The First Part: Brief Cognitive Function Assessment Scale in Middle Age and Beyond “The MCI Screen (Atama no Kenko Check)”

Background and Current Status of the Development

It is not difficult to imagine that increased opportunities for readers to become familiar with the aging of Japanese society in their daily lives. On the other hand, how much are people aware of the increase in dementia patients and its impact on society? It is estimated that one in five senior citizens will have dementia by 2025. In 2019, dementia was the most common cause of those aged 65 and over requiring nursing care, accounting for about 18% of those in need¹⁾. The growing number of people requiring nursing care has a wide range of effects, including an increase in the number of family members leaving the workforce because of nursing care, a shortage of nursing care workers, and an increase in senior people looking after more senior people.  

In June 2019, the Council of Ministers for the Promotion of Dementia Policies in Japan issued the “Outline for the Promotion of Dementia Policies,” which stated that measures should be promoted with “symbiosis” and “prevention” as the two wheels of the cart²⁾. However, this is also the flip side of the fact that there is no effective treatment for dementia. That's why early detection, early intervention, and “prevention” to delay the onset of the disease are of the utmost importance.

Research on early detection of dementia is, of course, being conducted proactively. For example, there are methods to detect mild cognitive impairment (MCI) at an early stage, such as using an app to check medical history and conduct tests³⁾ or measuring eye movements⁴⁾. However, while the former is simple and easy to use, it does not guarantee the reliability of the test, while the latter is the opposite, and there is no prospect of its widespread use in Japan. The “The MCI Screen (‘Atama no Kenko Check’ in Japanese)” introduced in this article deserves attention as a digital tool that can solve this very problem.

Coverage Area of the “The MCI Screen” Scale

The tool is derived from data mining of ADAS-Cog^*1 wordlist memory test and based on a demographic analysis method using an assessment algorithm developed in the U.S. in 2004. It is still used in the U.S. as an assessment item when purchasing private insurance. In Japan, Millennia Corporation, a subsidiary of SAINT-CARE HOLDING CORPORATION (ISIN Code: JP3424980005), has been developing and providing the Japanese version since 2006 based on a comprehensive alliance. The total number of cases tested in Japan and the U.S. exceeds 2 million⁵⁾. This cognitive function assessment tool is intended for people over 30 years of age with no complaints of forgetfulness. Anyone can administer it anywhere with an Internet environment and an examiner. The actual evaluation does not require complicated calculations and can be completed in about ten minutes. Furthermore, the reliability of test is also ensured regardless of the examiner’s knowledge, experience, and job skills by conducting according to a unique interface that assists the examiner. In addition to companies, hospitals, and medical checkup facilities contracting with the service, individuals who wish to take the test can also receive an individual test from home by telephone through a dedicated call center service for 4,378 Japanese yen (tax included). In this way, the “The MCI Screen” has a wide range of applications. Partly because it successfully compensates for the shortcomings of conventional tools, such as low evaluation accuracy in the younger age group and the healthy to MCI range, and differences in evaluation results caused by different examiners.

One of the most utilized areas is in the field of medical checkups. When the Japan Brain Dock Society revised the Guidelines for Brain Dock 2019 [5th edition] ^*2, the society changed its name from “Medical Association for Stroke” to “Medical Association for Stroke and Dementia Prevention.” Besides, cognitive function testing was added as a mandatory examination item. Perhaps due to this trend, the number of using “The MCI Screen” as one of the test items in Brain Dock seems to be increasing. 

This tool is also being used in the field of research, most notably in the dementia prevention registry IROOP (Integrated Registry Of Orange Plan) ⁶⁾. IROOP is a project led by the National Center of Neurology and Psychiatry as part of the AMED^*3 research project. It is a large-scale Internet-based database designed for participation in clinical trials, including healthy people aged 40 and over and those who are suspected as MCI. Here, too, the “The MCI Screen” was conducted every six months as a primary indicator of cognitive function. The project obtained trends in cognitive function along with a vast amount of questionnaire information on general conditions and lifestyle. The details of these studies and “The MCI Screen” will be described in detail in the following article.

Finally, I would like to introduce another essential feature of the “The MCI Screen.” 

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