title: Roles of consultation organizations in the early detection of dementia: from the practices of the Community Consultation Center for Citizens with Mild Cognitive Impairment and Dementia, Nippon Medical School.
abstract: BACKGROUND
  As society ages, early detection of dementia is becoming increasingly important. Many hospitals have opened memory-loss clinics, and various new approaches for early examination and appropriate diagnosis are being tried. However, these memory-loss clinics are ultimately part of the hospital establishment, implying that, in addition to the burdens of time and effort to undergo examinations and consultations, patients might have a certain psychological resistance. With a grant from the Ministry of Education, Culture, Sports, Science and Technology, the Institute of Development and Aging Science at Nippon Medical School has opened a center called the Community Consultation Center for Citizens with Mild Cognitive Impairment and Dementia, which is a dementia-related center outside the regular hospital. This center has been developing a system that makes consultations easier. We performed a retrospective follow-up study that aimed to determine how much this approach contributes to the early detection of dementia compared with outpatient visits to university hospitals.
  
  
  METHODS
  Persons who were found to have organic brain syndrome (defined as organic diseases related to dementia, including mild cognitive impairment) after visiting the Consultation Center during the survey period were referred to as the Consultation Center group, and persons who were found to have organic brain syndrome after an initial visit to the Department of Neurology at Nippon Medical School Musashi Kosugi Hospital were referred to as the Hospital group. We compared the groups in terms of sex, age, Mini-Mental State Examination (MMSE) score, and subclassification by means of the t-test and χ(2) test.
  
  
  RESULTS
  Both the mean MMSE score (p<0.001) and percentage of subjects with an MMSE score of 24 points of higher (p=0.007) were significantly higher in the Consultation Center group than in the Hospital group.
  
  
  CONCLUSIONS
  Consultations can be made more casually at the Consultation Center than at hospitals. Our results suggest that more casual consultations contribute to the early detection of dementia.
authors.affiliation: Community Consultation Center for Citizens with Mild Cognitive Impairment and Dementia, Institute of Development and Aging Science, Nippon Medical School, Kanagawa, Japan. t-nomura@nms.ac.jp
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Nomura
authors.forename: Satoko
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Shin
authors.initials: S
authors.lastname: Kitamura
authors.forename: Akiko
authors.initials: A
authors.lastname: Ishiwata
authors.forename: Chika
authors.initials: C
authors.lastname: Ishii
authors.forename: Rumi
authors.initials: R
authors.lastname: Nemoto
authors.forename: Oichi
authors.initials: O
authors.lastname: Kawanami
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000458:organization & administration / Q000592:standards; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D003704:Dementia / Q000175:diagnosis*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D012017:Referral and Consultation / Q000458:organization & administration* / Q000592:standards; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012577:Schools, Medical / Q000458:organization & administration; D012680:Sensitivity and Specificity