Perspectives

Survey on Screening of the Cognitive Decline for the Municipalities in Japan

Latest Report

Dementia is now an issue that needs to be addressed globally. In order to delay the onset of dementia, preventive interventions and lifestyle improvements from MCI(mild-cognitive impairment) in the preclinical stage of dementia are recommended. In this survey, we summarized attitudes and approaches to cognitive function screening methods in local governments across the country.

Background

Japan is one of the countries with the largest aging societies in the world, and its prevalence rate of dementia would be the highest in developed countries, since it is estimated that the number of patients will increase from approximately 4.62 million in 2012 to 7 million in 2025.

In May 2019, World Health Organization (WHO) published the guideline entitled "Risk reduction of cognitive decline and dementia" and showed the significance of intervention in mild-cognitive impairment (MCI). 

The Government of Japan announced “Framework for the Promotion of Policies for Dementia Care” in June, 2019. In this framework, for the period until 2025, when the elderly of the baby boomer generation will be aged 75 years or older, Japan aims to implement relevant measures firmly, focusing on “prevention” and “inclusion”, much like two wheels of a cart; “prevention” to delay the onset and progression of dementia, and “inclusion” to enable people with dementia to live with peace of mind in their communities.

It is expected that that municipalities would actively work on implementation related to dementia.

However, there are issues with extracting target population and promoting medical consultations appropriately at the municipalities, because methods for screening of mild-cognitive impairment (MCI) and preliminary stages of cognitive decline are undeveloped.

Therefore, Deloitte conducted the questionnaire survey on “Prevention and early detection for MCI and preliminary stage of dementia”, targeting the departments in charge of dementia care of the municipalities in Japan.

Survey Method

Targeted Municipalities

The questionnaires were sent by post to the departments in charge of dementia care of total 1,558 municipalities at cities/wards/towns levels except for villages.

Outline of questionnaire

The questionnaires were designed regarding the present implementation on MCI and preliminary stage of dementia as followings;

  • Main department in charge of dementia care
  • Target age for dementia care
  • Willingness on implementation for dementia care
  • Current situation for dementia care
  • Issues for dementia care
  • Plan to introduce for screening tools
  •  Private public partnership

Method

Collected the questionnaire by post

Survey duration

From 16th August 2019 (date of delivery) to 18th October 2019 (Date of deadline for collection)

Results of the questionnaire

Collection rate of the questionnaire

The number of delivery and the valid collection rate for the questionnaire were the following;

The number of delivery for the questionnaire: 1,558 municipalities in Japan

The valid number of collected questionnaire: 375 municipalities

The valid collection rate of the questionnaire: 24.1%

Breakdown of responded municipalities

The breakdown of the 375 municipalities was, 221 of  “City” (58.15%) accounted for more than half of total, 104 of “Town” (27.7%),  6 of “Ward” (1.6%), and 44 of “No answer (unnamed municipality)”  (11.6%).

Results

  • More than 80% of municipalities answered their willingness on implementation for dementia care, though they showed more willingness on implementation for prevention of dementia compared with early detection.
  • Most of municipalities answered that the actual starting age for prevention care was in the 60s. On the other hand, almost the same number of them answered that ideal target age should be in the 40s.
  • Regarding the early detection, most of municipalities answered that the actual target age was in the 60s, while most of them answered that ideal target age should be in the 40s. The results on early detection showed the similar trend with the results on prevention. It is estimated that many of municipalities have not implemented approaches for early detection of dementia, because the number of answers on ideal target age was more than the ones on actual target age.
  • Most of municipalities implemented approach for comprehensive long-term care, however only less than 20% of municipalities conducted screening test on cognitive decline.
  • Some of municipalities provided services on prevention of dementia with all people without any age restriction. However, half of municipalities provided it with people who were long-term care insurance recipients.
  • 53.1% of municipalities had no plan to introduce screening tools of cognitive decline which is the key to early detection. However, out of them, 28.6% answered that the screening tools would be needed in the future.
  • 14.4% of municipalities had experiences on public private partnership such as cohort research with universities and working with private companies.

Deloitte Touche Tohmatsu LLC, Risk Advisory Division, Healthcare Unit would continually contribute to survey on social issues for improving quality of health.

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