認知症の早期診断の取組み～アウトリーチ型スクリーニングの結果より～

抄録

The prevalence of dementia is constantly increasing because of the aging population, and it emerges not only as a medical but also a social problem in the world. Shortening the time from onset to diagnosis of dementia and providing appropriate medical and nursing care information from an early stage, can lead to the start of nursing care insurance services, and may affect the prognosis of patients and their families. Since 2014, we have implemented the “Project for Establishing a Medical and Nursing Care Coordination System for Dementia Care” as a joint project with the Mie Prefectural Medical Association and established the early detection and intervention system for dementia through outreach–type dementia care. Dementia IT Screening (DITS) is conducted for patients suspected of having dementia. When the family physician suspected the patient as dementia, the physician can order DITS. Cognitive function is assessed by Mini Mental State Examination (MMSE) and Brain Function Battery (BFB). Daily life is assessed with the Action Observation Sheet (AOS) and Dementia Assessment Sheet for Community–based Integrated Care System–21 items (DASC). The dementia specialist makes a comprehensive judgment for the necessity of visiting a specialized medical doctor. From April 2015 to March 2021, 708 examinees were tested. Of these, 415 (58.6%) were recommended to see a specialist medical doctor, 276 (66.5%) were referred to a specialist medical doctor, and 192 (69.5%) were diagnosed with dementia as a result of differential diagnosis. This system can provide the post–diagnosis support to the patients with dementia and their families by enabling early diagnosis through the corroboration between family physician and specialized medical doctor. Moreover, we also can promote medical and welfare cooperation between regional comprehensive support centers, early intensive support teams for dementia, and medical institutions.