RU2712704C1 - Method for improving cognitive functions disorders and a computer-readable medium - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: group of inventions refers to medicine and medical equipment, namely to diagnostics and self-diagnostics. Obtaining first data on the subject, which represent the subject's responses to pre-determined questions on at least one of: physical well-being, mental well-being, emotional well-being, professional life, level and sources of stress, satisfaction with aspects of life, physical activity, level of awareness, drug consumption. Obtain second data on subject, which represent results of subject performance of one or more pre-determined intellectually realized tasks. Obtaining third data on the subject, which represent physical conditions of the organism and contain at least one of: pedometer data, trekking data on various types of physical activity, data on heart rate with different types of physical activity and in the absence thereof, data on arterial pressure, data on sleep. Fourth data on the subject are obtained, which include data on nutrition of the subject – results of filling the diary with the subject. That is followed by obtaining fifth data on a subject which include results of early clinical and biochemical blood tests, wherein data on early clinical and biochemical analyzes represent results of filling the respective forms with the individual. Intelligent analysis of all obtained data on the subject is performed by detecting correlation relationships between different obtained data. Analysis is used to evaluate the probability of early cognitive impairment in a subject by comparison with reference values and comparison with previously obtained values in dynamics. Based on the performed analysis and the obtained assessment of the presence of early cognitive impairments in a subject, recommendations are given on improving cognitive functions of the subject, including at least one of: maintaining healthy lifestyles, correction of nutrition, work with stress, regulation of sleep, change of a mode and / or intensity of physical activity, prevention of an intoxication and / or detoxication of an organism, use of cognitive trainings. Method is realized by means of nonvolatile machine-readable medium.

EFFECT: group of inventions enables early self-diagnosis of cognitive disorders for subsequent effective correction and prevention of progression of cognitive disorders.

15 cl, 22 dwg, 13 tbl, 3 ex

Description

The group of inventions relates to medicine and medical equipment, the use of the latest computer, electronic technologies, gadgets for the early detection of cognitive impairment, which a person can independently produce, as well as their timely correction, taking into account the identified impaired indicators, to improve the condition.

According to the WHO, around the world 47.5 million people suffer from diagnosed dementia and 7.7 million new cases are detected every year. By 2050, 135.5 million people with clinically significant dementia are expected in the world, that is, almost 3 times more than at present. By 2025, 75% of countries will have national policy decisions, plans, and strategic programs for dementia.

The enormous loss of dementia and the threatening prospects are demonstrated by the expected twofold increase in the number of cases of dementia every 20 years. A trillion dollars of economic losses already in 2018 and a doubling of this value in 2030, as well as the fact that now the costs of dementia are comparable to the 18th largest economy in the world and continue to grow rapidly.

Regardless of the mechanisms of aging, human cognitive impairment always leads to a sharp decrease in labor potential (Dementia - Caring, Ethics, Ethnical and Economic Aspects: A Systematic Review, Stockholm: Swedish Council on Health Technology Assessment (SBU); 2008 Jun. SBU Assessment No . 172, 3 volumes).

Early diagnosis of cognitive impairment (CR) and the possibility of their effective prevention will potentially reduce the demographic burden on society. According to existing demographic forecasts, by the middle of the 21st century, the coefficient of demographic load will be 0.9 (one dependent person per employee). This situation is regarded as a demographic catastrophe. The use of preventive geroprotection is more effective from an economic and social point of view compared to the traditional approach, in which the effectiveness is determined by the number of added years of a healthy, full life per unit of financial cost (Zakharov V.V. Cognitive disorders without dementia: classification, main causes and treatment. Effective Pharmacotherapy Neurology and Psychiatry. 2016; 1 (1); 22-30); Krutko V.N. Technologies for the prevention of aging as a real practical tool for a radical reduction in mortality in Russia, http://www.perspektivy.info/print.php?ID=36245).

There is no data on the prevalence of mild forms of cognitive impairment (CR). The prevalence in the population of moderate CR (defined as a nosologically independent disease) is estimated at approximately 22% of those over 65 years old (Petersen, R. C, & Negash, S. (2008). Mild cognitive impairment: an overview. CNS Spectrums, 13, 45-53). At this stage of pathological brain involvement, as a rule, independence is still maintained in everyday life - professional and social. With timely diagnosis, deficiency correction and adequate therapy, CF recovery to normal is noted in 30-50% of patients (Patnode CD, Evans CV et al. Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Systematic Review for the US Preventive Services Task Force. Agency for Healthcare Research and Quality (US); 2017; 296 pp).

Known factors that increase the likelihood of CF recovery (Mitchell AJ, Shiri-Feshki M. Temporal trends in the long term risk of progression of mild cognitive impairment: a pooled analysis. J Neurol Neurosurg Psychiatr. 2008; 79: 1386-91):

- the exclusion of the reversible cause of moderate CR (depression, the use of anticholinergics, etc.);

- absence (compensation) of risk factors for progressive dementia;

- reduced volume of the hippocampus according to MRI of the brain;

- high rates of cognitive tests.

Factors that increase the likelihood of progression of the KR include:

- the presence of acute brain damage;

- the presence of decompensated somatic diseases.

Risk factors (RF) for the development of CR (Alzheimer's disease and other dementia) are divided into non-modifiable and modifiable.

Unmodifiable FR:

- age;

- family history of this pathology;

- the presence of mutations in the genes of APP, presenilin 1,2, APOE. Modifiable DF (Al Haj Ahmad RM, Al-Domi HA Thinking about brain insulin resistance; Diabetes Metab Syndr. 2018 May 6.pii: SI871-4021; Patnode CD, Evans CV, Senger C A, Redmond N, Lin JS. Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2017 Jul ll; 318 (2): 175-193. doi: 10.1001 / jama.2017.3303.13]):

1. cardiovascular disorders (in particular, arterial hypertension as a leading risk factor);

2. level of education;

3. intellectual, physical and social activity.

The aging factor is superior to all other pathogenic factors. Human viability in the age range of 15-95 years falls catastrophically, and the risk of death increases progressively - more than 500 times (Krutko V.N. Systemic mechanisms and models of aging / V.N. Krutko, V.I. Dontsov; Ros. Acad. of Sciences, Institute of Systems, Analysis. - Moscow: URSS, 2007. -334 p .: ill .: 22 cm. - (Problems of gerontology; issue 5). - Bibliography: p. 328-335).

In 2017, WHO developed the Global Public Health Plan for Dementia for 2017-2025, which aims to improve the lives of people with dementia, their families, and reduce the damage from dementia. The main areas of work are raising awareness about the signs of dementia, reducing risk factors for its development (primarily arterial hypertension), improving the quality of diagnosis, especially in the early stages.

In recent years, interest in subjective, mild and moderate (non-cement) CR has grown. Data from epidemiological studies demonstrate a high prevalence of CF disorders both in the elderly (10-15%) and among older outpatients (up to 70%) (Starchina Yu.A., Zakharov V.V. Non-cement cognitive impairment: role neurometabolic therapy, Neurology and Psychiatry. 2017; 3: 46-56).

Mild cognitive impairment (RBM) progresses to dementia at a rate of about 10-15% per year. Moreover, adequate correction of vascular and metabolic risk factors often allows patients with RBM to remain in a stable state for a long time. The main role in the correction of the condition of such patients is played by neurometabolic therapy, since anti-dementia drugs have not yet shown effectiveness in mild forms of cognitive impairment (KN) (see above - Starchina Yu.A. et al., 2017).

Since dementia is currently incurable, the main attention must be paid to non-dementia (pre-dementia) indigenous people whose prevalence exceeds that of dementia. Non-cemented SC with adequate correction can not only be in a stable state for a long time, but also regress. KH are often combined with a number of somatic diseases, and in some conditions they can be the first and leading clinical syndrome.

In 1997, R. Petersen proposed the term and diagnostic criteria for moderate cognitive impairment syndrome (UKI), which is understood as the polyetiological syndrome of impaired memory and / or other CFs, which does not lead to social, domestic or professional maladaptation. At the same time, the patient or his relatives complain about the deterioration of CF. The indicators of neuropsychological tests in case of UKN are worse than the age norm, the patient is having difficulty mastering complex intellectual skills, but he does not have significant limitations in everyday activities (Starchina Yu.A. Non-cement cognitive impairment: a modern view of the problem. Neurology, neuropsychiatry, psychosomatics. 2017; 9 (2): 71-76; Petersen RC, Smith GE, Waring SC, Ivnik RJ, Kokmen E, Tangelos EG. Aging, memory, and mild cognitive impairment. Int Psychogeriatr 1997; 9 Suppl 1: 65-9) .

Diagnostics of non-contributing CN usually includes the collection and analysis of complaints and medical history of the patient, neuropsychological examination of CF, determining the degree of dependence of the patient in everyday life. The indicators of neuropsychological tests should be compared with the indicators of the reference group of people of similar age who do not complain of memory impairment, and ideally should be evaluated taking into account the level of education of the patient.

A serious problem is the analysis of mild CN in the case when patient complaints are not objectified by the results of a neuropsychological examination.

In some cases, lung KN or UKN can be the result of emotional disturbances or iatrogenism (side effect of drugs or polypharmacy). The main complaints in case of CN: memory impairment, forgetfulness and fatigue, difficulty concentrating, selecting the right words in a conversation, a “heavy head”, etc. With mild CN and sometimes with UKN, subjective symptoms of decreased CF are often difficult to distinguish from a decrease in memory performance in the elderly. Most often, the main symptom of VHF is memory loss (amnestic type), although some researchers have come to the conclusion that the most common are VHIs affecting several CFs at the same time, not only memory (Starchina Yu.A. Non-cement cognitive impairment: a modern view of the problem. Neurology, neuropsychiatry, psychosomatics. 2017; 9 (2): 71-76; Petersen RC, Smith GE, Waring SC, Ivnik RJ, Kokmen E, Tangelos EG. Aging, memory, and mild cognitive impairment. Int Psychogeriatr 1997; 9 Suppl 1: 65-9).

In case of UKN, the patient at the time of the examination may have slight difficulties that do not limit his independence in some areas compared to the previous period of life. It is sometimes difficult to distinguish between purely cognitive symptoms and the symptoms of the same patient due to sensory deprivation (loss of visual acuity or hearing). Depression is widespread in the elderly (approximately 15%) and is often accompanied by vague somatic symptoms, poor memory, anxiety and inability to concentrate. Such patients themselves usually do not confirm a reduced mood background, but at the same time complain of poor sleep, poor appetite, decreased ability to have fun (nothing pleases) and, accordingly, decreased motivation for action (Petersen RC, Smith GE, Waring SC, Ivnik RJ , Kokmen E, Tangelos EG. Aging, memory, and mild cognitive impairment. Int Psychogeriatr 1997; 9 Suppl 1: 65-9).

Elderly patients with cognitive complaints are screened for emotional disturbances using the Depression and Anxiety Scales (Beck Depression Scale, Hamilton Depression Scale, Spielberger Anxiety Scale, Hospital Depression and Anxiety Scale).

Neuropsychologically examine the memory that controls the frontal and other CF in comparison with age norms. In non-dementive CNs, in some cases, common screening scales for assessing CF (similar to the Brief scale for assessing mental status) may not be sensitive enough, therefore, for the diagnosis of VCI, it is recommended to use the Montreal scale for assessing cognitive functions (24. Petersen RC, Smith GE, Waring SC, Ivnik RJ , Kokmen E, Tangelos EG. Aging, memory, and mild cognitive impairment. Int Psychogeriatr 1997; 9 Suppl 1: 65-9).

When a neuropsychological examination of patients with mild CN is usually used, standard studies of individual CFs (speech, memory, attention, praxis, etc.) are used, but the main thing in determining the severity of CN is the assessment of patient autonomy in everyday life, the presence of problems of social, domestic and professional adaptation that can be identified in the course of communication with relatives of the patient. If there are severe difficulties, even in one of these areas, a diagnosis of dementia is made.

In a number of patients with complaints of deterioration of CF during neuropsychological tests, only certain symptoms of a violation of CF of a neurodynamic nature (bradyphrenia, difficulty concentrating and excessive distractibility, a decrease in the reaction rate, increased sensitivity to interfering influences) are detected, which, although they differ from the age norm, do not form a clear syndrome of UKN. Mild CNs are individual cognitive symptoms that appear in waves. They do not interfere in everyday life, even with the most complex professional and social activities, but at the same time they bother a person and are a decrease in cognitive abilities compared to the individual norm (Zakharov V.V. Evolution of cognitive deficit: mild and moderate cognitive impairment. Neurology , Neuropsychiatry, Psychosomatics. 2012: Volume 4, No. 2: 16-21; Huang JY, Hafez DM et al., Altered NEP2 expression and activity in mild cognitive impairment and Alzheimer's disease. Alzheimers Dis. 2012; T. 28: 433- 441).

Diagnostic criteria for lung pulmonary disease:

- The presence of changes in CF detected in clinical and neuropsychological studies.

- The possibility of complaints of decreased memory, attention, or mental performance expressed independently or with active interrogation of a doctor.

- Lack of SC according to the results of screening scales (the result of the Short scale for assessing mental status is not less than 28 points).

- Lack of disturbances in daily life activity.

- The absence of RBM syndrome and dementia (Yakhno N.N., Zakharov V.V., Lokshina A.B., Koberskaya N.N., Mkhitaryan E.A. Dementia. A guide for doctors. Third edition. Moscow. “MEDpress- inform. "2011; Yakhno NN Cognitive disorders in a neurological clinic. Neurological journal. 2006: T. 11; S1: 4-12).

In addition, if older people have complaints of impaired memory and other CFs, compared with an initially higher level of CF, you can determine the subjective decrease in cognitive functions (subjective CN).

In this case, however, objective confirmation of a decrease in CF using any neuropsychological tests is impossible. This problem may be significant for the patient, but is almost invisible to others. 43% of people aged 65 to 74 years reported subjective memory problems, while the prevalence of dementia in this age group was less than 2.5% (Starchina Yu.A., Zakharov V.V. Non-cement cognitive impairment: role neurometabolic therapy. Neurology and Psychiatry. 2017; 3: 46-56; Petersen RC, Smith GE, Waring SC, Ivnik RJ, Kokmen E, Tangelos EG. Aging, memory, and mild cognitive impairment. Int Psychogeriatr 1997; 9 Suppl 1: 65-9; Bassett SS, Folstein MF. Use of proxies to measure health and functional status in epidemiologic studies of community-dwelling women aged 65 years and older. Journal of geriatric psychiatry and neurology. 1993. 6 (2): 105-111 )

Subjective KN is a heterogeneous group of conditions that is difficult to study, including various variants of the norm, moderate psychological problems (depression), severe psychosocial stress in everyday life, and cases of an increased risk of dementia themselves. Subjective complaints of KN can sometimes be the cause of overdiagnosis of subjective KN, since cognitively saved people tend to overestimate cognitive problems, and patients with VHC and objective memory deficiency often underestimate them (Petersen RC, Smith GE, Waring SC, Ivnik RJ, Kokmen E , Tangelos EG. Aging, memory, and mild cognitive impairment. Int Psychogeriatr 1997; 9 Suppl 1: 65-9; Edmonds EC, Weigand AJ, Thomas KR, Eppig J, Delano-Wood L, Galasko DR, Salmon DP, Bondi MW Increasing Inaccuracy of Self-Reported Subjective Cognitive Complaints Over 24 Months in Empirically Derived Subtypes of Mild Cognitive Impairment. J Int Neuropsychol Soc. 2018 Sep; 24 (8): 842-853. PMID: 30278855).

At the same time, the opinion that subjective CNs are predictors of the earliest stages of cognitive decline and possible progression of CN to dementia begins to prevail. Evidence is emerging for the association of subjective CNs with biomarkers of Alzheimer's disease (AD) and neuroimaging markers (atrophy of the gray matter, hypometabolism, and deposition of beta-amyloid) in the absence of objective cognitive dysfunction or depression. Based on studies that consider subjective CVs as a risk factor for AD, the Diagnostic Criteria for Subjective CN Syndrome (2014) have been developed:

- complaints of persistent deterioration compared with the initial level of mental performance that arose for no apparent reason;

- the absence of deviations from the age norm according to cognitive tests used to diagnose AD and other dementing diseases with CN;

- lack of connection of cognitive complaints with an established diagnosis of neurological or psychiatric disease or intoxication (Petersen RC, Smith GE, Waring SC, Ivnik RJ, Kokmen E, Tangelos EG. Aging, memory, and mild cognitive impairment. Int Psychogeriatr 1997; 9 Suppl 1: 65-9; Jessen F, Amariglio RE, van Boxtel M, et al. (Subjective Cognitive Decline Initiative (SCD-I) Working Group.A conceptual framework for research on subjective cognitive decline in preclinical Alzheimers disease. Alzheimers Dement. 2014; Nov; ; 10 (6): 844-52).

Researchers noted the duration of cognitive stability of subjective KN syndrome (Starchina Yu.A. Non-cement cognitive impairment: a modern view of the problem. Neurology, neuropsychiatry, psychosomatics. 2017; 9 (2): 71-76; Petersen RC, Smith GE, Waring SC, Ivnik RJ, Kokmen E, Tangelos EG. Aging, memory, and mild cognitive impairment. Int Psychogeriatr 1997; 9 Suppl 1: 65-9).

et al, стресс и симптомы депрессии отмечались почти в два раза чаще у пациентов с субъективными КН в сравнении с пациентами с УКН, при этом положительные биомаркеры БА при субъективных КН встречались у 14,4%, а при УКН - у 35%, что свидетельствует о важности тщательной оценки эмоционального и психологического состояния пожилых пациентов с когнитивными жалобами (Старчина Ю.А., Захаров В.В. Недементные когнитивные нарушения: роль нейрометаболической терапии. Неврология и психиатрия. 2017; 3: 46-56; Edmonds ЕС, Delano-Wood L, Galasko DR, Salmon DP, Bondi MW. Subjective cognitive complaints contribute to misdiagnosis of mild cognitive impairment. J Int Neuropsychol Soc. 2014; Sep; 20(8): 836-47;

Berg Al, Nordlund A et al.High Prevalence of Stress and Low Prevalence of Alzheimer Disease CSF Biomarkers in a Clinical Sample with Subjective Cognitive Impairment. Dement Geriatr Cogn Disord. 2016; 42(l-2):93-105).The progression of subjective CN to the level of VCI occurs in approximately 9%, and before dementia in 5% of patients over six years. Predictors of progression are an initially low level of amyloid (β42 in cerebrospinal fluid and memory loss in the first two years of observation. The fact that 86% of patients remained cognitively stable over the entire observation period indicates the “good quality” of subjective CNs. According to

et al, stress and symptoms of depression were observed almost twice as often in patients with subjective KN as compared with patients with UKN, while positive biomarkers of BA in subjective KN were found in 14.4%, and in UKN - in 35%, which indicates the importance of a thorough assessment of the emotional and psychological state of elderly patients with cognitive complaints (Starchina Yu.A., Zakharov V.V. Non-cement cognitive impairment: the role of neurometabolic therapy. Neurology and Psychiatry. 2017; 3: 46-56; Edmonds EU, Delano- Wood L, Galasko DR, Salmon DP, Bondi MW. Subjective cognitive complaints contribute t o misdiagnosis of mild cognitive impairment. J Int Neuropsychol Soc. 2014; Sep; 20 (8): 836-47;

Berg Al, Nordlund A et al. High Prevalence of Stress and Low Prevalence of Alzheimer Disease CSF Biomarkers in a Clinical Sample with Subjective Cognitive Impairment. Dement Geriatr Cogn Disord. 2016; 42 (l-2): 93-105).

A known method for the correction of cognitive impairment in patients with arterial hypertension on the background of type 2 diabetes mellitus according to patent RU 2555334 C1, publ. 07/10/2015, in which, against the background of standard pharmacotherapy, the drug Kudesan is administered at a dosage of 60 mg per day for two months. The introduction of Kudesan in the specified dose and mode provides an effective correction of cognitive impairment in this group of patients, combined with an improvement in the function of the cardiovascular system and metabolic processes. However, this solution is only a special case of the correction of one of the specific pathologies, but cannot provide an integral effect on the violation of cognitive functions as such.

Known systems and methods for providing recommendations on the health, nutrition and / or well-being of animals according to the application WO 2016/005911 (publ. 14.01.2016). A method of obtaining recommendations on the nutrition, health and / or well-being of an animal includes collecting data on one or more of the parameters of the animal’s health, diet, behavior and environment. In this case, data is collected using a wearable sensor that is worn on the animal, and a location sensor, which is a stationary sensor located in the place that the animal visits. Store data in cloud data architectures; analyzing the data, which includes a processor that uses a filter to track the average value of one or more of the parameters of the health, diet, behavior and environment of the animal and the atypical deviation from the initial value of at least one parameter of one or more of the health parameters , diet, behavior and environment of the animal. Moreover, the analysis additionally includes a processor that determines whether the atypical deviation is a random event or a trend. Get the result of data analysis using the processor; calculating by the processor the level for the result and determining by the processor whether the level for the result is above or below the threshold value. Moreover, the definition encourages the development of recommendations on the nutrition, health and / or well-being of the animal. A recommendation on nutrition, health and / or well-being is selected from the group consisting of environmental changes; administering or discontinuing the administration of vitamins, supplements, or drugs; changes in nutrition / feeding; visits to the veterinarian and their combination. A non-volatile machine-readable medium is also provided comprising a code representing instructions to the processor on the process, the code including a code for receiving recommendations on the nutrition, health and / or well-being of the animal in accordance with the above method. The invention improves the performance of the system for collecting animal data, analyzing data and providing recommendations on the nutrition, health and / or well-being of the animal based on the analyzed data.

However, such systems and methods relate to animals, i.e. unsuitable for the analysis of cognitive impairment in a person from the point of view of him as an individual with highly developed cognitive mental functions, in particular, thinking.

Also known is the "Method for the correction of mental conditions and the treatment of neurotic disorders and pathological dependencies" Integral-synergistic psychotherapy "according to RU 2276999 C2, publ. 05/27/2006. The method consists of three cycles. At the same time, during the first analytical cycle, an anamnesis is collected, a psychodiagnostic study is carried out, the psychosomatic status is determined and the etiology of the pathological mental or psychosomatic disorder is established. Then carry out a study of mental heredity by establishing hereditary-birth factors for the occurrence of the disorder and the mechanisms of its formation in interpersonal family relationships. At the same time, an analysis of significant events and a comparative analysis are carried out with the patient recognizing causal relationships in the occurrence and formation of pathological conditions with destabilization of the stereotypes of his perception and response. After that, during the second personality-correctional cycle, taking into account the results of the analytical cycle, the formation of new personality traits is carried out, the type of thinking and stereotypes of response to the impact of the social environment are changed. At the end of the second cycle, an analysis of the ongoing changes is carried out with an assessment of the patient's life positions.

In the third communicative and correctional cycle, the patient’s relationship with his social environment is corrected. At the same time, an analysis of his relationships in the aspect of value orientations is carried out, and correction is carried out with the awareness of the mechanisms of the formation of the intragroup status of the patient and his associated “I-image”. The method expands the arsenal of psychotherapeutic means of influencing the patient, however, is rather narrow, since the correction of disorders is carried out only with the help of psiotherapeutic methods.

In general, the known systems and methods are not able to provide an integral self-diagnosis taking into account a set of parameters of various areas of the patient’s life that make up the optimal and convenient algorithm for self-diagnosis of SC for their timely correction.

A number of electronic information services of group and individual psychological assistance to clients are presented on the modern market, aimed at increasing individual effectiveness, changing the image, losing weight (overweight and obesity are an independent risk factor for cognitive dysfunction). However, they, as a rule, concern any one specific problem (for example, weight loss), but do not contain the characteristics of the self-diagnosis algorithm and the possibility of obtaining individual recommendations for a wide area of different CNs, especially at their early stages, taking into account the optimal set of factor indicators affecting the development of CN.

The invention is aimed at achieving such technical results as determining the technology of early self-diagnosis of CR for subsequent correction and preventing the progression of CR, taking into account a whole group of primary etiopathogenetic factors characteristic of a particular patient and, at the same time, integral, creating methods and tests for experimental studies on the presence of patients etiopathogenetic factors of violations of CF and software electronic service, allowing such research research, in particular, the service “Healthy Brain & Brain Health”, as well as the development of correction algorithms for the identified CN.

It should be noted that for the self-diagnosis of early SC, you can use not only this resource, but any suitable one-providing the ability to determine the set of those significant indicators for self-diagnosis, which are discussed below.

In the process of research, the authors of this invention established a statistically significant relationship between the presence of such indicators with a further increase in the degree of SC, and therefore, these indicators were highlighted as a necessary combination of them in self-diagnosis of CR and included in the work of the electronic service for the purpose of subsequent correction of detected CP .

The principle of issuing recommendations by the system is such that they generally correspond to detected violations, however, they relate to the specific personality of the patient with specific KN. So, recommendations can be given on the basis of the principles: the need to prevent intoxication and optimize detoxification of the body and bring (approximate) to the standard lifestyle, the nature of nutrition, sleep regulation, mode and / or intensity of physical activity and the use of cognitive training to maintain and improve CF.

Thus, to achieve the above technical results, this is proposed:

A method for improving identified cognitive impairment (CF), including:

obtaining the first data about the subject, the first data about the subject being the subject's answers to predetermined questions about at least one of: physical well-being, mental well-being, emotional well-being, professional life, level and sources of stress, satisfaction with aspects of life, physical activity, level of awareness, drug use;

obtaining second data about the subject, the second data about the subject being the results of the subject performing one or more predetermined intellectually realized tasks;

obtaining third data about the subject, and the third data about the subject are the physical conditions of the body and contain at least one of: pedometer data, tracking data for different types of physical activity, heart rate data for different types of physical activity and in the absence of such as blood pressure data, sleep data;

obtaining fourth data about the subject, the fourth data about the subject including data on the nutrition of the subject, the data on the nutrition of the subject being the results of the subject filling out a nutrition diary;

obtaining fifth data on a subject, the fifth data on a subject including the results of previously performed clinical and biochemical blood tests, the data on earlier performed clinical and biochemical analyzes being the results of filling in the appropriate forms with the subject;

intellectual analysis of the obtained first, second, third and fourth data about the subject by identifying correlation relationships between the various received data;

assessment based on the analysis, the probability of the subject having early cognitive impairment, the assessment is carried out by comparing with reference values and by comparing with previously obtained values in dynamics;

generation on the basis of the analysis and the obtained assessment of the subject's early cognitive impairment, recommendations for improving the subject's cognitive functions, including at least one of: maintaining a healthy lifestyle, correcting nutrition, working with stress, regulating sleep, changes in the regime and / or intensity of physical activity, prevention of intoxication and / or detoxification of the body, the use of cognitive training.

Optionally, the first data about the subject is obtained at a frequency selected from the group: once an hour, once a day, once a week, once a month, once every six months.

Optionally, one or more predefined tasks represent a game.

Optionally, obtaining second data about the subject is performed at a frequency selected from the group: once an hour, once a day, once a week, once a month, once every six months.

Optionally, obtaining third data about the subject is performed at a frequency selected from the group: once an hour, once a day, once a week, once a month, once every six months.

Optionally, a nutrition diary is filled out by the subject after each meal.

Optionally, obtaining data, mining data, evaluating the likelihood of the subject having early cognitive impairment, and generating recommendations for improving the cognitive function of the subject is carried out using at least one portable computing device.

Optionally, at least one portable computing device is selected from the group including: mobile phone, smartphone, laptop, tablet, wearable device, including an electronic watch, electronic bracelet, clothes with an integrated electronic device.

Optionally, obtaining third data about the subject is carried out using sensors located on the body of the subject.

Optionally, nutritional correction includes a change in at least one of: the dietary regimen, the amount of food consumed, the calorie content of the food, the ratio of BJU, and the use of dietary supplements.

Optionally, the regulation of sleep includes a change in at least one of: mode, duration of sleep, sleep conditions.

Optionally, cognitive training includes simulators and games for training at least one of: memory, attention, reaction speed, concentration, cognitive flexibility, increasing cognitive potential, increasing self-control, improving visual and auditory sensory inputs.

Optionally, recommendations for improving the subject’s cognitive functions include recommendations for consultation with a general practitioner or specialist medical specialist.

Optionally, the method further includes informing the subject of the alleged causes leading to his condition, and recommendations for performing certain studies.

This application also relates to a non-volatile machine-readable medium containing instructions that, when executed, instruct the processor to perform the method in any of the above aspects.

As such a medium, a computer-readable medium may be used, such as a physical memory with encoded or embedded machine-readable instructions. When such instructions are executed by the processor, they direct it to perform functions in accordance with the methods of the method in the above aspects. A computer-readable medium may include many separate storage devices. Such separate storage devices, optionally, may include storage devices locally installed in the computing system, storage devices installed outside the computing system, and storage devices distributed between the computing system and external device (s).

To understand the essence of the claimed group of inventions, a number of explanations are given below.

Before the development of a gross violation of CF (pre-dementia stage), a person goes through the stages of mild to moderate violation of CF (Alzheimer's Disease Facts and Figures. Alzheimer's Association, 2017).

At this stage, the patient himself notes a decrease in memory, increased fatigue, and some other points that may signal a change in CF. In case of mild (subjective) cognitive impairment, CF can remain within the age norm, but at the same time decrease compared to the initial (previous deterioration) individual level. It is at this stage that it is important to learn how to diagnose these changes on your own, since worldwide patients' referrals to doctors for mild CF disorders are extremely low, including due to certain social attitudes. Therefore, as a rule, the period of reversible disturbances and the period of most favorable conditions for slowing down the progression of the Kyrgyz Republic are missed. This leads to significant social and economic losses for individuals, their families, employers and the state as a whole.

This group of inventions combines psychophysiological and biomedical approaches to assessing the status of cognitive status, its potential at the stage of subjective and lung CR to restore CF in situations where this is possible, and to slow the progression of CR in other cases.

It is based on the principles of preventiveness and predictiveness - prevention and / or early detection of minimal SC.

In particular, the Brain Health Brain service developed by the authors is advisory in nature and is aimed at early self-diagnosis of minimal KH and the complex of primary imbalances in the body that led to them, and it also has the ability to formulate personal recommendations based on dynamic monitoring of socio- and anthropometric, clinical laboratory indicators and screening multimodal psychological and psychometric tests and carry out a number of corrective techniques for training CF in KN. The service program uses the following:

- online monitoring of the main systems of the body (in constant mode or upon request for an online assessment) for monitoring and dynamics of the state;

- online coaching (support) based on the developed individual program of achievements in improving cognitive status and optimizing indicators of basic biochemical constants.

To formulate online recommendations, the client is invited to conduct online / offline self-diagnostics with a certain (arbitrarily set) frequency, which will increase the accuracy and detail of the recommendations.

The proposed solution is consistent with the principles of personification, as has the ability to customize, including taking into account the rehabilitation needs and capabilities of each individual. The client has the opportunity to choose a correction program suitable for him (its filling).

The service is based on the application of a preventive approach within the framework of an actively developing area of fundamental and integrative medicine - “prevention of premature aging”.

The service offers testing and analysis of a number of CFs with the identification of probable etiopathogenetic factors (imbalances in the body) of the occurrence and progression of CN in the following areas:

1) main health biomarkers in the form of biochemical constants, anthropometric indicators, as well as a standard and / or individually selected set of laboratory tests;

2) nutritional status;

3) physical status;

4) lifestyle.

Further, depending on the identified violations, the client is offered dynamic support (Life-coaching), including, in particular, referral to a specialized specialist. Simultaneously with the solution of identified problems (imbalances), the client will be able to train and dynamically monitor their CFs.

Cognitive training provided by this electronic service includes virtual simulators and games for training at least one of: memory, attention, reaction speed, concentration, cognitive flexibility, increasing cognitive potential, increasing self-control, improving visual and auditory sensory inputs . It is possible to use virtual simulators of other computer systems or services.

First, the first patient data is obtained, for which the following questionnaire is used to assess the functional state. It allows you to identify functional disorders and the need for lifestyle changes. For each of the questions (except personal data), the patient must choose one of 5 possible answers, depending on how much this symptom was expressed in his last 2-3 months. Approximate time required to fill: 10-15 minutes.

* Required

E-mail address *

First and last name of the patient *

Date of Birth *

Gender * Male / Female

For each of the following paragraphs, you need to select an answer from 0 to 4.

How to choose the answer: 0 = I never have this symptom or almost never (for the specified period); 1 = It happens from time to time, expressed slightly / moderately; 2 = It happens from time to time, strongly expressed; 3 = It happens often, expressed slightly / moderately; 4 = It happens often, it is strongly expressed.

EP-01: fatigue, lethargy *

EP-02: apathy (indifference to what is happening), drowsiness *

EP-03: hyperactivity (excessive motor activity and excitability) *

EP-04: anxiety (it is impossible to find a place for yourself, calm down) *

EP-05: mood swings *

EP-06: anxiety, fear or nervousness *

EP-07: anger, irritability or aggressiveness *

EP-08: depressed mood *

EP-09: insomnia *

EP-10: memory loss (difficulty remembering or remembering information) *

EP-11: confusion, difficulty perception / understanding of what is happening *

EP-12: hard to concentrate *

EP-13: hard to make a decision *

EP-14: difficulties in learning, mastering new information * EP-15: frequent ailments (any) * NS-01: tinnitus, hearing loss *

NS-02: blurred or narrowed field of vision (except for myopia or farsightedness) *

NS-03: feeling fainting *

NS-04: dizziness *

NS-05: impaired coordination of movements *

NS-06: stuttering, stuttering during a conversation (which did not exist before) *

NS-07: slurred speech (others cannot understand me) *

NS-08: headache *

NS-09: hot flashes, hot flashes *

NS-10: excessive sweating *

NS-11: sensation of numbness, tingling, "goosebumps" (in any part of the body) *

NS-12: pain in the back, lower back, neck *

SL-01: a feeling of uneven rhythm or interruptions in the heart *

SL-02: rapid or strong heartbeat *

SL-03: chest pain *

SL-04: feeling of stuffiness in the chest *

SL-05: wheezing, cough with sputum discharge *

SL-06: shortness of breath (rapid breathing or shortness of breath) *

SL-07: shortness of breath *

SL-08: persistent cough or cough *

ZHKT-01: nausea or vomiting *

GIT-02: abdominal pain *

ZHKT-03: diarrhea *

ZhKT-04: constipation *

GIT-05: a feeling of bloating in the abdomen *

ZhKT-06: belching *

ZHKT-07: heartburn *

GIT-08: insatiable appetite / thirst *

ZhKT-09: craving for certain products *

GIT-10: overweight *

GIT-11: an obsessive desire to eat *

GIT-12: underweight *

GIT-13: decreased appetite *

ODS-01: sharp or dull joint pain *

ODS-02: swelling, redness of the joints *

ODS-03: stiffness or limitation of range of motion in joints *

ODS-04: muscle pain *

ODS-05: muscle weakness or fatigue *

KS-01: itching in the ears *

KS-02: ear pain, ear infection *

KS-03: discharge from the ear *

KS-04: lacrimation or itching of the eyes *

KS-05: swelling, redness, or clumping of the eyelids *

KS-06: bags or dark circles under the eyes *

KS-07: choking, desire to clear the throat *

KS-08: sore throat, hoarseness, loss of voice *

KS-09: swelling or discoloration of the tongue, gums or lips *

KS-10: painful sores in the oral cavity *

KS-11: nasal congestion *

KS-12: sinus problems *

KS-13: allergic rhinitis *

KS-14: excessive formation of mucus in the nose *

KS-15: sneezing attacks * KS-16: acne, acne *

KS-17: pruritus, rash, or dry skin *

KS-18: hair loss *

KS-19: swelling (of any part of the body) *

KS-20: rapid, sudden and / or painful urination *

KS-21: genital itching or discharge *

Other: Indicate a symptom that bothers you, but was not mentioned among the questions. Give it a score (from 2 to 4), where 2 = It happens from time to time, it is strongly expressed; 3 = It happens often, expressed slightly / moderately; 4 = It happens often, it is strongly expressed

The patient can receive an interpretation of the results and recommendations by e-mail.

A questionnaire is also used to assess the influence of lifestyle factors of the patient. The total filling time is 20 minutes.

After filling out the questionnaire for functional disorders, you need to find out why these disorders occurred. This questionnaire is designed to help in finding the answer to this question.

The patient is asked to fill out several questionnaires regarding the following lifestyle factors:

1) Stress.

2) Sleep.

3) Movement.

4) Toxins (harmful substances entering the body).

5) The presence of skills to maintain a healthy lifestyle.

6) Nutrition.

B.1 Having skills to maintain a healthy lifestyle

(response time - 5 minutes)

Studies show that those who can restore and maintain their health are happier and more successful in life. This questionnaire will help identify areas of life that you manage well and those that need your attention and efforts. It can be used as an assessment tool, as the patient takes care of himself. There are no right or wrong answers; some answers will have to be considered.

In responding, the patient evaluates his ability to take care of his needs.

Select an answer as follows:

0 - never

1 - rarely

2 - sometimes

3 - often

4 - regularly

5 - always.

The higher the score, the better the patient is able to take care of himself and his well-being in each of the listed aspects of life. You can bring more balance to life if you try to increase the score in this questionnaire.

Pay attention to questions for which an answer of 3 or less is given. How can behavior be changed to enhance self-care?

What goals can you set for yourself to change for the better?

B.2 Food (response time - 5 minutes)

Answer the following questions:

- measure waist

- Are there clearly unhealthy foods in the diet that can violate health?

- Are there enough healthy foods in the diet, the lack of which (the nutrients contained in them) can violate health?

- Are there any undesirable eating patterns (eating habits)?

B.2.1 Analysis of food and drink consumption

The average frequency of consumption of various products over the past 6-12 months (1 serving = approximately 50 g for table B.5 and 100 g for most products of tables B.7-B.9):

0 - less than 1 serving per month

1- 1-3 servings per month

2- 1 serving per week

3 - 2-4 servings per week; 4-5-6 servings per week.

5 - 1 serving per day

6 - 2-3 servings per day

7 - 4-5 servings per day

8 - 6+ servings per day

A total of 59 types of products.

B.2.2 Adverse eating habits

What types of eating habits of the following apply to you:

1) I eat fast

2) I have an unstable diet

3) I eat too much

4) I like to eat

5) I eat late at night

6) I eat because I have to

7) I do not like healthy ("healthy") food

8) I have a bad relationship with food

9) I don't have much time to eat

10) The theme of food for me is a field for fighting

11) I eat more than half of my meals outside the home

12) I eat under the influence of emotions (when sad, lonely, bored, with depression)

13) I travel often

14) I do not have access to useful products

15) I eat too much under stress

16) I do not plan my dishes or menu

17) I eat too little under stress

18) I eat what is convenient

19) I do not like to cook

20) I am unsuccessfully choosing food for snacks

21) I eat at night

22) Some of my loved ones do not like healthy (healthy) food

23) I can't figure out nutrition tips

24) I often go on a diet for weight loss

B.3 Stress (response time - 6 minutes)

This part of the questionnaire is designed to answer the following questions:

1) How pronounced are the subjective mental and physical manifestations of stress? Are there any signs of stress decompensation?

2) What are the most likely sources of stress? (by areas of life; by triggering factors)

3) What are the prerequisites and conditions for chronic stress and / or for resistance to stress?

B.3.1. The severity of subjective mental and physical manifestations of stress, the presence of signs of stress decompensation.

Do you feel too much stress in your life? Well no

Do you feel a significant decrease in vitality over the past year? Well no

Do you think stress reduces the quality of your life? Well no

Do you feel that you can easily cope with stress in life? Well no

B.3.1.1 Psychological stress scale PSM25 [43] (quantitatively describes the state of an adult 18-65 years old, experiencing psychological stress)

Please rate your condition over the past week using an 8-point scale. To do this, in the questionnaire, next to each statement, mark a number from 1 to 8, which most accurately determines your experiences. There are no wrong or wrong answers. Answer as sincerely as possible. It takes approximately five minutes to complete the test.

The numbers from 1 to 8 indicate the frequency of experiences:

1 - never; 2 - "extremely rare"; 3 - "very rare"; 4 - “rarely”; 5 - “sometimes”; 6 - “often”; 7 - "very often"; 8 - "constantly (daily)."

Processing and interpretation of the results. The sum of all answers is calculated - an integral indicator of mental tension (PPN). Question 14 is evaluated in reverse order. The more PPN, the higher the level of psychological stress.

PPN more than 155 points - a high level of stress, indicates a state of maladaptation and mental discomfort, the need to use a wide range of tools and methods to reduce neuropsychic tension, psychological stress, change the way of thinking and life.

PPN in the range of 154-100 points - the average level of stress.

Low stress level, PPN less than 100 points, indicates the state of psychological adaptation to workloads.

B.3.2 Assessment of daily stress sources

(on a scale of 1 to 10: 1 - minimum stress, 10 - maximum):

At work_

In family / personal life_

In the immediate environment (society) _

In finance_

In connection with health_

B.3.2.1 Satisfaction and change

This part of the questionnaire is divided into 2 questions: satisfaction with various aspects of life and change.

Use the scales to rate your satisfaction with various aspects of your life:

1 - not satisfied (a) with the current situation or level of health;

2 - low level of satisfaction with the current situation or level of health;

3 - satisfied (a) with the average current situation or level of health;

4 - generally satisfied (a) with the current situation or level of health;

5 - completely satisfied (a) with the current situation or level of health.

B3.3 Prerequisites and conditions for chronic stress

Current stress can be determined by those factors that have accumulated throughout life. Indicate which factors apply to you:

- Injuries in childhood (psychological, physical), dysfunctional family situation in childhood

- Perfectionism (increased criticality to oneself and others)

- Divorce or abrupt change in relationship

- Caring for a sick family member

- Problems with work or career

- Disease - acute or chronic

- Diets: constant attempts to lose weight through diets

- menopause

- You have been abused, been a victim of a crime, or suffered a serious injury

What are the prerequisites for resistance to stress?

Yes? Well no

Do you feel the meaning and purpose in your life? Well no

Do you like the business you are doing? Well no

Have you had big losses in your life? Well no

B.4 Sleep (response time -1-2 minutes)

Answer the following questions:

1) Is there enough sleep in quantity?

How many hours a day do you sleep on average: more than 10 / 8-10 / 6-8 / less than 6 (optimally 6-8; less than 6 hours is not enough, more than 10 hours is a sign of trouble, possibly adrenal insufficiency; depression; chronic syndrome fatigue, etc.)

2) Is sleep satisfactory in quality?

Do you have trouble falling asleep? Well no

Do you have insomnia (frequent waking up during the night)? Well no

Do you wake up rested? Well no

Do you have to take sleeping pills? (no / rarely / regularly)

3) Does the quality of sleep affect functioning throughout the day?

On mood, energy level or relationship? No / sometimes / regularly

On the ability to concentrate, on productivity and vigor? No / sometimes / regularly

Do you have drowsiness during the day? No / sometimes / regularly

4) What are the possible causes of sleep quality problems associated with lifestyle?

How often do you have to work the night shift or significantly change the time you go to bed? (Never / less than 1 time per week / 1-3 times per week)

What time do you usually go to bed? (optimally until 23 hours; worse than 23-24 hours; bad after midnight)

What time do you usually get up? (optimally up to 7 hours; worse than 7-9 hours; poorly after 9 hours)

How long before sleep do you usually have your last meal? (optimally 2-3 hours, worse 1-2, poorly less than 1 hour)

Do you take alcohol before bedtime? (never / sometimes / regularly)

What is the last time you drink coffee / caffeinated drink (strong tea, energy drinks)? (I do not drink at all / more than 12 hours before bedtime / less than 12 hours before bedtime)

How long before going to bed do you usually stop working at a computer / watching TV / using a phone (social networks, etc.)? (more than 1 h / 30-60 minutes / less than 30 minutes)

Is there any lighting in the bedroom during your sleep? (no / a little light comes from the street / the light is on or the TV in the room is turned on)

Do you ventilate the room before going to bed? Well no

Do you perform regular moderate exercise or exercise? Yes / No Stress can also negatively affect sleep; it was rated higher (table B. 10).

B.5 Movement, physical activity (FA) (response time - 1.5 minutes)

To answer the question: is there enough movement / physical activity in a person’s lifestyle, a short international questionnaire can help to determine physical activity (table B. 12).

The questionnaire is based on FA accounting over the past week. Identifies individuals with physical inactivity. Please recall your physical activity over the past week and answer 7 questions:

B.5.1 Hypodynamia

Based on the scoring, the presence of signs of physical inactivity in a patient is determined (Table B. 13).

Identification of moderate activity criteria (low / moderate physical activity border):

1) identify how many hours / minutes per day / week of intense physical activity (at least 10 minutes at a time; accompanied by sweating and / or rapid breathing and may include weight lifting, digging, running, etc., aerobic exercise, fast a ride on the bicycle);

2) to determine how many hours / minutes per day / week of average intense physical activity (at least 10 minutes at a time; accompanied by a small increase in breathing compared to a state of rest, may include carrying small loads, cycling at an average speed, playing calmly in tennis);

3) to identify how many hours / minutes per day / week of easy physical activity (walking at an average pace);

4) estimate how many hours a day / week a person sits / lies (except for sleep) - this time includes sitting at work, at home, at a party, in transport / driving, watching TV.

B5.2 High Intensity Interval Training (HIIT)

Note: the questionnaire does not take into account the use of high-intensity interval loads as a way to fill the body's need for movement, as well as articular gymnastics, stretch marks and balance exercises - which are also very useful.

HIIT provides a much more effective reduction in overweight (6–9 times) with less time (2 times) and, interestingly, calories (2 times) compared to cardio loads.

HIIT mode is achieved at 80% heart rate max (heart rate max = 207- (0.7 * age, years); for a 45-year-old person, this is 0.8 * (207- (0.7 * 45)) = 140 beats / min.

HIIT should be carried out for 10-15 minutes 2-3 times a week, not more often; total duration per week - 20-45 minutes.

Therefore, additional questions are asked:

1) Do you do high-intensity interval training (HIIT) or metabolic training? Well no

Accounting: for “yes” - add 7 points

2) Do you do joint gymnastics and / or do stretching exercises? No / sometimes / regularly; accounting: 0/3/5 points

B6. Toxins (response time - 2 minutes)

Answer the following questions:

1) How pronounced is the effect on a person of the most common toxins associated with a person’s personal choice (smoking, alcohol)? Smoking:

- Do you currently smoke? Well no

- Are you regularly exposed to secondhand smoke? Well no

- Have you smoked before on a regular basis? Well no

- How to consider: consider as an active factor in the answer “yes” to questions 1 or 2

Alcohol:

- Do you drink alcohol more than 1 glass of wine per week? Well no

“Have you been told that you should reduce your drinking?” Well no

- Do you get annoyed with questions about how much alcohol you drink? Well no

- Do you have any guilt about drinking alcohol? Well no

- Do you have increased resistance to alcohol? Well no

- Did you have such a way that you did not remember what happened on the eve of drinking alcohol? Well no

- Have you had any quarrels or fights after drinking alcohol? Well no

- Have you ever thought about asking for help in refusing alcohol? Well no

Counting rules: each answer “yes” - +1 point; consider as a significant factor in the amount of points> = 2; consider as a likely cause of chronic functional impairment with a score of> = 3.

2) How likely is the toxic effect in humans of commonly used drugs?

Do you take the following groups of drugs on a regular basis (at least 1 time per week):

painkillers / antipyretics yes / no steroid hormones yes / no, hormonal contraceptives yes / no,

heartburn medications (proton pump inhibitors) yes / no, cholesterol lowering agents (statins) yes / no

How many antibiotic courses have you taken in the last 10 years? More than 2 / 1-2 / did not accept

You have dental fillings with amalgam (“silver”) yes / no / don't know

3) How likely is exposure to common toxins used in industry and agriculture?

Do you visit places where crop protection products are sprayed (pesticides / herbicides)?

Yes, regularly / yes, sometimes / no

Do you use pesticides in your summer cottage? Yes, regularly / yes, sometimes / no

Do you come in contact with varnishes, paints, organic solvents, cleaning products, furniture, floor coverings? Well no

Do you work in the field of construction or repair? Well no

Do you live or work near sources of industrial pollution (for example, a highway, factory, incinerator, gas station, power plant, etc.)? Well no

Are you exposed to combustion products (smoke) from food / wood burning or plastic / car exhaust? Yes, regularly / yes, sometimes / no

Do you live or work near sources of electromagnetic radiation (for example, cell towers, high-voltage power lines, other unknown objects)? Yes / no / don't know

Do you have contact at home or at work with stoves / other devices that use wood, propane or petroleum products? Well no

 Do you regularly walk / run / bike along busy streets? Well no

4) How likely is exposure to toxic substances in household items (cosmetics, household chemicals, etc.)?

Do you apply cosmetics (make-up, creams, lotions, deodorants, etc.) to your skin?

Yes, regularly / yes, sometimes / no

Do you use household chemicals in the household (detergents, disinfectants, insecticides)? Well no

Do you give dry cleaning? Well no

Do you come in contact with detergents, cleaners, disinfectants, hands, air fresheners, scented candles and other scented products at home or at work? Yes / rarely / no

5) How likely is exposure to biological toxins?

Do you have hypersensitivity or intolerance to certain foods? Yes / no / don't know

Do you live or once lived in a damp room or were exposed to mold? Yes / no / don't know

Do you have an allergy to any environmental factors (tree pollen, house dust, animals, pungent odors, etc.)? Yes / no / I don’t know.

In the study of CF, methods of prospective and single-profile screening are also often used: a test for counting, a test for memorizing words, a Stroop test - a method for verbal-digital interference, a Luscher test, a clock drawing test, a MIS method - a self-relation research technique, psychometric techniques - progressive Ravena matrices , Bourdon test, Luria test, excess exclusion test, Mini-Cog screening test, stress psychodiagnostic screening methods, assessment of psychological and emotional stability using Beck scales for amootsenki depression and anxiety.

These tests or their acceptable modifications can also be used in the proposed method, since their validity for identifying relevant features or violations is well known and proven.

As part of the creation of the service, we set the task of evaluating the following CFs: memory, attention, speed of response, analysis and synthesis of incoming information, the ability to generalize, identify similarities and differences, build logical conclusions, perception, concentration, clarity of thought, focus, emotional state. Accordingly, suitable known tests can be involved in their evaluation, which can be entered into the electronic service used.

The need to optimize a set that includes precisely these test characteristics is associated with the need to simultaneously objectify the assessment of cognitive status and significantly reduce testing time, taking into account the SMART approach and the difficulty of achieving client compliance.

In addition to the possibility of using the mentioned well-known tests, we propose to use our own algorithm (see Fig. 1-9) of the self-diagnosis of CF based on a selected set of tested parameters. However, only the principle of selecting tests is important - so that they allow an assessment of the mentioned CFs, an exhaustive list of considered evaluation factors.

Moreover, in figures 1-9 illustrated:

FIG. 1. The scheme of the algorithm of the tests for self-diagnosis of cognitive functions (memory score, words).

FIG. 2. The scheme of the algorithm of the tests for self-diagnosis of cognitive functions (memory score, pictures).

FIG. 3. The scheme of the algorithm of the tests for self-diagnosis of cognitive functions (memory score, numbers).

FIG. 4. Scheme of the algorithm of the tests for self-diagnosis of cognitive functions (Attention assessment).

FIG. 5. The scheme of the algorithm of the tests for self-diagnosis of cognitive functions (Assessment of thinking, exclude unnecessary).

FIG. 6. The scheme of the algorithm of the tests for self-diagnosis of cognitive functions (Assessment of thinking, the allocation of essential features).

FIG. 7. Scheme of the algorithm for identifying "deficits" based on data entered by the client

FIG. 8. The scheme of the algorithm for generating recommendations based on identified deficits.

FIG. 9. The scheme of the algorithm of the service "Healthy Brain & Brain Health".

So, the client part of our service is developed in the form of 7 mini-games implemented in JavaScript (with the possibility of using any js-frameworks).

After user authorization, it is possible to launch a specific game or start a game cycle (play all games in order). At the end of the game, earned points are stored in a database (DB). You can hide points from the player and the ability to visualize the dynamics of test scores.

For the server side, it is possible to use PHP with MySQL or any convenient framework. For self-control by users of cognitive status, the dynamics of its changes and training, a web application has been developed, which is a web site that provides the general information content of the project and the interactive part, which is transferred to the user's personal account.

The web application has the following features:

- registration and authorization of users;

- input, storage and analysis of data received from users of the service, including anonymized general medical data and other parameters, the changes of which the user wants to track;

- interpretation of the result of data analysis, construction of dynamic graphs based on the data obtained.

When starting a web application in the browser, a start window appears (Fig. 11).

The menu contains the main items:

1) About the project - containing the information page of the site about the project.

2) Agreements - information page with user agreements.

3) Registration - registration of a new user of the service.

4) Login - entrance to the personal account of a registered user.

In the user's personal account for testing and training the brain, the system develops online games that affect memory, attention and allow you to evaluate the work of thinking. Below on the monitor is the main window with simulator games (Fig. 12).

Simulator games are divided into three groups:

1) Memory score.

2) Assessment of attention.

3) Assessment of thinking.

Each group contains several games in this category.

Memory rating

1) Three words.

The user is invited to remember three words that open one after another with a three-second interval (Fig. 13).

Next, the user is given the opportunity to mark the memorized words from a set of 9 elements (Fig. 14).

The number of points and the time taken to complete the task are calculated.

So, in the first module they study the memorization of three words from a row:

- Subject (station, briefcase, book, scarf, drink, table, bed, wagon, etc.)

- A process or concept (responsibility, reason, education, program, question, order, law, etc.)

- Object (pensioner, welder, woman, writer, tax officer, comrade, cat, adjuster, etc.)

3 cards open and close sequentially (one word on each) for 3 seconds. each one.

A level below opens another 9 cards (3 × 3) in random order containing 3 of the above cards. The countdown is 10 seconds, during which 3 preset cards must be noted. After the time elapses, the delay is counted. With the right answer, an incentive is given in the form of a sound of applause and animation.

Assessment: correct repetition (all three words are remembered - 3 points, two words - 2 points, 1 word - 1 point, 0 words - 0 points).

2) Remembering three images (images) from a row:

- Subject (station, briefcase, book, scarf, drink, table, bed, wagon, etc.)

- Animal (responsibility, mind, education, program, question, order, law, etc.)

- Object (pensioner, welder, woman, writer, tax officer, comrade, cat, adjuster, etc.)

3 picture cards open and close sequentially (each one has a specific image) for 3 seconds. each (Fig. 15).

The level below opens another 9 cards-pictures (3 × 3) in random order, containing 3 specified above cards (Fig. 16). The countdown is 10 seconds, during which 3 preset cards must be noted. After the time elapses, the delay is counted. With the right answer, an incentive is given in the form of a sound of applause and animation.

Assessment: correctness of repetition (all three words - 3 points, two words - 2 points, 1 word - 1 point, 0 words - 0 points).

3) Remembering six numbers:

At the same time, 6 cards are opened with random numbers from 1 to 99 for 10 seconds. (Fig. 17). Counting down.

A level below opens cards with blank values for input (Fig. 18). Countdown - 20 sec. After the time is over, delay seconds are counted, for another 20 seconds. With the right answer, an incentive is given in the form of a sound of applause and animation.

Assessment: correctness of repetition and sequence (6 numbers in the correct sequence - 3 points, 5-6 numbers in the wrong sequence - 2 points, 4 or less numbers with a sequence violation - 1 point, inability to repeat the given numbers - 0 points).

Block rating:

- Excellent - 8-9 points + time-honored

- Good - 5-7 points + time-honored

- Not very good - below 5 points and going beyond the time frame. The second module includes an assessment of attention:

1) Test “Drumsticks”.

An animation of a drum with drum sticks is presented on the screen.

One stick knocks on the drum, the second with a click (click) the user answers.

A total of 6 rounds of the game are provided, during which the game randomly sets the number of drum beats (1, 2 or 3) and the drum hits are expected from the user (Fig. 19).

Countdown after computer 5 seconds. With the right answer, an incentive is given in the form of a sound of applause and animation.

The following conditions may be specified, for example, but not limited to:

a) 1 hit / sound of the program - 3 hits (click, click) of the user,

b) 2 beats / sound signals of the program - 1 beat (pressing) of the user,

c) 3 beats / sound signals of the program - 2 beats (clicks) of the user, etc.

Score: 6-5 correct answers - 3 points, 4-3 - 2 points, 1-2 - 1 point, 0 correct answers - 0 points.

2) "Remember and play."

At the first stage of the game, the user is presented with 6 cards with animals with a random “orientation in space”: up, down, left, right (Fig. 20).

The set of pictures and the direction of the head for each new task are set randomly.

6 random picture cards are opened (for example, a snail, zebra, fish, snake, crab, chicken, elephant, butterfly) with a head position in one of four directions for 10 sec. Then the pictures are hidden.

Next, you need to arrange the pictures in alphabetical order and indicate the correct direction of the creature’s head. To rotate a picture, click on it. To move - drag with the mouse. There is no time limit.

The number of points and the time taken to complete the task is calculated.

Score: 6-5 correct answers - 3 points, 4-3 - 2 points, 1-2 - 1 point, 0 - 0.

Verification of the result is made with respect to the correct positioning in alphabetical order and the correct position of the head.

Correct answers are highlighted (framing) in green, wrong answers are highlighted (framing) in red and sway.

The block is also evaluated:

- Great - 5-6 points

- Average - 4-3 points

- Not very good - below 3 points.

The third module includes an assessment of thinking:

1) "Exclude unnecessary."

4 random sets of five words in random order are displayed on the screen (Fig. 21). The user selects the superfluous in meaning and throws them (by clicking the mouse) into the basket at the bottom of the screen.

There is a countdown of 20 seconds, after which the result is automatically accepted, or the "Confirm" button interrupts the countdown and ends the task.

Examples of word sets (extra highlighted):

- decrepit, old, worn, small, dilapidated,

- heroic, brave, fearless, fierce, decisive,

- Sergey, Stepan, Oleg, Petrov, Alexander,

- milk, yogurt, cottage cheese, cheese, lard,

- soon, quickly, in a hurry, little by little, hastily,

- deep, wide, light, low, long,

- leaf, bud, bark, tree, branch,

- house, barn, hut, hut, building,

- alder, aspen, tree, fir, poplar,

- dark, light, long, clear, dull,

- anthill, nest, burrow, calf, lair,

- failure, collapse, failure, loss, anxiety.

Etc. (Psychological Stress Scale PSM25 https://lektsii.org/15-50125.html).

Score: 4 correct words in the basket - 3 points, 3-2-2 points, 1-1 point, 0-0 points.

2) "The selection of essential features."

2 random sets of words are displayed in sequence. The key word on the left (highlighted in bold and color) and five keyword keywords (in random order) on the right (Fig. 22). The user selects several essential features (2-4). Countdown - 15 seconds, after which the result is automatically accepted, or the “Confirm” button interrupts the countdown and completes the task.

Examples of words:

Garden (plants, gardener, dog, fence, land)

Barn (hayloft, horses, roof, cattle, walls)

Division (class, dividend, pencil, divider, paper)

Ring (diameter, diamond, fineness, roundness, seal)

Game (cards, players, fines, penalties, rules)

Cube (corners, drawing, side, stone, wood)

River (shore, fish, fisherman, tina, water)

Reading (eyes, book, picture, print, word) (Psychological stress scale PSM25 https://lektsii.org/15-50125.html).

Rating:

- correctly indicated all the words in the sets - 3 points,

- did not indicate an additional 1-2 words (correct) in the sets - 2 points,

- indicated incorrect words and did not additionally indicate up to 2 words (correct) - 1 point,

- indicated incorrect words and did not indicate more than 2 correct words - 0 points,

Block rating:

- Great - 5-6 points

- Medium - 4-3 points

- Not very good - below 3 points.

The data of the results of user game sessions on simulators is stored in a database in relation to the user ID and time. Work is underway to improve the visual reflection of the dynamics of results over time, so that the user can visualize the quality and dynamics of the "brain work" during the games. Such simple game tasks allow us to identify the initial stage of emerging systemic changes in the main CFs and the dynamics of their changes.

It should be noted that the specified score, as well as the presentation of any specific tests, is not critical - other tests can be given to evaluate these indicators of CF, and their other assessment, for the convenience of the user, in a different point expression. The principle itself is important as such to maintain the regularity of calculations.

This program offers the user to pass this game testing daily with the "accumulation" of indicators in the database. If there is a persistent low level (for example, after a predetermined period - more than 7 days) or if any tested functions worsen for more than 7 days, the program prompts the user to pay attention to this and offers diagnostics and (if necessary) correction of lifestyle, nutrition, sleep, exercise, laboratory diagnostics of the main conditions leading to minimal cognitive dysfunction (to detect anemia, hypothyroidism, deficiencies of B vitamins, vitamin D, magnesium, etc.).

During the implementation of the recommendations, regular game testing is carried out on a reminder of the service or on their own.

The method also uses a questionnaire for measuring awareness, containing 5 independently developed scales for measuring 5 aspects of awareness:

observation skill

skill to describe the experience,

act with awareness

Invalid attitude to one’s inner experience, unreacting attitude to one’s own experience.

“Read the statement and note its fairness for you using the following scale: 1 - never or very rarely true; 2 - true rarely; 3 - sometimes true; 4 - more often true; 5 - almost always true.

While walking, I specifically focus on the sensations of my moving body.

Without difficulty, I look for words that describe my feelings.

I always scold myself when I am experiencing irrational or inappropriate emotions.

I celebrate my emotions, but do not respond to them.

If I do something, I often think about something else and therefore get distracted.

While taking a bath or washing in the shower, I carefully feel the water on my body.

I can easily formulate my views and positions in words.

I do not pay attention to what I am doing, as I fantasize, worry or be distracted by something else.

I monitor my feelings without diving into them.

I assure myself that I should not experience what I am experiencing.

I notice the effect of food and drink on my thoughts, feelings of my body and my emotions. It’s hard for me to find words to describe what I think. I am free to be distracted.

I consider my individual thoughts to be unnatural or disgusting, and I think that I should not think so.

I pay attention to the physical sensations arising from a blow of wind in my hair or a ray of sunshine on my face.

I feel difficulties finding the right words to explain what I am experiencing for one reason or another.

I rate my thoughts: whether they are bad or good.

I find it difficult to focus on what is happening at the moment.

If I feel discomfort, frustration (stress) due to some picture or thought that has arisen in my head, I take a “step back” and become aware of this thought or picture without allowing them to possess me.

I notice sounds, such as the ticking of a clock, the singing of birds, the sound of a passing car.

In difficult cases, I can take a “time out” and not respond immediately.

If I experience a sensation in the body, it is difficult for me to describe it, since I cannot find the right words.

It’s as if I’m working “on autopilot,” without recognizing what I’m really doing.

When depressing thoughts or pictures come into my head, then I quickly calm down.

I say to myself: "I dare not think as I think."

I smell the fragrances and smells of things around me.

Even if I'm very upset, I can find words to describe my condition.

I rush from class to class, especially not paying attention to them.

If thoughts or pictures appearing in my head depress me, I can, without reacting, simply mark them.

I believe that some of my emotions are inappropriate, and I should not have experienced them.

I observe visual elements in art and nature, for example: color, shape, texture, the play of light and shadow.

I have a natural desire to put my feelings into words.

If thoughts or pictures appearing in my head upset me, I mark them and just let them go.

I do things “automatically,” not being sure about what I am doing.

If thoughts or pictures appearing in my head upset me, I imagine whether I am good or bad, depending on what thoughts or pictures appeared in my head.

I notice how my emotions affect my thoughts and behavior.

As a rule, I can describe in detail how I feel at the moment.

I notice that I am doing something without focusing on it.

“I scold myself when irrational thoughts come to my mind.”

Scoring:

Items marked R are counted in reverse order (1 = 5, 2 = 4, 4 = 2, 5 = 1)

Observation skill scale: 1, 6, 11, 15, 20, 26, 31, 36

Experience Description Skill Scale: 2, 7, 12R, 16R, 22R, 27, 32, 37

Awareness scale with awareness: 5R, 8R, 13R, 18R, 23R, 28R, 34R, 38R

Scale of an unappraised attitude to one’s inner experience: 3R, 10R, 14R, 17R, 25R, 30R, 35R, 39R

The scale of non-responsive attitude to your experience: 4, 9, 19, 21, 24, 29, 33

The Mindful Attention Awareness Scale (MAAS) rating scale is used for self-assessment by subjects. The scale is used to evaluate the results of mindfulness meditation skills in scientific research and has successfully established itself. The test takes less than 10 minutes of time.

The questionnaire consists of 15 points, evaluated on a scale of 1 - almost always, to 6 - almost never. Only one parameter is evaluated - awareness in everyday life. It is used for self-assessment by subjects and therefore subject to all the shortcomings of self-assessment methods. The scale has been repeatedly used to evaluate the results of the training of mindfulness meditation in scientific research (in relation to college students, workers, cancer patients) and has successfully established itself. The test takes about 10 minutes of time.

Application Guide:

The following are statements about everyday life. Applying a scale of 1 to 6 points, you need to evaluate how often or rarely something similar happens to you. Each question must be answered separately.

Ratings (in points):

1 = Almost always

2 = often enough

3 = Often

4 = Rarely enough

5 = Very rare

6 = Almost never

Questions:

It happens that I feel emotion, but I realize it only after some time.

I drop or break things out of recklessness, or inattention, or because my thoughts think of something else.

I feel that it’s hard for me to focus on what is happening at this moment.

I have a habit of going somewhere swiftly, without noticing what is happening around, or what happens on the way.

I do not pay attention to the symptoms of physical stress or discomfort until they become very pronounced.

Almost always, I forget the name of the person who is told to me during the first meeting.

I often act in an automatic manner, not realizing what I really do.

The majority of classes I practice without really focusing.

I focus so much on goals that I often lose touch with what I'm doing at the moment to achieve them.

I do my work automatically, without focusing much on it.

I had to listen to people in half, while at the same time doing something else.

Sometimes I find myself in different places, not knowing why and how I ended up there.

I worry about the future or the past.

Sometimes I do something without understanding what I am doing and why.

Sometimes I eat without realizing that I absorb food.

Evaluation of the results:

The level of your awareness in everyday life is assessed. To evaluate, you need to summarize the answers for each item. The higher the amount, the more conscious you are in everyday life.

Since the application is an information service, it also provides recommendations for seeking medical help if it detects that the indicators determined during self-diagnostics have exceeded the normative (reference) values (based on survey results and other data entered by the client into the system, for example, physiological and biochemical parameters) to explain changes. Thus, the assessment of CF is carried out in dynamics.

Since the causes of functional changes in the brain are multifactorial, and in most cases, when they are eliminated, the severity of functional disorders decreases, the most complete knowledge of these factors is necessary.

The proposed solution allows a person to independently identify their presence at home and timely control.

Thus, systemic biomarkers of health are known, the violation of the levels of which lead to premature aging, worsening the cognitive status of a person:

- basic universal biomarkers (holotranscobalamin, ferritin, TSH, IGF-1, vitamin 25 (OH) D, glycated hemoglobin, interleukin-6, ferritin, ALT, ultra-sensitive C-reactive protein, HOMA-IR insulin resistance index, uric acid;

- biomarkers for assessing the state of the antioxidant system (coenzyme Q10, vitamins A, E, K, beta-carotene),

- biomarkers of oxidative stress (glutathione, selenium, zinc, copper, manganese, malondialdehyde, 8-OH-deoxyguanosine),

- biomarkers of stress level (cortisol, DHEA),

- biomarkers of systemic inflammation (C-reactive protein, ultra-sensitive, omega-3 index),

- biomarkers of the usefulness of the intake and assimilation of nutrients (organic acids),

- biomerkers of the development of cardiovascular diseases (homocysteine, sex hormone binding globulin, testosterone, insulin, vitamin E, fibrinogen, coenzyme Q10, total cholesterol and its fractions, triglycerides).

In addition, vitamins and microelements, being cofactors and activators of enzymes or regulators at the transcription level, also play an important role in the implementation of metabolic processes and physiological functions of the body.

So, the symptoms of iodine deficiency associated with the central nervous system are: fatigue, lethargy, decreased IQ, memory and concentration, speech impairment, a feeling of being broken in the morning, increased irritability, psychological and emotional problems, difficulties in social adaptation, deviant behavior, work dysfunction thyroid gland, impaired synthesis of thyroxine and triiodothyronine, thyroid hormone conversion, deregulation of deiodinases, impaired redox processes, protein synthesis, which leads to a separate pathogenetic pathway of cognitive impairment.

Iron deficiency is the most common nutrient deficiency in the world. Iron is necessary for the normal formation of hemoglobin. As a result of anemia, the main function of red blood cells is disrupted - oxygen delivery to tissues, tissue respiratory enzymes work inefficiently. Also, iron is an indispensable element for the development of the child’s nervous system and the improvement of CF in the adult brain.

Iron deficiency leads to impaired myelination of nerve fibers, since the genes that are activated by iron control myelination. Its deficiency leads to disruption of the neural networks of the hippocampus. Memory quality and playback speed suffer.

Various cognitive impairments are also known with a deficiency of vitamin D, which is a neurosteroid, as well as magnesium, which is actively involved in energy, plastic and electrolyte types of metabolism, magnesium deficiency occurs under various stresses.

Hormones also actively affect CF. Progesterone inhibits apoptosis of nerve cells and induces neurogenesis (Reddy D, 2010).

Estrogens increase resistance to stress, slow down neurodegeneration, have antioxidant and anxiolytic effects.

Thyroid hormones are one of the fundamental in ensuring the vital functions of the whole organism:

- intensify the transport of amino acids into the cell,

- regulate the activity of Na | K-ATPase,

- regulate the activity and number of mitochondria,

- regulate the transcription of genes and the synthesis of a specific set of proteins,

- regulate the metabolism of carbohydrates (including the work of the Krebs cycle), lipid metabolism,

- regulate the activity of steroid hormone biosynthesis enzymes.

Hypothyroidism reduces iron absorption. With iron deficiency, the activity of deiodinase decreases, converting inactive T ₄ into active T ₃ . Hypothyroidism suppresses hematopoiesis and is associated with a deficiency of group B vitamins. Each of these factors is a link that enhances and forms disorders in the cognitive sphere.

In addition, normal insulin levels and normal insulin receptor sensitivity are a prerequisite for the effective functioning of neurons. It has been proven that brain cells express insulin receptors (mainly in synapses). Brain neurons themselves are capable of synthesizing insulin. Slowing down of insulin transport is noted with aging, obesity, prolonged fasting. With age, the expression of insulin receptors decreases and the concentration of insulin in the cerebrospinal fluid decreases.

Of particular importance in the prevention of AD and other types of dementia is the prevention of peripheral and central insulin resistance. Self-diagnosis of insulin resistance is very simple. Measure your waist. An increase in its volume above 80 cm in women and 90 cm in men gives a serious reason to suspect the presence of insulin resistance. And in the presence of excess weight, insulin resistance is a constant companion.

Statistical studies conducted by the authors on groups of patients with mild and moderate CNs revealed possible etiopathogenetic factors for the occurrence of CNs, the so-called "Imbalances of the body" in the following specific areas:

- basic health biomarkers, biochemical constants (anthropometric indicators, as well as a set of laboratory tests);

- nutritional status;

- physical status;

- Lifestyle.

Their assessment is also included in the proposed self-diagnosis algorithm for SC:

1) An imbalance of the main biomarkers of health, biochemical constants is detected using laboratory tests. The proposed laboratory tests are carried out by the client independently in any of the laboratories offered by the program. Then the obtained research results are entered into the client’s personal account in the program. The program automatically identifies a zone of dangerous “red” - a changed indicator in each of the presented parameters that goes beyond the boundaries of the level optimal for a given age and gender.

2) Assessment of the nutritional balance is based on the analysis of the diary of the patient’s diet, the calculation of daily calorie intake, the qualitative and quantitative composition of food (proteins, fats, carbohydrates, basic micronutrients) and their comparison with the optimal norm for a given age, gender and level of physical activity .

3) An assessment of the imbalance of physical status is carried out on the basis of determining the patient's biometric indicators - monitoring the pulse, respiration, their changes at different loads, as well as daily activity indicators - counting steps, taking into account daily and weekly physical activity. Assessment of somatic status is carried out using the main anthropometric indicators - weight, height, body mass index (BMI), waist circumference, monitoring of pulse and respiration, tracking physical activity.

4) An assessment of lifestyle imbalance is carried out on the basis of biological components — the sleep-wake cycle, the presence or absence of “bad” habits, addictions, and the assessment of “psychological workload” —the assessment of the level of stress and reaction to it, the assessment of emotional lability, and the nature of professional activities (some specialties are obviously more aggressive in terms of the Kyrgyz Republic).

For customer self-diagnosis, aimed at identifying a number of these imbalances, developed questionnaires based on the principles of functional medicine, the contents of which as examples of the questionnaires and questionnaires used are presented above:

- Questionnaire for assessing the functional state,

- Questionnaire on lifestyle factors, which includes an assessment of lifestyle factors such as nutrition, stress, sleep, physical activity, assessment of harmful substances entering the body (toxins), the presence of skills to maintain a healthy lifestyle and adherence to them,

- Awareness factors questionnaire - an optional questionnaire for people who are consciously and seriously engaged in cognitive psychological training and practice meditative awareness practices for this purpose - demonstrates the level of progress in the development of awareness.

Note that these questionnaires and questionnaires are given only as examples, without limiting the possibility of using other suitable questionnaires, scales, questionnaires, which reflect the characteristics of the same factors for the development of indigenous people, which are discussed above, and are able to give them an appropriate assessment.

During the daily passing of the game testing of CF, information on the test results is accumulated and their values and dynamics are tracked. In the case of persistent (for example, specified by the program duration of such monitoring of 7 days or more) low values of the test indicators or a persistent tendency to deterioration of any tested functions for more than 7 days, the program prompts the user to pay attention to this and undergo further self-diagnosis.

With a one-time or short-term decline in indicators, the program suggests paying attention to this episode and correlating it with the previous sharp negative change in lifestyle factors (nutrition, stress, sleep, physical activity, harmful substances entering the body) (Fig. 7).

If the above negative changes in CF are identified, the client may be asked to take a survey on lifestyle factors that have an impact on CF in accordance with the Questionnaire on lifestyle factors, including, in particular, the following blocks:

1) skills to maintain a healthy lifestyle;

2) nutrition;

3) stress;

4) sleep;

5) motor activity with a series of motor tests;

6) toxins (harmful substances entering the body).

Filling out the questionnaires is possible both at the same time, and with a spacing of blocks in time.

When analyzing skills to maintain a healthy lifestyle, physical well-being is assessed; mental / emotional / spiritual well-being; professional life, work, career; social life, family, relationships.

When analyzing nutrition evaluate:

1) the presence / absence in the diet of 59 main types of products in blocks:

the use of harmful foods and drinks;

conditionally neutral products;

healthy foods and drinks and dishes based on them;

2) adverse eating habits.

When analyzing the level of stress assessed:

the severity of subjective mental and physical manifestations of stress, the presence of signs of decompensation;

Psychological Stress Scale Condition PSM25;

daily sources of stress;

satisfaction with various aspects of life and change;

prerequisites and conditions for chronic stress.

When analyzing sleep, one evaluates its quality, quantity, effect on daily activity, energy, and the inverse effect of lifestyle factors themselves on the quality and quantity of sleep.

In the analysis of motor activity evaluate:

sufficiency of movement / physical activity in a person’s lifestyle;

physical activity according to the IPAQ International Questionnaire;

the presence of physical inactivity;

quantitative use in training of high-intensity interval training;

the results of a number of motor tests - data on heart rate, respiration, blood pressure and other physiological parameters at rest and with various types of physical activity.

When analyzing toxins (harmful substances entering the body), they determine:

the severity of the effects of the most common toxins associated with a person’s personal choice;

the likelihood of toxicity to humans of commonly used drugs;

common industrial and agricultural toxins; household toxic substances and biotoxins.

If adverse lifestyle factors are identified, the client is invited to eliminate them by continuing to regularly undergo game testing of CFs.

With a significant improvement in indicators against the background of optimization of lifestyle factors, the client is invited to continue regular game and training cognitive testing. If a negative trend is detected, the client is again sent to a survey on lifestyle factors that have an impact on CF.

If the rate of improvement of cognitive indicators is insufficient, there is no improvement or deterioration against the background of the recommended lifestyle changes during the time period specified by the program, the client is asked to take a questionnaire to assess the functional state of organs and systems in accordance with the Functional State Assessment Questionnaire. This questionnaire can be selected and passed by the client himself for preventive purposes even with good cognitive testing rates.

A questionnaire to assess the functional state of organs and systems makes it possible to probabilistically assess the presence of disorders conditionally grouped into sections: emotions and psyche; nervous system; heart and lungs; gastrointestinal tract; musculoskeletal system; skin and mucous membranes.

Based on the results of a survey on lifestyle factors and questionnaires to assess the functional state, the need for lifestyle changes is clarified, and modifiable risk factors for the development of KI are identified probabilistically - “weak points”: primary etiopathogenetic “body imbalances”, including deficiencies in a number of nutrients ( vitamins D, group B, K, folic acid, iodine, iron, magnesium, zinc, amino acids, omega-3 fatty acids, phospholipids).

At any stage of the self-diagnosis, based on the data entered by the patient in case of suspicion of serious diseases or conditions requiring medical intervention, the program strongly recommends that the client consult a doctor.

If it is not possible to do this promptly, the client is given information about the alleged causes that led to his condition, and it is proposed to perform certain laboratory tests (which can presumably be useful: confirm or deny the presence of CN) in order to further present them to the doctor and enter the data for verification in the appropriate section of this service for reconciliation with normative (reference) values from the service database (see Fig. 10).

It should be noted that the very number of certain physiological parameters (for example, biochemical blood analysis - total protein, albumin, ALT, ACT, electrolytes, etc.) is not fundamental - it is only clear that the more significant factors are evaluated, the more accurate there will be a self-diagnosis. However, a minimal amount of these significant factors may be sufficient to screen yourself for the presence of SC. Which is confirmed by the examples below.

At the same time, in addition to routine analyzes, the client may be asked to undergo research in high-tech laboratory partners of the service to clarify the functional state of the body by determining one or more of the above biomarkers from the series:

universal biomarkers (holotranscobalamin, ferritin, TSH, IGF-1, vitamin 25 (OH) D, glycated hemoglobin, interleukin-6, ferritin, ALT, ultra-sensitive C-reactive protein, HOMA-IR insulin resistance index, uric acid);

biomarkers of systemic inflammation (C-reactive protein, ultra-sensitive, omega-3 index);

biomarkers of the development of cardiovascular diseases (homocysteine, sex hormone-binding globulin, testosterone, insulin, vitamin E, fibrinogen, coenzyme Q10, total cholesterol and its fractions, triglycerides);

stress level biomarkers (DHEA, cortisol);

oxidative stress biomarkers (glutathione, selenium, zinc, copper, manganese, malondialdehyde, 8-OH-deoxyguanosine);

biomarkers of the state of the antioxidant system (coenzyme Q10, vitamins A, E, K, beta carotene);

biomarkers of the usefulness of the intake and assimilation of nutrients (organic acids).

In the same way, the program monitors the negative changes in the results of the tested functions, and with their persistence (more than a certain number of days set by the patient or his attending physician, which for each type of change can be different, for example, for 2 days sleep disturbance, physical activity 3 days, cognitive impairment - 7 days, etc.), suggests making corrections corresponding to the identified changes (for example, as shown in Fig. 8). So, in case of sleep disturbance, it may be recommended to increase the amount of sleep for a certain time, if the calorie intake is increased / decreased or the selected proportions of macronutrients are not observed, correct this disturbance, and if it reduces / increases physical activity, correct it, suggesting that the client perform certain active steps for this.

Activities may be proposed for:

1) maintaining healthy lifestyle skills;

2) nutritional correction (mode, volume, multiplicity, kolorozha, ratio of BZHU, products containing the necessary amount of necessary nutrients, dietary supplements);

3) working with stress and changing reactions to stressful conditions;

4) sleep regulation (mode, duration, conditions, control),

5) the regimen and intensity of motor activity;

6) prevention of intoxication of the body and its detoxification.

7) cognitive training using online simulators and games for daily multimodal training of CF: memory, attention, reaction speed, concentration, cognitive flexibility, increasing cognitive potential and self-control, improving visual and auditory sensory inputs.

If, as a result of laboratory tests, the presence of modifiable risk factors for KN is revealed, including deficiencies in a number of nutrients (vitamins D, groups B, K, A, E, folic acid, iodine, iron, magnesium, zinc, copper, amino acids, omega- 3 fatty acids, phospholipids, etc.) and lifestyle needs of the client, depending on the identified specific violations of biochemical constants, health biomarkers (deficiency of certain vitamins and minerals, anemia, hypothyroidism, hypo- or hyperglycemia, electrolyte disturbances, dep essiya, sleep apnea, infection, impaired vision / hearing, etc.), the program offers the client to pass a primary online or offline consultation with a doctor. Contact with a doctor can end with a single consultation on the results of the initial laboratory screening, and can be continued in different ways, for example, in the form of one-time consultations on demand or medical coaching for a long period until optimal correction of CF.

For each of the identified areas of imbalance, the client is offered dynamic support (Life-coaching):

1) drug and / or nutritional correction in accordance with violations of biochemical constants - selected by the doctor individually during online or offline consultations (optional);

2) correction of nutritional status - the doctor selects individually the type of nutrition, diet, if necessary vitamin-mineral complexes, other biologically active additives;

3) correction of physical status - the type, frequency and degree of physical activity are individually selected;

4) lifestyle imbalance - an individual lifestyle coaching is performed.

The application is an information service, therefore, recommendations are provided for seeking medical help to explain the changes that have occurred.

At any stage of self-diagnosis or diagnosis in case of suspicion of serious diseases or conditions requiring medical intervention, the program strongly recommends that the client consult a doctor.

Based on the analysis of the likelihood of interest of certain organs and systems, recommendations are given on contacting a general practitioner or specialized medical specialist.

If it is impossible to promptly consult a doctor, the client is given information on the alleged reasons that led to his condition, and it is proposed to perform certain studies with a view to subsequently presenting it to the doctor and possibly entering the data for verification in the corresponding section of the service for compliance with regulatory values.

The work of the service program provides for the generation of a set of individual recommendations for identifying and correcting the primary imbalance in the body (at the level of biochemical constants, anthropometric data), which can lead to cognitive spectrum disorders (Fig. 9). The proposed combination of “cerebral aerobics”, accompanied by correction of the primary deficiency state in the human body, is a unique feature of the program and increases the efficiency of its use and profitability.

Thus, the service can be conditionally algorithmically divided into 4 main interconnected blocks:

1) Collecting maximum information about the client, ensuring the successful and efficient operation of the application. At the same time, keeping a food diary with calorie count and nutrient content is possible directly within the framework of this service.

2) Dynamic tracking of various indicators by zones and, if possible, analysis of correlation relationships.

3) Evaluation of the results of dynamic observation.

4) Generation of informational recommendations.

The service provides for the possibility of a daily format for assessing cognitive components, changes in the amount of physical activity, the amount of sleep, calorie content and qualitative composition of food, assessing lifestyle changes, cognitive changes both in a separate context and in interconnection.

Once every six months or more often, an assessment of the main functional imbalances and a comparison of the obtained data with the initial ones can be carried out.

Thus, “Healthy Brain & Brain Health” is a recommendation service on a mobile platform aimed at early self-diagnosis of minimal KH (including dynamics) and the complex of primary body imbalances that led to them, with the formation of personalized recommendations to the client.

In addition to the information provided by the client himself, information on the status of body systems (including the brain) can be received:

- from partner organizations that performed offline system diagnostics (partner software must have a “docking” with mobile platform software); it is possible to download medical data on the state of the human body, access to an electronic medical record or test the cardiovascular, endocrine, immune and other body systems in a medical institution (project partner);

- from an electronic medical record of a person (subject to his consent);

- from databases of other market participants with the necessary information (with the consent of the client);

- from a mobile device with a built-in accelerometer,

- from a wearable device for taking indicators (tracker / watch, etc.).

Consumers of this service can be individuals, HR specialists, doctors, coaches, social services.

The advantages of this service are:

- the use of reliable methods for assessing CF, as well as the basic biochemical constants of the body;

- issuance of individually oriented recommendations, allowing to increase / maintain the level of mental and physical working capacity of the client, generally improve health, change lifestyle, including, perhaps, choose / change the scope of professional activity;

- ease of use of the service for diagnostics and communications;

- guarantees of the safety of personal information;

- The opportunity to share the results of assessments and achievements with friends and a doctor.

The following are examples confirming the efficiency and effectiveness of the claimed group of inventions.

Example 1. Patient D.O.E. May 18, 1962

Heredity is burdened by Alzheimer's disease (AD) with an early onset (the patient’s mother suffers from established AD from 57 years old).

The patient first came to the clinic at the age of 55 with complaints of distraction, memory impairment for previous events, difficulties in remembering new information, alarming concerns regarding the development of asthma and dementia due to hereditary burden. Complaints have been troubling for the past 6 months. The patient has begun to forget the authors of what she has read, and has difficulty, if necessary, immediately recalling familiar names. Leaving home, he systematically checks whether the appliances are turned off, and notes an increase in touchiness and tearfulness.

However, the performance of production (works in a scientific office) and domestic duties (serves himself, his spouse, deals with his grandchildren) does not suffer. There are no bad habits, alcohol is used very rarely, and denies contacts with toxic substances. Sleep, in general, is alarming, of insufficient duration, with frequent nocturnal awakenings. Life as a whole is satisfied, but fears for health interfere.

As a result of the self-diagnosis using the claimed method, using the above-mentioned algorithm, the initial manifestations of mild CN in the system of memory, attention, low level of physical activity, a tendency to tachycardia and increased blood pressure with little physical activity were established. In addition, according to the results of the evaluation using the electronic service used, the program recommended that the patient undergo tests for biomarkers (beta-amyloid, the level of vitamins D, groups B, A and E, as well as the level of magnesium and selenium in the blood, insulin resistance index and cholesterol fractions) , and also keep a food diary taking into account calorie content and the content of the main micro- and macronutrients for 1 month.

During subsequent monitoring using the service, according to the data received, the program detected a deficiency of vitamins B and D, a slightly reduced magnesium content, an atherogenic index increased slightly, insulin resistance was within normal limits. Amyloid beta was not detected. Lack of exercise, overweight.

According to the MRI of the brain, performed for control, outside the scope of the claimed method is a mild external and internal communicating hydrocephalus. The lateral ventricles of the brain are slightly dilated in the bodies, the subarachnoid spaces of the furrows of the hemispheres of the frontal, temporal and parietal lobes are slightly expanded. Signs of vascular lesions of the brain were not detected.

The electronic service program gave the patient recommendations for nutrition correction (reducing the proportion of carbohydrates and increasing the proportion of protein in the diet, as well as products containing magnesium, fractional nutrition), with continued nutrition diary. A complex of simple physical exercises was suggested that contribute to the fight against physical inactivity, as well as taking a vitamin complex and, in case of deterioration during the next month when testing with the game's game unit, an in-person visit to a neurologist.

No deterioration was noted. The patient has been observed in the clinic for 3 years, uses the electronic service, controlling her cognitive status.

After fulfilling the recommendations provided by the program, the patient's well-being improved, when tested she gets high scores in assessing memory, attention and thinking, her body weight returned to normal. The patient continues to perform a set of physical exercises. Sleep normalized, satisfaction with various aspects of life increased. Testing using the service in accordance with the proposed method is carried out by the algorithm at least every month, using the service through a personal computer.

It happens that the patient feels tired, but this is caused by objective situations at work and at home.

According to the control MRI and analysis for beta-amyloid, there are no changes compared with the data of 3 years ago.

Thus, the electronic service in the framework of the claimed method allowed the patient to conduct a self-diagnosis in accordance with the claimed method and to establish the presence of early CNs for which specific factors significantly affecting their development were identified, taking into account which recommendations of the electronic service used to correct the cognitive status were given patients, which led to an improvement in general health (normalization of body weight, sleep, increased physical activity, elimination of nutritional deficiencies, improved mental health biological status). KF indicators have improved and continue to remain at this level under the control of monthly monitoring using the electronic service used.

Example 2. Patient T.K.K. November 10, 1967

Heredity is burdened by cardiovascular diseases (the patient’s father has repeated strokes against the background of chronic discirculatory encephalopathy since 56 years old).

The patient first went to the clinic at the age of 60 with complaints over the past year about irritability, periodic forgetting of the right words in the conversation, where he put this or that thing, fear of stroke and dementia. According to the patient, all these symptoms gradually increase, although they do not significantly prevent him from continuing to work (not engaged in intellectual work) and to do household and country chores.

The patient is married, has children and grandchildren, smokes for more than 40 years at least a pack a day, alcohol is strong, 5-6 doses per week, sufficient physical activity, body weight within normal limits. The patient does not come into contact with toxic substances. The sleep is satisfactory, long-lasting in time (always sleeps at least an hour in the afternoon, at night - 7-8 hours).

As a result of the self-diagnosis using the claimed method, using the above-mentioned algorithm, the initial manifestations of mild CN in the system of memory, attention and thinking are established. The level of physical activity is sufficient for a given age, gender and body weight.

The patient is prone to tachycardia, from 55 years old has an established diagnosis of hypertension (blood pressure up to 220/110 mm Hg), constantly takes antihypertensive drugs, against which blood pressure is generally stable.

According to the results of testing using the electronic service used as part of the claimed method, the patient was recommended by the program to conduct laboratory diagnostics for cholesterol fractions, the level of hepatic ALT and ACT, blood electrolytes, markers of endothelial dysfunction, insulin resistance index, as well as keeping a nutrition diary taking into account calorie content and basic micro and macronutrients for 1 month.

During subsequent monitoring using the service, according to the data obtained, the program found a high index of atherogenicity and insulin resistance, the presence of pronounced endothelial dysfunction, an increase in the level of liver enzymes and the level of basic electrolytes.

According to brain MRI, performed for monitoring, outside the scope of the claimed method, there are no data for current cerebrovascular disorders, as well as the consequences of earlier disorders. Signs of vascular lesions of the brain were not detected.

In accordance with the identified violations and the presence of risk factors identified using the service, the electronic service program gave the patient recommendations for nutrition correction (to reduce the proportion of salt, carbohydrates and fats and increase the proportion of protein in the diet, fractional nutrition), with the continuation of keeping a nutrition diary, avoiding harmful habits. In the event of a continuing deterioration over the next two weeks during testing (using the game’s game block), an in-person visit to a cardiologist and neurologist was recommended.

Over the next year, the patient used the electronic service, controlling his cognitive status, tried to quit smoking and reduced the dose of alcohol consumed.

After a year, he smokes about half a pack a day, complaints of recurring heart pain such as coronary heart disease and headaches, a periodic increase in blood pressure, despite taking antihypertensive drugs and changing them after visiting a medical specialist.

The number of points when testing memory, attention and thinking remains low, as a year ago (has not improved). The patient did not correct nutrition, the nutrition diary, despite the recommendations of the service, does not lead. Physical activity is increased. According to laboratory tests proposed by the service to the patient for monitoring violated biochemical parameters, there are no improvements.

Testing using the service in accordance with the algorithm proposed by this method, the patient conducts at least every month, uses the service through a laptop. However, the recommendations of the service are carried out carelessly, irregularly and incompletely.

According to the control MRI, manifestations of ischemia in the pool of the left internal carotid artery are observed, isolated foci of micro-strokes are visible.

After receiving MRI data, the patient realized the need for strict adherence to the recommendations provided by the service.

Over the next year, according to testing using an electronic service in accordance with the proposed method, there are improvements in memory, attention and thinking (increase in score). Testing is carried out at least once every 2 weeks, not only for self-diagnosis, but also for training CF (game block).

These improved results became possible due to the fact that the patient adjusted his diet, practically abandoned bad habits and started training CF using the electronic service used, according to the claimed method.

A year later, on the control MRI of new foci of ischemia, no microstrokes were found.

Thus, the electronic service in the framework of the claimed method allowed the patient to conduct a self-diagnosis in accordance with the claimed method and to establish the presence of early CNs for which factors significantly affecting their development were identified. However, the patient's non-compliance with the recommendations of the service for the correction of disorders led to a deterioration in a number of health aspects, assessed using the electronic service used.

At the same time, after the patient began to follow the recommendations of the service, using self-testing tests according to the claimed method, as well as the ways of correcting the condition recommended by the service taking into account the identified factors, his CF and overall health status in various aspects stabilized and even improved.

Example 3

Since 2017, 73 volunteers aged 26 to 65 years (28 men, 45 women, the average age of which was 43 years old) participated in the test of the electronic service in the framework of the claimed method of improving detected violations of CF from 2017. Assumed based on the use of the service in the framework of the claimed method for self-diagnosis, the health problems of the subjects were confirmed in 43 people. Using an electronic server, in accordance with the detected factors affecting the deterioration of CF, patients of this group were given recommendations on corrective actions, such as lifestyle changes, abandonment of bad habits, normalization of sleep and diet, physical activity - to bring their indicators closer to reference for the appropriate gender, age and body weight of the patient. Patients were engaged in cognitive trainings of memory, attention, reaction speed, concentration, cognitive flexibility, increasing cognitive potential, increasing self-control, improving visual and auditory sensory inputs.

In the dynamics during subsequent tests conducted by patients on their own in the intervals from 1 day to six months, indicators of CF, which were previously defined as impaired, showed significant improvements.

Nine subjects showed no significant health problems. 21 people with suspected health problems have not yet performed the medical research and corrective actions recommended by the service, and 16 of them showed varying degrees of deterioration in CF indicators, with negative dynamics during testing in the interval - a week, a month, half a year.

The algorithm developed and provided by the claimed method is of high social significance, its potential users are persons interested in active longevity, taking care of their somatic and cognitive health. The proposed sequence of gradual self-diagnosis, monitoring the dynamics of early indigenous people and improving them through corrective measures based on the use of an exhaustive list of fundamentally significant risk factors for developing indigenous people allows for preventive measures to remove the serious consequences of impending dementia.

Thus, the application of the proposed method of self-diagnosis of early development of indigenous people will allow patients to ensure the effectiveness of preventive and therapeutic measures in patients with risk factors due to the individualization of therapeutic measures and their early onset.

Claims (23)

1. A method for improving identified cognitive impairment, including: obtaining the first data about the subject, the first data about the subject being the subject's answers to predetermined questions about at least one of: physical well-being, mental well-being, emotional well-being, professional life, level and sources of stress, satisfaction with aspects of life, physical activity, level of awareness, drug use; obtaining second data about the subject, the second data about the subject being the results of the subject performing one or more predetermined intellectually realized tasks; obtaining third data about the subject, and the third data about the subject are the physical conditions of the body and contain at least one of: pedometer data, tracking data for different types of physical activity, data on heart rate for different types of physical activity and in the absence thereof, blood pressure data; sleep data; obtaining fourth data about the subject, the fourth data about the subject including data on the nutrition of the subject, the data on the nutrition of the subject being the results of the subject filling out a nutrition diary; obtaining fifth data on a subject, the fifth data on a subject including the results of previously performed clinical and biochemical blood tests, the data on earlier performed clinical and biochemical analyzes being the results of filling in the appropriate forms with the subject; intellectual analysis of the obtained first, second, third, fourth and fifth data about the subject by identifying correlation relationships between the various received data; assessment based on the analysis of the probability of the subject having early cognitive impairment, the assessment is performed by comparing with reference values and by comparing with previously obtained values in dynamics; generation based on the analysis and the obtained assessment of the subject's early cognitive impairment, recommendations for improving the subject's cognitive functions, including at least one of: maintaining a healthy lifestyle, nutrition correction, working with stress, regulating sleep, changing the regimen and / or intensity of physical activity, prevention of intoxication and / or detoxification of the body, the use of cognitive training. 2. The method according to p. 1, in which the first data about the subject is obtained at a frequency selected from the group: once an hour, once a day, once a week, once a month, once every six months. 3. The method of claim 1, wherein the one or more predetermined tasks is a game. 4. The method according to p. 1, in which the second data about the subject is obtained at a frequency selected from the group: once an hour, once a day, once a week, once a month, once every six months. 5. The method according to p. 1, in which the third data about the subject is obtained at a frequency selected from the group: once an hour, once a day, once a week, once a month, once every six months. 6. The method according to claim 1, in which the diary is filled out by the subject after each meal. 7. The method of claim 1, wherein obtaining the data, mining the data, assessing the likelihood of the subject having early cognitive impairment, and generating recommendations for improving the cognitive function of the subject is carried out using at least one portable computing device. 8. The method according to claim 7, in which at least one portable computing device is selected from the group including: mobile phone, smartphone, laptop, tablet, wearable device, including an electronic watch, electronic bracelet, clothes with built-in into it by an electronic device. 9. The method according to p. 1, in which the receipt of third data about the subject is carried out using sensors located on the body of the subject. 10. The method according to p. 1, in which the correction of nutrition includes changing at least one of: diet, the amount of food consumed, calorie intake, the ratio of BJU, the use of dietary supplements. 11. The method according to p. 1, in which the regulation of sleep includes changing at least one of: mode, duration of sleep, sleep conditions. 12. The method according to claim 1, in which cognitive training includes simulators and games for training at least one of: memory, attention, reaction speed, concentration, cognitive flexibility, increasing cognitive potential, increasing self-control, improving visual and auditory sensory inputs. 13. The method according to p. 1, in which recommendations for improving the cognitive functions of the subject include recommendations for consultation with a general practitioner or specialist medical specialist. 14. The method according to p. 13, further comprising informing the subject of the alleged causes that led to his condition, and recommendations for performing certain studies. 15. Non-volatile machine-readable medium containing instructions that, when executed, require the processor to perform the method according to any one of claims. 1-14.

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