[Toward constructing a system for detecting and coping with XXXX in early stages among community-dwelling older @entity1 ].

@entity1 @entity1032 @entity303 @entity73 @entity1294 @entity195
OBJECTIVES: To establish a community health care system for screening community-dwelling older @entity1 with @entity73 ( @entity73 ) and early diagnosis by a medical specialist. METHODS: Out of all the elderly residents aged 65 years and over living in Yoita town in 2000 (n = 1673), 1544 participated in the interview survey held at community halls or at home (92.3% response). They underwent a Mini-Mental State Examination (MMSE) for assessment of cognitive function and answered questionnaires covering socio-demographic, psychological, physical and medical, and social activity items (2000/11). We defined @entity73 as an MMSE < or = 1 SD below the age-specific mean (n = 371). Out of a total eligible population of 332, 158 pairs of subjects and their proxies participated in a follow-up survey (2001/11). The subjects themselves underwent MMSE again, and were asked for complaints of memory-related problems. Proxies answered about functional capacity and memory-related problems of subjects, for which we assessed the level of @entity303 with the Clinical @entity303 Rating (CDR). We established criteria for encouragement to undergo detailed examination by a medical specialist as follows. 1) MMSE scores < or = 1 SD below age-specific means at both baseline and follow-up surveys, or 2) CDR > or = 0.5, and 3) not due to @entity1032 . RESULTS: Non- @entity1 had significant higher MMSE scores but were younger in the follow-up survey. Out of 96 subjects eligible for the detailed examination, 47 @entity1 showed a tendency for older age with lower MMSE scores or younger age with higher MMSE scores than the average in the follow-up survey. The detailed examinations confirmed @entity303 of @entity195 in 22 and @entity1294 in 13 on DSM-IV or magnetic resonance imaging. During our screening, 8 community care saloons were opened and the number of facilities for older @entity1 with @entity73 is increasing. CONCLUSIONS: To establish a community health care system to screen and cope with community-dwelling older @entity1 with @entity73 in earlier stages, increased awareness of residents with slight @entity73 is especially important. Our attempt also suggested the importance of educational lectures, methods for testing cognitive function, and @entity303 care activity.
