JP5959051B2 - Dementia inquiry support device - Google Patents

Description

  The present invention relates to a dementia inquiry support device for supporting diagnosis of dementia.

  Dementia is said to occur in 1 in 4 people over the age of 85 and is expected to double in the next 20 years as we enter a super-aging society. Although the burden on the mind and body of the patient and the caregiver of the patient accompanying the onset of dementia is very large, early detection and early treatment can be expected to reduce symptoms, delay progression, and partially cure dementia.

  However, because there is a shortage of dementia specialists, discovery is delayed, and about 80% of patients with dementia end their lives only with treatment by non-specialists. Therefore, it is desired that a non-specialist can easily make an inquiry about dementia during early diagnosis of a patient (especially an elderly patient) and make an early diagnosis of dementia.

  On the other hand, a system for obtaining knowledge such as whether dementia has developed or the level of developing dementia has been proposed (see, for example, Patent Documents 1 and 2). .

  The dementia diagnosis support system described in Patent Document 1 can determine the symptom level by asking a patient an atypical question. In addition, the dementia test support system described in Patent Document 2 displays prior knowledge, precautions, actions to be taken by health care workers, evaluation methods, and score data, so that medical staff can become familiar with dementia tests. It is possible to obtain a uniform inspection result regardless of the degree.

JP 2007-282929 A JP 2010-259634 A

  However, in the dementia diagnosis support system described in Patent Document 1, it is generated from “various information” such as patient schedule information, weather information, map information, news information, etc., other than personal information that can be acquired from “electronic medical records”. Although it is a dynamic question / answer, it is difficult to accurately generate a question / answer pair from such various information, including acquisition of information from information sources and knowledge / language processing algorithms, Feasibility is low. In addition, since weather information may differ from the actual forecast, the uncertainty is high. Therefore, with such a system, it is not possible to calculate an accurate symptom level of dementia, and it is not possible to clarify core symptoms.

  In addition, if the symptom level is the initial state (when the dementia symptom level information is not recorded in the electronic medical record), the system asks questions with many variable parts (variable parts), Since the method of increasing the level is adopted, the efficiency is poor.

  Moreover, since the medical worker needs to evaluate the dementia test | inspection support system of patent document 2 whenever a test subject responds, it takes a long time to carry out the test, and in parallel with other medical care Difficult to do.

  The present invention has been made in view of such circumstances, and its purpose is to automatically determine accurately and in a short time the determination of the presence or absence of dementia and the estimation of the degree of progression and core symptoms of dementia. It is to provide a dementia inquiry support device that can be performed at the same time.

In order to solve the above-mentioned problem, a first technical means of the present invention is a dementia interrogation support device for estimating a core symptom of a patient with dementia, the patient and / or a caregiver of the patient. A storage unit that stores question information indicating a question to be performed, and answer information indicating an answer obtained from the patient and / or the caregiver corresponding to the question information, and based on the answer information, there is a suspicion of dementia A dementia suspected presence / absence determining unit that determines whether or not there is a dementia suspected presence / absence determining unit, and when the suspected dementia suspected presence / absence determining unit determines that there is a suspicion, based on the answer information, a progress estimation unit Based on the degree of progress estimated by the degree-of-progress estimation unit and the answer information, the core symptom that is strongly expressed among the core symptoms of dementia that can be estimated from the estimated degree of progress is estimated as the core symptom of the patient. comprising a core symptoms estimator for the, Serial advanced level estimation unit, the result of judgment in the dementia suspected presence determining unit, in which is characterized by having the progress of limitation unit for limiting the progression of dementia which can be taken as estimation results.

  According to a second technical means of the present invention, in the first technical means, the question information includes information indicating a question asking whether there is a behavior specific to a dementia patient.

  A third technical means of the present invention is characterized in that, in the first or second technical means, the question information includes information indicating a question asking whether or not to carry out daily life activities.

  According to a fourth technical means of the present invention, in any one of the first to third technical means, the question information includes information indicating a question asking a content recognized by the patient. Is.

  According to a fifth technical means of the present invention, in any one of the first to fourth technical means, the storage unit stores answer information obtained from both the patient and the caregiver as the answer information, The dementia inquiry support device includes an answer determination unit that determines whether or not the answer information obtained from the patient matches the answer information obtained from the caregiver, and the determination result in the answer determination unit is obtained. The dementia suspected presence / absence determining unit and / or the progress estimating unit is used for estimation.

A sixth technical means of the present invention is the technical means according to any one of the first to fifth technical means, wherein the progress estimation unit is configured to estimate the progress to the answer information obtained by differentiating the question information. Based on the progress degree determination unit that determines whether or not two or more estimated degrees of progress coincide with each other, and the degree of progress is determined as the final estimation result It is characterized by.

According to a seventh technical means of the present invention, in any one of the first to sixth technical means, the core symptom estimation unit is a core that can be taken as an estimation result from the degree of progress estimated by the progress degree estimation unit. It is characterized by having a core symptom limiting part that limits symptoms.

  According to the present invention, it is possible to automatically determine accurately and in a short time the determination of the presence or absence of dementia and the estimation of the degree of progression of dementia and core symptoms. Has the effect of promoting early detection and early treatment of symptoms.

It is a block diagram which shows the example of 1 structure of the dementia inquiry support system provided with the dementia inquiry support apparatus which concerns on this invention. It is a block diagram which shows the example of 1 structure of the dementia inquiry support apparatus (server) in the dementia inquiry support system of FIG. It is a flowchart for demonstrating an example of the procedure of the support application use process performed with PC (personal computer) in the dementia inquiry support system of FIG. It is a flowchart for demonstrating an example of the inquiry procedure of the support application use process performed by PC in the dementia inquiry support system of FIG. It is a flowchart for demonstrating the other example of the procedure of the support application use process performed by PC in the dementia inquiry support system of FIG.

  FIG. 1 is a block diagram showing a configuration example of a dementia interview support system including a dementia interview support apparatus according to the present invention. FIG. 2 is a block diagram showing a configuration example of a server as a dementia inquiry support device in the dementia inquiry support system of FIG.

  A dementia inquiry support system 100 illustrated in FIG. 1 includes a plurality of PCs 1, a plurality of printers 2, and a server (server computer) 3, which are interconnected via a network N.

  The server 3 is an example of a dementia inquiry support device according to the present invention, the details of which will be described later, determine the presence or absence of suspected dementia and estimate the degree of progression to support the dementia inquiry. It is a device that estimates the patient's core symptoms and outputs the results. The server 3 is mainly used in the dementia inquiry support system 100 and supports the dementia inquiry in conjunction with the PC 1.

  Here, an example in which a dementia inquiry support system is constructed by a client server system has been described. However, the dementia inquiry support apparatus exemplified by the server 3 is not limited to the installation form connected to the PC 1 or the printer 2, but is a stand alone. It is also possible to build a dementia interview support system.

  The network N is formed using the Internet, a LAN (Local Area Network), or the like. All of the network N may be configured by wireless connection, all of the network N may be configured by wired connection, and of course, only a part may be configured by wireless connection.

  The PC 1 and the printer 2 are installed in the patient's home, a nursing facility, a hospital, or the like. These users are caregivers. A care worker is a care worker (a patient's family, a care worker at a welfare facility or a specific health facility, or the like) or a medical worker (a doctor, a clinical psychologist, a nurse, or the like). Caregivers and patients are different people.

  The PC 1 includes a control unit 11, a RAM (Random Access Memory) 12, a storage unit 13, an operation unit 14, a display unit 15, and an I / F (interface) unit 16, as illustrated in FIG. ing. The control unit 11 includes a control device such as a CPU (Central Processing Unit) or an MPU (Micro Processing Unit). The RAM 12 is a volatile storage device and is used as a work area.

  As the storage unit 13, a nonvolatile mass storage device can be applied. Specifically, the storage unit 13 may be a flash ROM (Read Only Memory), an EEPROM (Electrically Erasable and Programmable ROM), a hard disk, or the like. The storage unit 13 includes a client-side computer program (hereinafter referred to as a support application) for realizing a dementia care support method using the dementia inquiry support system 100, and an image used during execution of the support application. Data etc. are stored.

  The operation unit 14 includes a keyboard and a mouse. A care worker inputs necessary information or an instruction to the PC 1 by operating the operation unit 14. The display unit 15 is configured by, for example, a liquid crystal display, an organic EL (electroluminescence) display, or the like. The I / F unit 16 is an interface for connecting the PC 1 and the network N.

  The control unit 11 is a control center of the PC 1, and controls each unit of the PC 1 by using the RAM 12 as a work area and reading and executing an OS (operation system) and a support application stored in the storage unit 13 to the RAM 12. Or execute various processes. For example, the control unit 11 that functions as the information receiving unit 11 a receives information or instructions input to the PC 1 via the operation unit 14. The control unit 11 functioning as the display control unit 11 b causes the display unit 15 to display a UI (User Interface) image based on the received image data or image data stored in the storage unit 13. The control unit 11 functioning as the communication unit 11 c communicates with other devices connected to the network N via the I / F unit 16.

  The printer 2 includes a control unit 21, a RAM 22, a recording unit 23, and an I / F unit 24. The recording unit 23 is a printer engine that records an image on recording paper using toner or ink. The control unit 21 is a control center of the printer 2, and uses the RAM 22 as a work area, for example, by reading and executing control firmware stored in a storage device inside the control unit 21, so that each unit of the printer 2 Control various processes. For example, the control unit 21 gives the image data received via the I / F unit 24 to the recording unit 23. At this time, the recording unit 23 records an image based on the given image data on a recording sheet. With such a configuration, the printer 2 can also print the determination and estimation results in the server 3.

  As illustrated in FIG. 2, the server 3 includes a control unit 30, an input unit 32, a display unit 33, a display control unit 34, a network interface unit 35, and a storage unit 36, and dementia inquiry support according to the present invention. Each unit 37 to 46 for realizing the function is provided, and they are connected by a bus 31.

  The control unit 30 includes a control device such as a CPU or MPU. The input unit 32 includes a keyboard and a mouse as in the operation unit 14. The display unit 33 is configured by, for example, a liquid crystal display, an organic EL display, or the like, similar to the display unit 15. The display control unit 34 is a part that controls display on the display unit 33 and is similar to the display control unit 11b. The network interface unit 35 is an interface similar to the I / F unit 16 and is an interface for connecting the server 3 and the network N.

  As the storage unit 36, a non-volatile mass storage device can be applied in the same manner as the storage unit 13. The storage unit 36 stores various control programs 36a such as an OS. The various control programs 36a are read and executed by the control unit 30 in a work area secured in the storage unit 36 (or a RAM provided in the control unit 30).

  The storage unit 36 stores patient data 36b, question data 36c, answer data 36d, and behavior / emotional data 36e. The temporary storage data 36f is data such as program data and various data 36b to 36e temporarily stored for processing in the secured work area.

  Next, although each part 37-46 is demonstrated, each part 37-46 actually has the dementia inquiry support application (server side application) for functioning a server computer as a dementia inquiry support function which concerns on this invention. It functions by being stored in the storage unit 36 and read out from the control unit 30 to a work area secured in the storage unit 36 (or a RAM provided in the control unit 30) and executed.

  The patient information accepting unit 37 accepts input of patient information such as the patient's name, ID, and chart information via the input unit 32 (or via the network interface unit 35 from the PC 1), and the storage unit 36 as necessary. The patient data 36b stored in is updated.

  The question information output unit 38 outputs the question data 36c, which is question information data indicating a question, stored in the storage unit 36 in advance to the PC 1 via the network interface unit 35. The PC 1 receives the question data 36c and displays the question on the display unit 15. Here, the question is a question used for diagnosis of presence / absence of dementia, degree of progression, and core symptom, and is a question to be asked to a patient and / or a caregiver of the patient (hereinafter referred to as a caregiver of the patient). Point to. The question for the patient and the question for the caregiver of the patient may be the same, or part or all of them may be different.

  When outputting a question, even if the patient has already been registered in the patient data 36b, the patient information receiving unit 37 may first receive at least a name or ID. A question such as “?” Or “What is your ID?” May be included. In addition, a patient who is not registered in the patient data 36b may be registered after receiving a normal medical examination and outputting a question. Further, all the questions included in the question data 36c may be output at a time, may be output one question at a time, or may be output for each step-by-step inquiry as will be described later.

  The response information reception unit 39 responds to the question information from the PC 1 via the network interface unit 35 or the input unit 32, and displays response information indicating responses obtained from the patient and / or patient caregivers. It memorize | stores in the memory | storage part 36 as 36d. It is preferable to select and input an answer by outputting the assumed contents as options in advance. In this way, the storage unit 36 stores the question information and the answer information. Furthermore, it is preferable that the answer information receiving unit 39 receives the behavior / emotional information indicating the behavior and emotion of the patient and / or the caregiver of the patient together with the answer information, and stores the behavior / emotional information 36e in the storage unit 36.

  The patient himself / herself does not input an answer from the PC 1 or the input unit 32, but a caregiver, doctor, or nurse who has heard the answer from the patient may execute the input. Similarly, doctors and nurses may input the answers of patient caregivers. Also, the answers of the patients and their caregivers may be input in an actual hospital or may be performed from home before coming to the hospital.

  Of course, each answer in the answer data 36d is associated with each question in the question data 36c. More simply, information indicating that the answer data 36d is the answer of the question data 36c is included, and each answer may be stored in association with the question number. The answer data 36d is associated with the patient data 36b of the patient who made the answer or the patient cared for by the caregiver, and the behavior / emotional data 36e is also associated with the patient data 36b.

  Further, when obtaining answers from both the patient and the caregiver of the patient, for example, the patient is first asked a question, and the answer information is recorded in the storage unit 36. At this time, it is preferable that the caregiver of the patient sees and inputs the behavior and emotion information together with the response contents. As for the behavior and emotion, the assumed contents may be output as options in advance and selected and input. Next, a similar question is asked to the caregiver of the patient, and the response content is recorded in the storage unit 36. Like the patient, at this time, it is preferable that a person other than the caregiver (however, preferably not a patient) inputs the behavior and emotion of the caregiver who is answering together with the contents of the reply.

  When asking a patient a question at the time of an examination, in order to shorten the inquiry time for conducting questions to the caregiver of the patient, use the waiting time for the examination to answer the patient's planned answer to the patient in advance. A person may input from the PC 1 installed in the hospital, or may input an answer from the PC 1 at home before going to the hospital. In any case, since the answer information is recorded in the server 3, it can be browsed from the PC 1 used by the doctor at the time of the examination.

  In addition, regarding the behaviors and emotions, the situation in which the patient or caregiver inputs an answer can be observed directly or via a Web camera or the like provided separately by a doctor or nurse. Or, if the patient or caregiver fills in the answer on the form instead of inputting directly from the PC 1 or the input unit 32, and the doctor or nurse enters the answer, the doctor or nurse provides it directly or separately. It can also be observed through a web camera. In either case, the doctor or nurse can input the behavior or emotion of the patient or caregiver.

  Then, the dementia suspected presence / absence determining unit 41 stores the response information stored in the storage unit 36 as the response contents of the patient and / or the caregiver of the patient with respect to the question (determination, estimation target patient and answer information of the caregiver of the patient) The same shall apply hereinafter) to determine whether there is a suspicion of dementia. The contents of the question may be questions about the contents of the patient and the patient's family and the life contents of the patient.

  The suspected dementia output unit 42 outputs this determination result to the progress estimation unit 43 when there is a suspicion, and stores it as a part of the patient's chart in the patient data 36b when there is no suspicion. To the unit 36.

  Next, the progression degree estimation unit 43 estimates the degree of progression of dementia based on the answer information stored in the storage unit 36 when the dementia suspected presence / absence determination unit 41 determines that there is a suspicion. The degree of progress may be estimated only by answering a question to be newly implemented, but may be estimated including the content of the answer to the question used for the determination by the dementia suspected presence / absence determining unit 41.

  Here, the degree of progress can be divided into, for example, six levels: boundary, amnesia, mild, moderate, altitude, and severe. Of course, other divisions may be adopted. A question specific to each degree of progress is performed, and the degree of progress is estimated from the contents of answers of the patient and the caregiver of the patient to the question. The progress output unit 44 outputs the estimation result to the core symptom estimation unit 45 and also outputs the estimation result to the storage unit 36 so as to be stored as a part of the patient's chart in the patient data 36b.

  Then, the core symptom estimation unit 45 estimates the core symptom of dementia based on the progress degree and the answer information estimated by the progress degree estimation unit 43. The core symptom estimator 45 estimates the core symptom from the result of the degree of progress estimated by the progress estimator 43. At this time, if the degree of progress is a boundary or amnesia, the core symptom is estimated to be amnesia. To do. At other stages of progression, multiple core symptoms may occur; for mild, forgetfulness and disorientation, for moderate, forgetfulness, disorientation and disapproval, for severe, disapproval and apraxia, severe Estimates which of the core symptoms of apraxia and agnosia are strong. Such estimation, that is, estimation of the core symptom may be performed based only on the answer of the newly implemented question, but the question used in the determination of the dementia suspected presence / absence determination unit 41, the degree of progress estimation unit 43 You may estimate from the answer content with respect to the question used for estimation, and you may estimate including the question performed newly and those.

  The core symptom output unit 46 outputs the estimation result to the storage unit 36 so as to store it as a part of the patient's chart in the patient data 36b. In addition, although the core symptom is distinguished by amnesia, disorientation, agnosia, apraxia, and aphasia, it may be distinguished by other methods. For example, it may be distinguished by memory impairment, disorientation, aphasia, apraxia, agnosia, executive dysfunction, or by memory impairment, cognitive impairment (aphasia, agnosia, apraxia, executive dysfunction) Good. The answer determination unit 40 will be described later.

  As described above, the server 3 can automatically determine whether or not there is a suspicion of dementia, and estimate the degree of progression of dementia and core symptoms. Such determination and estimation can be performed accurately.

  Further, the server 3 can perform such determination and estimation in a short time. The reason that it is possible in a short time is that determination and estimation can be automatically performed at the stage where the answer information is stored. In addition, it is possible to execute the judgment of suspected dementia, the estimation of the degree of progression, and the estimation of the core symptom in three stages while obtaining answers by asking each necessary question. Can be done in a short time. In any case, doctors can examine other patients at the stage of accepting answer information or at the stage of accepting answer information at each of the three stages. Can be implemented.

  In addition, the question information includes (i) information indicating a question asking whether or not there is a behavior specific to a dementia patient, (ii) information indicating a question asking whether or not to carry out daily life behavior, and (iii) the patient is aware It is preferable that any one or more of the information which shows the question which asks the content are included. For example, the information (i) can be used for determination by the dementia suspected presence / absence determination unit 41, and the information (ii) can be used for estimation by the progress estimation unit 43. The information of iii) can be used for estimation in the core symptom estimation unit 45.

  Of course, the information of (i) above can be used for estimation of the degree of progression or the core symptoms directly through the result of the above determination. The information (ii) can also be used for the above-described determination, and can also be used for estimation of core symptoms through the estimated progress or directly. The information (iii) can also be used for the above determination or estimation of the degree of progress.

  As the information (i), for example, when the progress is amnesia, a question such as “Do you often repeat the same story” is given. For the answer, it is preferable to output the choice of “Yes” or “No” and select and input it. At this time, regardless of the patient's response, if the patient's caregiver answers “Yes”, it can be determined that there is a suspicion of dementia, and the degree of progression is estimated to be “amnestic”. it can. Furthermore, if the patient responds “No” and the patient's caregiver responds “Yes”, it can be determined that the patient is not aware of the disease, and the suspicion of dementia tends to be strong, and the progress is It can be estimated that the tendency corresponding to "is stronger.

  The information (ii) is, for example, “Can I choose and wear clothes that suit my season?” Answers may be output as choices of “possible” or “impossible”, and may be selected and input. Similar to the estimation from the answer to the information (i) above, it is desirable to estimate by the answer of the patient caregiver or the answer of the patient and the answer of the patient caregiver.

  The information (iii) is, for example, “What is this?” While showing a watch. Answers may be output as choices of “correct answer” and “incorrect answer”, and may be selected and input. The estimation for this example is based only on patient responses. In addition, regarding the contents that need to be confirmed by the patient's caregiver, such as “What is the breakfast menu for this morning?” It is estimated by whether or not the caregivers' answers are consistent.

  The answer determination unit 40 determines whether or not the answer information obtained from the patient and the answer information obtained from the caregiver of the patient match. That is, when the answer determination unit 40 stores the answer information obtained from both the patient and the caregiver of the patient as the answer information in the storage unit 36, the answer determination unit 40 obtains the answer information obtained from the patient and the patient caregiver. It is determined whether or not the answer information matches.

  In the server 3, the determination result in the answer determination unit 40 may be used for the determination in the dementia suspected presence / absence determination unit 41 and / or the estimation in the progress estimation unit 43. For example, depending on the question, it may be determined / estimated that there is no suspicion of dementia as a correct answer when matched. Some questions are determined to be suspicious if one question is incorrect. The judgment criteria for the presence or absence of suspicion are set in advance by supervision of a dementia specialist, but each doctor can set the judgment criteria at a high level.

  It is possible to make accurate judgments and estimations by obtaining answers from not only patients but also attendants who are caregivers of patients, and using whether or not they match to determine the presence of suspected dementia and to estimate the degree of progression In addition, depending on the question, the daily situation of the patient can be accurately recorded, and the diagnostic accuracy can be improved. Of course, even if the answer determination unit 40 is not provided, the determination by the dementia suspected presence / absence determination unit 41 is possible as described above.

  Moreover, it is preferable that the progress degree estimation part 43 has the progress degree limitation part 43a which limits the progression degree of the dementia which can be taken as an estimation result from the result determined in the dementia doubt existence determination part 41. For example, even if there is a suspicion of dementia, the progress limiter 43a limits the progress to a higher level if the suspicion is high, and limits the progress to a lower level if the suspicion is low. The progress estimation unit 43 may perform processing such as estimating the progress by selecting the progress level from the inside.

  Moreover, it is preferable that the progress estimation part 43 has the following progress coincidence determination part 43b. The degree-of-progress determination unit 43b executes the estimation of the degree of progress two or more times based on the answer information obtained by making the question information different (results obtained by making the question information different). It is determined whether or not the above degrees of progress match. Then, when the progress degree coincidence determination unit 43b determines that the degree of progress is the same, the progress degree estimation unit 43 may determine the degree of progress when the degree of coincidence is the final estimation result.

  The progress degree coincidence determining unit 43b can be provided together with the progress degree limiting unit 43a. In this case, if there are two or more degrees of progress when they match, the progress degree limiting unit 43a narrows down to one. You may make it like, and you may limit by the progress degree limitation part 43a according to the result of estimation of each time (or estimation in times other than the last).

  The latter case will be described with an example in which the estimation is performed twice in total and the degree of progress is limited at the first estimation. The progress degree coincidence determination unit 43b estimates the degree of progress from the answer to the question performed by the dementia suspected presence / absence determination unit 41. In order to distinguish in terms of words, the level of progress that is the first estimation result will be described as the progress prediction level. The progress degree limiting unit 43a selects a question specific to each progress degree in the second estimation of the progress degree (that is, selects an answer to the question) according to the estimated progress degree prediction level. Limit the degree of progression of dementia.

  First, among the progress levels 1 to 6, when the progress prediction level is estimated, for example, when the progress prediction level is estimated to be 2, the question corresponding to the “boundary” is selected. In addition, the number of progress prediction level levels can be set in advance. If it is set to 6 levels, it will be an example as described above, and if it is set to 2 levels, for example, if it is estimated to be the lower level, it corresponds to the boundary to mild If a question is selected and the upper level is estimated, a question corresponding to moderate to severe may be selected.

  In this way, the progress degree coincidence determination unit 43b executes the second degree of progress estimation from the contents of answers to the questions narrowed down corresponding to the progress degree prediction level, and compares the estimation results. If the progress coincidence determination unit 43b uses the answer information about the selected question and the progress estimation unit 43 finally estimates the progress, the level that can be taken as the progress is limited by selecting the question. That's right. Of course, when the answer information is not obtained for the selected question, if the question is asked at that time and recorded as a part of the answer data 36d, the final estimation by the progress estimation unit 43 is possible.

  In the progress degree estimation part 43, when it is the answer as a result of the determination in the progress degree coincidence determination part 43b, for example, it is an answer which generally corresponds to the question content of the implemented progress degree, it estimates that it is the progress degree. In general, the relevant standards are set in advance by supervision of a dementia specialist, but the total score is set to 20% or more and less than 90%. The score may be determined in advance so as to differ depending on the question contents to be asked. If it is almost applicable, the problem with the same degree of progress is implemented and the degree of progress is similarly estimated. If the results of the progress estimation obtained are the same, the progress of the executed question is estimated.

  As described above, the progress degree coincidence determination unit 43b performs the degree of progress estimation twice or more, and determines whether or not the obtained progress degree results match (fit). If the ratio corresponding to the question of the degree of progress executed at the first time is high, a question of a higher degree of progress is executed, and if the ratio is low, a question of a lower degree of progress is executed. For example, when the ratio corresponding to the first mild question is low, the question corresponding to amnesia is executed the second time. In addition, when the ratio corresponding to the first mild question is high, the second question is asked as a moderate question. The degree of progress is similarly estimated from the content of the answer to the question of the degree of progress conducted the second time. The degree of progress is similarly estimated from the corresponding ratio, and the process is repeated until the obtained results of the degree of progress match.

  The core symptom estimating unit 45 preferably includes a core symptom limiting unit 45a that limits the core symptom that can be taken as an estimation result from the degree of progress estimated by the degree of progress estimating unit 43. For example, if the level of progression is high, no limitation is made assuming more symptoms as the core symptom, and if the level of progression is low, for example, focusing on forgetfulness and disorientation only, The symptom estimation unit 45 may perform processing such as estimation by selecting a core symptom. The core symptom limiting unit 45a estimates the core symptom from the answer to the question (and the question performed by the dementia suspected presence / absence determination unit 41) performed by the progress estimation unit 43, and estimates the core symptom according to the core symptom. The core symptoms that can be taken as a result may be limited by selecting questions specific to each core symptom. This method itself is the same as limiting the degree of progress.

  In addition, when a predetermined dementia test is performed on a patient, the degree of progression and core symptoms can be limited based on the results. Examples of the predetermined dementia test include Mini Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and Japanese version of Livermead Action Record Test (Japanese version of RBMT). The score is used to limit the degree of progress, and the limitation of the core symptom is limited from the contents of the answer by tagging the core symptom corresponding to the examination question in advance. These are performed by the progress limiting unit 43a and the core symptom limiting unit 45a.

  Next, an example of a processing procedure in the dementia inquiry support system 100 as described above will be briefly described with reference to FIGS. 3 and 4. FIG. 3 is a flowchart for explaining an example of the procedure of the support application use process executed by the PC in the dementia inquiry support system of FIG. FIG. 4 is a flowchart for explaining an example of the inquiry procedure of the support application use process executed by the PC in the dementia inquiry support system of FIG.

  As shown in FIG. 3, first, personal information such as a patient's name, that is, patient information is received (step S1). Next, an inquiry is made on the PC 1 or by actual examination, the answer is stored in the storage unit 36 (step S2), and it is determined whether there is a suspicion of dementia from the obtained answer content. (Step S3) The result of whether or not there is a suspicion of dementia is output by displaying it on the display unit of the PC 1 used by the doctor (Step S4).

  When there is a suspicion of dementia, the degree of progress is limited from the contents of the answer obtained in the inquiry in step S2 (step S5), and the question content of the limited level of progress is extracted, and again on PC1 or actually An inquiry is made at the examination, and the answer is stored in the storage unit 36 (step S6). The first degree of progress estimation (progression degree estimation I) is executed from the contents of the answer obtained in the inquiry in step S6 (step S7), the inquiry of the estimated degree of progress is extracted, and the diagnosis is performed again on the PC 1 or actually. The medical interview is conducted and the answer is stored in the storage unit 36 (step S8).

  The second degree of progress estimation (progression estimation II) is executed from the answer contents obtained in the inquiry in step S8 (step S9), and the degree of progress obtained in the progress estimation I and the degree of progress estimation II are obtained. It is determined whether or not the degree of progress matches (step S10). As a result of the determination, if they match (in the case of YES in step S11), the matched progress is output as an estimated progress displayed on the display unit of the PC 1 used by the doctor (step S12). If the result of determination in step S10 is not the same (NO in step S11), the process returns to step S6, and the inquiry and determination are repeated until they match.

  Next, the core symptom is limited from the contents of the answers obtained in the interviews in steps S2, S6, and S8 (step S13), the question contents of the core symptom are extracted, and the interview is performed again on the PC 1 or in actual examination. The answer is stored in the storage unit 36 (step S14). The core symptom is estimated from the contents of the answer obtained by the inquiry in step S14 (step S15), and the estimated core symptom is displayed on the display unit of the PC 1 used by the doctor and output (step S16).

  Here, the inquiry in steps S2, S6, S8, and S14 will be described with reference to FIG. First, the server 3 transmits the question information to the PC 1 on the patient side (step S21), and the PC 1 on the patient side that receives this displays the question. When the doctor or nurse performs input, the question information may be transmitted to the PC 1 of the doctor or nurse. Next, the patient and the caregiver of the patient input the reply contents and the behavior / emotional information on the patient-side PC 1 and the server 3 accepts them (step S22). Finally, the server 3 determines whether or not the answer contents of the patient and the caregiver of the patient match or whether the answer contents of the patient match the correct answer (step S23). This determination result is used for determination and estimation in steps S3, S7, S9, and S15.

  Next, another example of the processing procedure in the dementia inquiry support system 100 will be briefly described with reference to FIG. FIG. 5 is a flowchart for explaining another example of the procedure of the support application use process executed by the PC in the dementia inquiry support system of FIG.

  As shown in FIG. 5, first, the same processing as steps S1 to S10 in FIG. 3 is performed (steps S31 to S40). In step S40, it is determined whether or not the degree of progress obtained by the degree of progress estimation I matches the degree of progress obtained by the degree of progress estimation II. If the result of the determination is the same (YES in step S41). In the case), in the same manner as in step S12, the matched progress is displayed as an estimated progress on the display unit of the PC 1 used by the doctor and output (step S45).

  If the results of the determination in step S40 do not match (NO in step S41), the degree of progress estimated from both the degree of progress estimated I and the degree of progress estimated II. Is extracted, and an inquiry is performed again on the PC 1 or in practice, and the answer is stored in the storage unit 36 (step S42).

  The third degree of progress estimation (progression estimation III) is executed from the answer contents obtained by the inquiry in step S42 (step S43), and the degree of progress obtained by the degree of progress estimation III and the degree of progress estimation I are obtained. It is determined whether the degree of progress or the degree of progress obtained in the degree-of-progress estimation II matches (step S44). Following step S44, the process proceeds to step S45, and if they match, the doctor obtains the estimation result in the degree of progress estimation III (that is, the degree of progress in which the degree of progress estimation I or II matches) as the estimated degree of progress. Output by displaying on the display unit of the PC 1 to be used.

  If they do not match in step S44, it may be displayed in step S45 that the estimation could not be performed. Alternatively, among the progress estimations I, II, and III, for example, it is estimated and displayed as one of the lowest progress, intermediate progress, and lowest progress, or is uniquely “boundary”. May be displayed. Which degree of progress is adopted may follow a predetermined rule. On the other hand, in step S43, the question may be repeated until the progress estimation III in step S44 becomes possible.

  After the process of step S45, the process similar to step S13 to S16 of FIG. 3 is performed (step S46 to S49), and the process is terminated. In addition, what is necessary is just to perform the inquiry in step S32, S36, S38, S42, S47 in the procedure demonstrated in FIG.

  As described above, the dementia interview support apparatus according to the present invention and the dementia interview support system including the apparatus have been described. However, the present invention describes the dementia interview support as described in the processing procedure related to dementia interview support. A form as a dementia interview support method in which the device (and a dementia interview support system including the device) estimates a core symptom of a patient with dementia can also be adopted.

  This dementia inquiry support method includes a memory step, a dementia suspected presence / absence determination step, a progress estimation step, and a core symptom estimation step. The storage step stores question information indicating questions to the patient and / or a caregiver of the patient and answer information indicating answers obtained from the patient and / or caregiver corresponding to the question information. To do. In the dementia suspected presence / absence determination step, the dementia suspected presence / absence determination unit determines whether or not there is a suspected dementia based on the answer information. In the progress level determination step, when the progress level estimation unit determines that there is a suspicion in the dementia suspected presence / absence determination step, the progress level estimation unit estimates the progress level of dementia based on the answer information. In the core symptom estimation step, the core symptom estimation unit estimates the core symptom of dementia based on the progress degree estimated in the progress degree estimation step and the answer information. Other application examples and effects are as described for the dementia inquiry support system, and the description thereof is omitted.

  In addition, the present invention is implemented on a PC as a form of a dementia interview support program (that is, the dementia interview support program described in FIG. 2) for causing a computer (server computer) to execute the dementia interview support method described above. It is also possible to adopt a form as a client-side program (that is, the support application described with reference to FIG. 1), or a form of a computer-readable storage medium storing one or both of the programs. Examples of the storage medium include portable recording media such as a CD (Compact Disc), a DVD (Digital Versatile Disc), and a BD (Blu-ray Disc).

DESCRIPTION OF SYMBOLS 1 ... PC, 2 ... Printer, 3 ... Server, 11 ... PC control part, 11a ... Information reception part, 11b ... Display control part, 11c ... Communication part, 12 ... PC RAM, 13 ... PC storage part, 14 DESCRIPTION OF SYMBOLS Operation part 15 ... Display part of PC, 16 ... I / F part of PC, 21 ... Control part of printer, 22 ... Printer RAM, 23 ... Recording part, 24 ... I / F part of printer, 30 ... Control 31 ... Bus 32 ... Input unit 33 ... Display unit 34 ... Display control unit 35 ... Network interface unit 36 ... Storage unit 36a ... Various control programs 36b ... Patient data 36c ... Question data 36d ... Reply data, 36e ... Behavior / emotional data, 36f ... Temporary storage data, 37 ... Patient information receiving part, 38 ... Question information output part, 39 ... Answer information receiving part, 40 ... Answer judging part, 41 ... Presence of dementia Judgment 42 ... Dementia suspected presence / absence output unit, 43 ... Progression level estimation unit, 43a ... Progression level limitation unit, 43b ... Progression level coincidence determination unit, 44 ... Progression level output unit, 45 ... Core symptom estimation unit, 45a ... Core symptom Limited part, 46 ... core symptom output part, 100 ... dementia inquiry support system.

Claims (7)

A dementia interview support device that estimates core symptoms of patients with dementia,
A storage unit for storing question information indicating a question to be asked to the patient and / or the caregiver of the patient, and answer information indicating an answer obtained from the patient and / or the caregiver corresponding to the question information; ,
Based on the answer information, a dementia suspected presence / absence determining unit that determines whether or not there is suspected dementia, and
When it is determined that there is a suspicion in the dementia suspected presence / absence determination unit, based on the answer information, a progress estimation unit that estimates the degree of progression of dementia,
Based on the degree of progress estimated by the degree-of-progress estimation unit and the answer information, a core that estimates a core symptom that is strongly expressed among the core symptoms of dementia that can be estimated from the estimated degree of progress is a core symptom of the patient A symptom estimation unit;
Equipped with a,
The progress degree estimating unit includes a progress degree limiting unit that limits a degree of progress of dementia that can be taken as an estimation result from a result determined by the dementia suspected presence / absence determining part .   The dementia inquiry support apparatus according to claim 1, wherein the question information includes information indicating a question asking whether there is a behavior specific to a dementia patient.   The dementia inquiry support apparatus according to claim 1, wherein the question information includes information indicating a question asking whether or not daily life behavior can be performed.   The dementia inquiry support apparatus according to any one of claims 1 to 3, wherein the question information includes information indicating a question asking about contents recognized by the patient. The storage unit stores answer information obtained from both the patient and the caregiver as the answer information,
The dementia inquiry support device includes an answer determination unit that determines whether or not the answer information obtained from the patient matches the answer information obtained from the caregiver,
The determination result in the answer determination unit is used for determination in the dementia suspected presence / absence determination unit and / or estimation in the progress estimation unit. Dementia inquiry support device. The progress estimation unit performs the estimation of the progress two or more times based on the answer information obtained by making the question information different, and determines whether or not the two or more estimated progresses match. The dementia interrogation support apparatus according to any one of claims 1 to 5, further comprising a progress degree coincidence determination unit that determines a progress degree when the two coincide with each other as a final estimation result . The said core symptom estimation part has a core symptom limitation part which limits the core symptom which can be taken as an estimation result from the progress estimated in the said progress estimation part, The any one of Claims 1-6 characterized by the above-mentioned. Dementia inquiry support device according to item.

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