MMSE) provided to the subject.

The Mini-Mental State Examination (MMSE) is the most widely used screening test for dementia. MMSE is a simple cognitive screening test, and has the advantage of being able to examine changes over time.

K-MMSE is an improved version of MMSE to suit the current state of dementia screening in Korea. The total score of K-MMSE is 30 points, orientation to time (reality sense) 5 points, orientation to place 5 points, memory registration ability 3 points, attention and calculation ability 5 points, memory recall ability 3 points, language It can consist of 8 points for ability and 1 point for spatiotemporal construction ability.

Patients with a score of less than 20 on the K-MMSE are classified as the elderly group with dementia requiring confirmation by a specialist. ' can be subdivided into

In the K-MMSE, patients with a score of 25 or higher can be classified as the normal elderly group, and patients with a score of 24-20 can be classified as borderline.

Thereafter, the processor 120 may screen for the cognitive decline in the elderly by integrating the bioimpedance and the test result. That is, the processor 120 may comprehensively consider the results of the bioimpedance and MMSE collected by the electrodes attached to the surface of the human body to evaluate the cognitive decline in the elderly for the subject.

For example, the processor 120 adjusts the MMSE score by -1 in consideration of the bioimpedance for the subject receiving the test result of the MMSE of 20 points, which is the boundary area, so that the subject can be newly classified as the elderly group with dementia. there is.

In another embodiment, the geriatric cognitive decline screening apparatus 100 may screen for geriatric cognitive decline by additionally using dementia risk factors.

To this end, the interface 110 may collect dementia risk factors related to at least one of sociodemographic risk factors, genetic risk factors, environmental risk factors, and physical and mental health conditions from the subject.

Dementia may be a kind of syndrome showing cognitive decline due to various causative diseases. Although dementia risk factors may differ depending on the causative disease, Alzheimer's dementia and vascular dementia, which account for about 90% of the causes of dementia, are known to share a significant number of risk factors, such as demographic and vascular risk factors.

Socio-demographic risk factors may include age, gender, educational background, and the like.

With respect to age, old age is the most consistent and strong risk factor for dementia, and the risk of dementia increases rapidly with increasing age. The prevalence of dementia in the elderly 65 years and older doubles for every 5 years of age, and by age group, the proportion of the elderly with dementia among the elderly aged 65 to 69 is about 3%, whereas in the elderly aged 80 to 84, this rate is 25 increase to %.

As for gender, most epidemiological studies show that women are at higher risk of Alzheimer's than men. Vascular dementia, on the other hand, has a higher risk in men, which may be because smoking and drinking, which are major risk factors for stroke, are more common in men than in women.

Regarding education, the relationship between education and dementia is still controversial, but overall, it is believed that the lower the educational level, the more likely the dementia is. Stern et al. reported that those with eight or more years of education had a 50-fold reduced risk of Alzheimer's dementia compared to those without education. The European Collaboration on Dementia (EURODEM) study reports that low education is a risk factor for dementia in women but not in men. It is also possible that educational attainment indirectly affects the risk of developing dementia, because people with lower education levels are more likely to suffer from drug or nutritional deficiencies.

Genetic risk factors may include a family history of dementia and genetic mutations and polymorphisms.

With respect to a family history of dementia, immediate family members of Alzheimer's disease patients are 2-4 times more likely to develop Alzheimer's disease than others, and the risk is further increased if there are two or more Alzheimer's patients in an immediate family member. Even if familial Alzheimer's disease caused by genetic problems is excluded, the risk is 15-19% when one parent or sibling has Alzheimer's disease, 40% when fraternal twins are patients, and when identical twins are patients The risk reaches 84%.

Regarding gene mutations and polymorphisms, only 5% of all Alzheimer's disease patients are familial Alzheimer's disease patients caused by a genetic problem, and most patients have sporadic Alzheimer's disease.

Environmental risk factors include smoking, drinking, nutrition, social support networks and activities.

It has been reported that smoking increases the risk of Alzheimer's disease by 1.79 times and the risk of vascular dementia by 1.78 times.

Regarding drinking, it is reported that drinking reduces the risk of dementia by 0.63 times and the risk of Alzheimer's disease by 0.57 times, regardless of the type of alcohol. However, drinking more than 3-5 glasses of alcohol a day may increase the risk of cognitive impairment and dementia.

Regarding nutrition, it has been reported that people who eat meat mainly have a higher risk of dementia compared to people who mainly eat vegetarian food, and high blood lipids, saturated fat, and cholesterol more than double the risk of dementia.

Regarding social support networks and activities, the elderly who are not married, living alone and socially isolated for other reasons have a higher risk of Alzheimer's disease than those who are not. Elderly people who are not socially active or do not enjoy leisure activities are also at high risk of Alzheimer's disease. In an epidemiological study conducted by Wang et al., it was confirmed that the incidence of dementia decreased when leisure activities, reading, board games, playing musical instruments, dancing, etc. were performed.

Physical and mental health conditions may include cardiovascular disease, depression, head trauma, estrogen, anti-inflammatory drugs, and the like.

For cardiovascular disease, most vascular risk factors are known to be associated with Alzheimer's disease as well as vascular dementia. Hypertension, the most important risk factor for cerebrovascular disease, is an important risk factor for cognitive decline and vascular dementia. .

As for depression, depression has been found in several studies to more than double the risk of developing Alzheimer's.

Regarding head trauma, it is accepted that moderate to severe head trauma increases the risk of dementia.

For estrogen, estrogen replacement therapy (ERT) has been reported to lower the risk of Alzheimer's disease in postmenopausal women.

Regarding analgesic drugs, in a recent Rotterdam study that followed 6,989 adults 55 years of age and older for 7 years, those who took nonsteroidal anti-inflammatory drugs (NSAIDs) for 2 years or more had an approximately 80 risk of developing Alzheimer's disease compared to those who did not. % decreased, and there was no effect in vascular dementia.

Thereafter, the processor 120 may screen for the cognitive decline in the elderly by combining the bioimpedance and the dementia risk factor. That is, the processor 120 may comprehensively consider the bioimpedance collected by the electrodes attached to the human body surface and the dementia risk factors diagnosed from the subject, and evaluate the cognitive decline in the elderly for the subject.

For example, the processor 120 may evaluate the dementia risk according to the sociodemographic risk factor to be lower than that of the corresponding age group in consideration of the bioimpedance for the elderly subject 80 years or older.

According to an embodiment of the present invention, it is possible to provide a method and apparatus for screening for cognitive decline in the elderly using bioimpedance, which improves the accuracy of assessment of cognitive decline in MMSE and enables MMSE to be used for more diverse purposes.

In addition, according to an embodiment of the present invention, it is possible to provide a technology for screening for cognitive decline in the elderly by using bioimpedance information.

In addition, according to an embodiment of the present invention, senile cognitive decline can be diagnosed using the MMSE questionnaire.

In addition, according to an embodiment of the present invention, through the MMSE questionnaire and bioimpedance data fusion technology, the accuracy of the cognitive function evaluation can be improved compared to when the MMSE is used alone.

In addition, according to an embodiment of the present invention, when bioimpedance is used alone, information such as age, height, weight, gender, which are demographic risk factors for dementia, can be integrated and used to ensure MMSE level accuracy.

In addition, according to an embodiment of the present invention, it is possible to implement a biosignal-based geriatric cognitive decline screening technology that is easy and fast to measure and has no learning effect even if repeated measurement is performed.

In addition, according to an embodiment of the present invention, it is possible to overcome the learning effect of the repeated test, which is the biggest drawback of MMSE, and to implement a new biosignal technology that can be utilized to evaluate cognitive decline.

In addition, according to an embodiment of the present invention, it is possible to simply screen for cognitive decline in the elderly without requiring a separate professional manpower for cognitive function evaluation.

The present invention relates to a method and apparatus for screening senile or degenerative cognitive decline using bioimpedance information.

The present invention is a fusion technology for screening senile or degenerative cognitive decline that integrates bioimpedance information and dementia screening test paper (MMSE).

The present invention includes a method for screening senile/degenerative cognitive decline by combining bioimpedance information with dementia risk factors such as age, educational background, gender, height, and weight.

Bioimpedance information uses phase angle, reactance, and impedance components at 50 kHz as main variables, and impedance information at 250 kHz and 5 kHz may be additionally utilized.

For the population age 55 and older, the "bioimpedance + K-MMSE" linear regression equation for the evaluation of prefrontal cognitive decline can be as follows.

The correlation improvement results for each area of SNSB II cognitive function by linking the K-MMSE questionnaire and bioimpedance data are as follows.

Attention/Concentration: (K-MMSE) r = 0.45 → (K-MMSE + Bioimpedance) r = 0.56,

Language ability: (K-MMSE) r = 0.50 → (K-MMSE + Bioimpedance) r = 0.59,

Memory: (K-MMSE) r = 0.59 → (K-MMSE + Bioimpedance) r = 0.68,

Frontal lobe: (K-MMSE) r = 0.62 → (K-MMSE + Bioimpedance) r = 0.72

The geriatric cognitive decline screening apparatus 100 of the present invention can estimate the SNSB II cognitive function score only with bioimpedance information and demographic information for a population group 55 years of age or older (research result: 537 elderly people). Areas for which presumptive potential has been confirmed are, for example, concentration (Digit span Backward), language ability (Naming K BNT, Naming S K BNT, SNSB II Domain Language), memory (RCFT immediate recall, RCFT delayed recall), prefrontal (cognition) (COWAT animal) , Stroop Test Word reading time, DSC correct, K TMT E A time, SNSB II Domain Frontal), correlation (r) = 0.4 ~ 0.6, cognitive function can be estimated with 'attention'.

The geriatric cognitive decline screening device 100 of the present invention measures the SNSBII precision cognitive function measurement questionnaire and bioimpedance (InBody S10) for 537 elderly people 55 years of age or older to form a linear regression model with only bioimpedance measurement values and basic demographic information. It can be created and operated as a screening device by analyzing the correlation with the SNSB measurement score.

The geriatric cognitive decline screening apparatus 100 of the present invention uses demographic information (height, weight, gender, BMI, age, etc.) and bioimpedance information (impedance, reactance, phase angle, etc.) to evaluate a part of cognitive function developed an algorithm to

In addition, the geriatric cognitive decline screening apparatus 100 of the present invention developed a K-MMSE + bioimpedance fusion algorithm that can supplement the simple K-MMSE questionnaire.

In addition, the geriatric cognitive decline screening apparatus 100 of the present invention derives correlation improvement results for each SNSB II cognitive function domain by interworking with the K-MMSE questionnaire and bioimpedance data.

Attention/Concentration: (K-MMSE) r = 0.45 → (K-MMSE + Bioimpedance) r = 0.56,

Language ability: (K-MMSE) r = 0.50 → (K-MMSE + Bioimpedance) r = 0.59,

Memory: (K-MMSE) r = 0.59 → (K-MMSE + Bioimpedance) r = 0.68,

Frontal lobe: (K-MMSE) r = 0.62 → (K-MMSE + Bioimpedance) r = 0.72

Hereinafter, a cognitive function scoring model using the MMSE questionnaire + bioimpedance information is exemplified.

SNSB_II_Domain_Attention for attention/concentration is "K_MMSE_total_score + AGE + HEIGHT + WEIGHT + X5khz.RL.Reactance + X5khz.LL.Reactance + X50khz.RL.Reactance + X50khz.LL.Reactance + X50khz.RL.Phase.Angle + X50khz. A scoring model can be presented by expressing "LL.Phase.Angle + X5khz.LA.Phase.Angle + X5khz.RL.Phase.Angle + X5khz.LL.Phase.Angle".

SNSB_II_Domain_Language for language ability is "K_MMSE_total_score + AGE + HEIGHT + WEIGHT + BMI + X5khz.RL.Reactance + X5khz.LL.Reactance + X50khz.LA.Reactance + X50khz.RL.Reactance + X50khz.LL.Reactance + X50khz.RL. A scoring model can be presented by expressing ".Phase.Angle + X5khz.RA.Phase.Angle + X5khz.LA.Phase.Angle + X5khz.RL.Phase.Angle + X250khz.LL.Phase.Angle".

SNSB_II_Domain_Memory regarding memory can be expressed as "K_MMSE_total_score + AGE + GENDER + HEIGHT + X50khz.RA.Phase.Angle + X5khz.LA.Phase.Angle" to present a scoring model.

SNSB_II_Domain_Frontal for the frontal lobe is "K_MMSE_total_score + AGE + GENDER + HEIGHT + WEIGHT + X5khz.RL.Reactance + X5khz.LL.Reactance + X50khz.LL.Reactance + X5khz.RA.Phase.Angle + X5khz.LA. A scoring model can be presented by expressing "X5khz.LL.Phase.Angle + X250khz.LL.Phase.Angle".

The senile/degenerative cognitive function evaluation model equation according to the present invention can be exemplified as follows for 'MMSE + Bioimpedance + Demography'.

2 is a conceptual diagram of a screening technique for aging/degenerative cognitive decline according to an embodiment of the present invention.

As shown in FIG. 2 , the geriatric cognitive decline screening apparatus 100 of the present invention can screen the subject for cognitive decline in the elderly by analyzing the subject's Bioimpedance and the MMSE questionnaire integrally.

For example, in screening for senile cognitive decline with respect to the frontal (Frontal) of the subject, the geriatric cognitive decline screening apparatus 100 is "SNSB_II_Domain_Frontal ~ K_MMSE_total_score + AGE + GENDER + HEIGHT + WEIGHT + 5khz.RL.Reactance + 5khz.LL. Reactance + 50khz.LL.Reactance + 5khz.RA.Phase.Angle + 5khz.LA.Phase.Angle + 5khz.LL.Phase.Angle + 250khz.LL.Phase.Angle" to evaluate the degree of cognitive decline in the elderly. can

3 is a diagram for illustrating improvement of correlation between K-MMSE + Bioimpedance - SNSB II field.

In FIG. 3, using the score distribution in the SNSB II_Domain for the subject's memory and frontal, the possibility of senile cognitive decline occurring is visualized as a diagram on a plane.

4 to 6 are diagrams for explaining a correlation analysis result regarding SNSB II.

In FIG. 4, SNSB II - Naming S K BNT correlation analysis (bioimpedance + demographic information) is illustrated by way of example.

The correlation analysis with respect to Naming S K BNT can be performed through the following analytical formula.

In FIG. 5, SNSB II - DSC correct correlation analysis (bioimpedance + demographic information) is illustrated by way of example.

Correlation analysis with respect to DSC_correct may be performed through the following analysis equation.

In FIG. 6, SNSB II - Domain Frontal correlation analysis (bioimpedance + demographic information) is illustrated by way of example.

Correlation analysis on domain frontal can be performed through the following analysis equation.

SNSB II fields that are highly correlated with bioimpedance include 'Digit_span_Backward' on attention, 'Naming_K_BNT, Naming_S_K_BNT, SNSB_II_Domain_Language' on language skills, 'RCFT_immediate_recall, RCFT_Test_animal read, Stroop_time, DWWcorrect, RCFT_Delayed_Stroop', K_TMT_E_A_time, SNSB_II_Domain_Frontal', etc. may be exemplified.

In the present invention, correlation can be improved by fusion of K-MMSE & SNSB II correlation (r) and bioimpedance information. For example, the correlation of attention changes from 0.45 → 0.56 (add bioimpedance), the correlation of language ability changes from 0.50 → 0.59 (add bioimpedance), and the memory improves from 0.59 → 0.68 (add bioimpedance), and the frontal lobe can be improved by 0.62 → 0.72 (add bioimpedance).

7 is a diagram for comparing the correlation between MMSE questionnaire scores and SNSB II fields.

As shown in FIG. 7 , the geriatric cognitive decline screening apparatus 100 for five items of K_MMSE_score, SNSB_Attention, SNSB_Language, SNSB_Memory, and SNSB_Frontal can express the correlation between each other in numerical values and charts.

Except for autocorrelation, the items with the highest correlation among the correlations among other items are SNSB_Memory and SNSB_Frontal, which were derived with a correlation of 0.626, and through this, it was confirmed that there is a high correlation between memory and frontal lobe in relation to cognitive decline in the elderly. can be selected

8 is a diagram for comparing the correlation between questionnaire scores for each MMSE field and SNSB II field.

As shown in FIG. 8 , the geriatric cognitive decline screening apparatus 100 may express the correlation between K_MMSE_score , SNSB_Attention, SNSB_Language, SNSB_Memory, SNSB_Frontal and each of these MMSE results numerically.

Except for autocorrelation regarding K_MMSE_score, the item with the highest correlation among the correlations between other items was derived with a correlation of 0.751, K_MMSE_score and SNSB_Attention & calc. , and it can be determined that there is a causal relationship between attention deficit and cognitive decline in the elderly.

Hereinafter, a work flow of the geriatric cognitive decline screening apparatus 100 according to embodiments of the present invention will be described in detail with reference to FIG. 9 .

The emotional evaluation method according to the present embodiment may be performed by the geriatric cognitive decline screening apparatus 100 .

9 is a flowchart illustrating an emotion evaluation method according to an embodiment of the present invention.

First, the geriatric cognitive decline screening apparatus 100 obtains bioimpedance information of the subject ( 910 ). Step 910 may be a process of receiving bioimpedance information regarding a biosignal sensed through an electrode attached to the subject, wired or wireless, from the electrode.

The electrode may be attached to the surface of the subject's body, and may be a means for obtaining a biosignal, an EMG signal, or the like from the subject.

Bio-impedance information is information generated by applying a minute alternating current to the human body through electrodes and measuring the internal impedance in response to this, and is mainly used to analyze the body composition of the human body. can be utilized.

In addition, the geriatric cognitive decline screening apparatus 100 screens the aged cognitive decline for the subject based on the bioimpedance information ( 920 ). Step 920 may be a process of evaluating the degree of senile cognitive decline for the subject based on the biosignal input through the electrode.

Here, screening refers to a search and screening method, and may refer to a population screening method for detecting the presence of geriatric cognitive decline diseases such as memory loss, behavioral disorders, dementia, and the like.

The bioimpedance information may include at least one of a phase angle, reactance, and impedance component of 5 kHz, 50 kHz, and 550 kHz, respectively.

More specifically, the bioimpedance information is, Ht ² /Xc5, Ht ² /Xc50, Ht ² /Xc250, Ht ² /Z(R)5, Ht ² /Z(R)50, Ht ² /Z(R) 250, Xc5/Ht ² , Xc50/Ht ² , Xc250/Ht ² , Z(R)5/Ht ² , Z(R)50/Ht ² , Z(R)250/Ht ² , Ht/Xc5, Ht/ Xc50, Ht/Xc250, Ht/Z(R)5, Ht/Z(R)50, Ht/Z(R)250, Xc5/Ht, Xc50/Ht, Xc250/Ht, Z(R)5/Ht, Z(R)50/Ht, Z(R)250/Ht, and PhA50/ECWR can be used as variables.

Here, the Ht is the height, the Xc is the reactance, the Z(R) is the impedance (resistance), the PhA is the phase angle, the ECWR is the extracellular water rate, the 5 is 5 kHz, the 50 is 50 kHz, the 250 may refer to 250 kHz.

The geriatric cognitive decline screening apparatus 100 may determine the current state of the subject with respect to geriatric cognitive decline through the above-described bioimpedance variables.

For example, the geriatric cognitive decline screening device 100 compares the height and the variable 'Ht ² /Xc5' related to the impedance of 5 kHz with the variable 'Ht ² /Xc250' related to the height and the impedance of 250 kHz. It can be inferred that he is in a state of cognitive decline.

In another embodiment, the geriatric cognitive decline screening apparatus 100 may screen for geriatric cognitive decline by additionally using MMSE.

To this end, the geriatric cognitive decline screening apparatus 100 may receive a test result for a dementia screening test strip (MMSE) provided to the subject.

The Mini-Mental State Examination (MMSE) is the most widely used screening test for dementia. MMSE is a simple cognitive screening test, and has the advantage of being able to examine changes over time.

K-MMSE is an improved version of MMSE to suit the current state of dementia screening in Korea. The total score of K-MMSE is 30 points, orientation to time (reality sense) 5 points, orientation to place 5 points, memory registration ability 3 points, attention and calculation ability 5 points, memory recall ability 3 points, language It can consist of 8 points for ability and 1 point for spatiotemporal construction ability.

Patients with a score of less than 20 on the K-MMSE are classified as the elderly group with dementia requiring confirmation by a specialist. ' can be subdivided into

In the K-MMSE, patients with a score of 25 or higher can be classified as the normal elderly group, and patients with a score of 24-20 can be classified as borderline.

Thereafter, the geriatric cognitive decline screening apparatus 100 may screen for the geriatric cognitive decline by integrating the bioimpedance and the test result. That is, the geriatric cognitive decline screening apparatus 100 may evaluate the geriatric cognitive decline for the subject by comprehensively considering the bioimpedance and MMSE results collected by the electrodes attached to the human body surface.

For example, the geriatric cognitive decline screening apparatus 100 corrects the MMSE score by -1 in consideration of the bioimpedance for the subject who received the test result of the MMSE of 20 points, which is the boundary area, and converts the subject to the dementia elderly group. can be newly classified.

In another embodiment, the geriatric cognitive decline screening apparatus 100 may screen for geriatric cognitive decline by additionally using dementia risk factors.

To this end, the geriatric cognitive decline screening device 100 may collect dementia risk factors related to at least one of sociodemographic risk factors, genetic risk factors, environmental risk factors, and physical and mental health conditions from the subject. .

Dementia may be a kind of syndrome showing cognitive decline due to various causative diseases. Although dementia risk factors may differ depending on the causative disease, Alzheimer's dementia and vascular dementia, which account for about 90% of the causes of dementia, are known to share a significant number of risk factors, such as demographic and vascular risk factors.

Socio-demographic risk factors may include age, gender, educational background, and the like.

With respect to age, old age is the most consistent and strong risk factor for dementia, and the risk of dementia increases rapidly with increasing age. The prevalence of dementia in the elderly 65 years and older doubles for every 5 years of age, and by age group, the proportion of the elderly with dementia among the elderly aged 65 to 69 is about 3%, whereas in the elderly aged 80 to 84, this rate is 25 increase to %.

As for gender, most epidemiological studies show that women are at higher risk of Alzheimer's than men. Vascular dementia, on the other hand, has a higher risk in men, which may be because smoking and drinking, which are major risk factors for stroke, are more common in men than in women.

Regarding education, the relationship between education and dementia is still controversial, but overall, it is believed that the lower the educational level, the more likely the dementia is. Stern et al. reported that those with eight or more years of education had a 50-fold reduced risk of Alzheimer's dementia compared to those without education. The European Collaboration on Dementia (EURODEM) study reports that low education is a risk factor for dementia in women but not in men. It is also possible that educational attainment indirectly affects the risk of developing dementia, because people with lower education levels are more likely to suffer from drug or nutritional deficiencies.

Genetic risk factors may include a family history of dementia and genetic mutations and polymorphisms.

With respect to a family history of dementia, immediate family members of Alzheimer's disease patients are 2-4 times more likely to develop Alzheimer's disease than others, and the risk is further increased if there are two or more Alzheimer's patients in an immediate family member. Even if familial Alzheimer's disease caused by genetic problems is excluded, the risk is 15-19% when one parent or sibling has Alzheimer's disease, 40% when fraternal twins are patients, and when identical twins are patients The risk reaches 84%.

Regarding gene mutations and polymorphisms, only 5% of all Alzheimer's disease patients are familial Alzheimer's disease patients caused by a genetic problem, and most patients have sporadic Alzheimer's disease.

Environmental risk factors include smoking, drinking, nutrition, social support networks and activities.

It has been reported that smoking increases the risk of Alzheimer's disease by 1.79 times and the risk of vascular dementia by 1.78 times.

Regarding drinking, it is reported that drinking reduces the risk of dementia by 0.63 times and the risk of Alzheimer's disease by 0.57 times, regardless of the type of alcohol. However, drinking more than 3-5 glasses of alcohol a day may increase the risk of cognitive impairment and dementia.

Regarding nutrition, it has been reported that people who eat meat mainly have a higher risk of dementia compared to people who mainly eat vegetarian food, and high blood lipids, saturated fat, and cholesterol more than double the risk of dementia.

Regarding social support networks and activities, the elderly who are not married, living alone and socially isolated for other reasons have a higher risk of Alzheimer's disease than those who are not. Elderly people who are not socially active or do not enjoy leisure activities are also at high risk of Alzheimer's disease. In an epidemiological study conducted by Wang et al., it was confirmed that the incidence of dementia decreased when leisure activities, reading, board games, playing musical instruments, dancing, etc. were performed.

Physical and mental health conditions may include cardiovascular disease, depression, head trauma, estrogen, anti-inflammatory drugs, and the like.

For cardiovascular disease, most vascular risk factors are known to be associated with Alzheimer's disease as well as vascular dementia. Hypertension, the most important risk factor for cerebrovascular disease, is an important risk factor for cognitive decline and vascular dementia. .

As for depression, depression has been found in several studies to more than double the risk of developing Alzheimer's.

Regarding head trauma, it is accepted that moderate to severe head trauma increases the risk of dementia.

For estrogen, estrogen replacement therapy (ERT) has been reported to lower the risk of Alzheimer's disease in postmenopausal women.

Regarding analgesic drugs, in a recent Rotterdam study that followed 6,989 adults 55 years of age and older for 7 years, those who took nonsteroidal anti-inflammatory drugs (NSAIDs) for 2 years or more had an approximately 80 risk of developing Alzheimer's disease compared to those who did not. % decreased, and there was no effect in vascular dementia.

Thereafter, the geriatric cognitive decline screening apparatus 100 may screen for the geriatric cognitive decline by combining the bioimpedance and the dementia risk factor. That is, the geriatric cognitive decline screening apparatus 100 can evaluate the geriatric cognitive decline for the subject by comprehensively considering the bioimpedance collected by the electrode attached to the human body surface and dementia risk factors diagnosed from the subject.

For example, the geriatric cognitive decline screening apparatus 100 may evaluate the risk of dementia according to sociodemographic risk factors lower than that of the corresponding age group in consideration of bioimpedance for an elderly subject 80 years of age or older.

According to an embodiment of the present invention, it is possible to provide a method and apparatus for screening for cognitive decline in the elderly using bioimpedance, which improves the accuracy of assessment of cognitive decline in MMSE and enables MMSE to be used for more diverse purposes.

In addition, according to an embodiment of the present invention, it is possible to provide a technology for screening for cognitive decline in the elderly by using bioimpedance information.

In addition, according to an embodiment of the present invention, senile cognitive decline can be diagnosed using the MMSE questionnaire.

In addition, according to an embodiment of the present invention, through the MMSE questionnaire and bioimpedance data fusion technology, the accuracy of the cognitive function evaluation can be improved compared to when the MMSE is used alone.

In addition, according to an embodiment of the present invention, when bioimpedance is used alone, information such as age, height, weight, gender, which are demographic risk factors for dementia, can be integrated and used to ensure MMSE level accuracy.

In addition, according to an embodiment of the present invention, it is possible to implement a biosignal-based geriatric cognitive decline screening technology that is easy and fast to measure and has no learning effect even if repeated measurement is performed.

In addition, according to an embodiment of the present invention, it is possible to overcome the learning effect of the repeated test, which is the biggest drawback of MMSE, and to implement a new biosignal technology that can be utilized to evaluate cognitive decline.

In addition, according to an embodiment of the present invention, it is possible to simply screen for cognitive decline in the elderly without requiring a separate professional manpower for cognitive function evaluation.

The method according to the embodiment may be implemented in the form of program instructions that can be executed through various computer means and recorded in a computer-readable medium. The computer-readable medium may include program instructions, data files, data structures, etc. alone or in combination. The program instructions recorded on the medium may be specially designed and configured for the embodiment, or may be known and available to those skilled in the art of computer software. Examples of the computer-readable recording medium include magnetic media such as hard disks, floppy disks and magnetic tapes, optical media such as CD-ROMs and DVDs, and magnetic media such as floppy disks. - includes magneto-optical media, and hardware devices specially configured to store and execute program instructions, such as ROM, RAM, flash memory, and the like. Examples of program instructions include not only machine language codes such as those generated by a compiler, but also high-level language codes that can be executed by a computer using an interpreter or the like. The hardware devices described above may be configured to operate as one or more software modules to perform the operations of the embodiments, and vice versa.

Software may comprise a computer program, code, instructions, or a combination of one or more thereof, which configures a processing device to operate as desired or is independently or collectively processed You can command the device. The software and/or data may be any kind of machine, component, physical device, virtual equipment, computer storage medium or apparatus, to be interpreted by or to provide instructions or data to the processing device. , or may be permanently or temporarily embody in a transmitted signal wave. The software may be distributed over networked computer systems and stored or executed in a distributed manner. Software and data may be stored in one or more computer-readable recording media.

As described above, although the embodiments have been described with reference to the limited drawings, those skilled in the art may apply various technical modifications and variations based on the above. For example, the described techniques are performed in an order different from the described method, and/or the described components of the system, structure, apparatus, circuit, etc. are combined or combined in a different form than the described method, or other components Or substituted or substituted by equivalents may achieve an appropriate result.

Therefore, other implementations, other embodiments, and equivalents to the claims are also within the scope of the following claims.

100: geriatric cognitive decline screening device
110: interface
120 : processor

Claims (11)

obtaining bioimpedance information of the subject; and
Based on the bioimpedance information, screening for senile cognitive decline for the subject
A screening method for cognitive decline in the elderly using bioimpedance comprising a. According to claim 1,
The bioimpedance information is
5 kHz, 50 kHz, 550 kHz each comprising at least one of a phase angle, reactance, and impedance component
A screening method for cognitive decline in the elderly using bioimpedance. 3. The method of claim 2,
The bioimpedance information is
Ht ² /Xc5, Ht ² /Xc50, Ht ² /Xc250, Ht ² /Z(R)5, Ht ² /Z(R)50, Ht ² /Z(R)250, Xc5/Ht ² , Xc50/Ht ² , Xc250/Ht ² , Z(R)5/Ht ² , Z(R)50/Ht ² , Z(R)250/Ht ² , Ht/Xc5, Ht/Xc50, Ht/Xc250, Ht/Z( R)5, Ht/Z(R)50, Ht/Z(R)250, Xc5/Ht, Xc50/Ht, Xc250/Ht, Z(R)5/Ht, Z(R)50/Ht, Z( R) using 250/Ht, PhA50/ECWR as a variable
-The Ht is the height, the Xc is the reactance, the Z(R) is the impedance (resistance), the PhA is the phase angle, the ECWR is the extracellular water rate, the 5 is 5 kHz, the 50 is 50 kHz, the 250 is refers to 250 kHz -
A screening method for cognitive decline in the elderly using bioimpedance. According to claim 1,
receiving a test result for the dementia screening test sheet (MMSE) provided to the subject; and
Screening for the cognitive decline in the elderly by integrating the bioimpedance and the test result
Geriatric cognitive decline screening method using bioimpedance further comprising a. According to claim 1,
collecting dementia risk factors related to at least one of sociodemographic risk factors, genetic risk factors, environmental risk factors, and physical and mental health conditions from the subject; and
Screening for cognitive decline in the elderly by combining the bioimpedance and the dementia risk factor
Geriatric cognitive decline screening method using bioimpedance further comprising a. an interface for acquiring bioimpedance information of a subject; and
Based on the bioimpedance information, a processor for screening geriatric cognitive decline for the subject
A screening device for geriatric cognitive decline using bioimpedance comprising a. 7. The method of claim 6,
The bioimpedance information is
5 kHz, 50 kHz, 550 kHz each comprising at least one of a phase angle, reactance, and impedance component
A screening device for cognitive decline in the elderly using bioimpedance. 8. The method of claim 7,
The bioimpedance information is
Ht ² /Xc5, Ht ² /Xc50, Ht ² /Xc250, Ht ² /Z(R)5, Ht ² /Z(R)50, Ht ² /Z(R)250, Xc5/Ht ² , Xc50/Ht ² , Xc250/Ht ² , Z(R)5/Ht ² , Z(R)50/Ht ² , Z(R)250/Ht ² , Ht/Xc5, Ht/Xc50, Ht/Xc250, Ht/Z( R)5, Ht/Z(R)50, Ht/Z(R)250, Xc5/Ht, Xc50/Ht, Xc250/Ht, Z(R)5/Ht, Z(R)50/Ht, Z( R) using 250/Ht, PhA50/ECWR as a variable
-The Ht is the height, the Xc is the reactance, the Z(R) is the impedance (resistance), the PhA is the phase angle, the ECWR is the extracellular water rate, the 5 is 5 kHz, the 50 is 50 kHz, the 250 is refers to 250 kHz -
A screening device for cognitive decline in the elderly using bioimpedance. 7. The method of claim 6,
The interface is
receiving the test results for the dementia screening test paper (MMSE) provided to the subject,
The processor is
Screening for the cognitive decline in the elderly by using the bioimpedance and the test results integrated
A screening device for cognitive decline in the elderly using bioimpedance. 7. The method of claim 6,
The interface is
Collecting dementia risk factors related to at least one of sociodemographic risk factors, genetic risk factors, environmental risk factors, and physical and mental health conditions from the subject,
The processor is
By combining the bioimpedance and the dementia risk factor, screening for the cognitive decline in the elderly
A screening device for cognitive decline in the elderly using bioimpedance. A computer-readable recording medium recording a program for executing the method of any one of claims 1 to 5.

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