title: [Regional network for patients with dementia--carrying out Kumamoto model for dementia].
abstract: The Japanese government has tried to establish 150 Medical Centers for Dementia (MCDs) since 2008 to overcome the dementia medical service shortage. MCDs are required to provide special medical services for dementia and connect with other community resources in order to contribute to building a comprehensive support network for demented patients. The main specific needs are as follows: 1) special medical consultation; 2) differential diagnosis and early intervention; 3) medical treatment for the acute stage of BPSD; 4) corresponding to serious physical complications of dementia; 5) education for general physicians (GPs) and other community professionals. According to the population rate, two dementia medical centers were planned in Kumamoto Prefecture. However, it seemed to be too few to cover the vast Kumamoto area. Therefore, the local government and I proposed to the Japanese government that we build up networks that consist of one core MCD in our university hospital and several regional MCDs in local mental hospitals. The local government selected seven (nine at present) centers according to the area balance and condition of equipment. The Japanese government has recommended and funded such networks between core and regional centers since 2010. The main roles of the core centers are as follows: 1) early diagnosis such as Mild cognitive impairment, very mild Alzheimer's disease, Dementia with Lewy bodies, and Frontotemporal lobar degeneration using comprehensive neuropsychological batteries and neuroimagings, such as MRI and SPECT scans; 2) education for GPs; 3) training for young consultants. The core center opens case conferences at least every one or two months for all staff of regional centers to maintain the quality of all centers and give training opportunities for standardized international assessment scales. While the main roles of the regional centers are differential diagnosis, intervention for BPSD, and management of general medical problems using local networks with general hospitals and GPs, and organizing local networks for dementia with GPs and care staff In short, the regional centers take responsibility for ordinal clinical work for dementia. To construct a more extensive network, each regional center must hold regional case conferences and lectures on dementia for care staff and GPs sharing knowledge and skills acquired from case conferences by the core center.
authors.forename: Manabu
authors.initials: M
authors.lastname: Ikeda
mesh_terms: D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003153:Community Health Services; D003159:Community-Institutional Relations; D003704:Dementia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D018479:Early Intervention, Educational; D006801:Humans; D007564:Japan; D010348:Patient Care Team; D010819:Physician's Role