OBJECTIVES: The healthcare expenditure seriously worsen local finance, because of lower tax revenue and more rapid population aging than urban area. Hirosaki University started a routine checkup in 2005 in Iwaki Town located in Aomori Prefecture which shows the least life expectancy in Japan. It also established Center of Healthy Aging Innovation (COI) program in 2013 for enlightening residents using checkup results. The aim of this study is evaluating the effect of COI program especially on the maintenance of cognitive function.

METHODS: We used checkup data since 2008 and identified subjects with “suspected mild cognitive impairment (MCI)” and time to occurrence of “suspected MCI”, on the basis of Mini-Mental State Examination (MMSE) scores. We also distinguished subjects initiated this regular checkup before the COI start (“before-COI” group) from those initiated it after the COI start (“after-COI” group). We compared the probability of MCI occurrence between groups and age classes using Kaplan-Meier (KM) curves. A multivariate analysis was also performed to evaluate factors associated to MMSE changes.

RESULTS: KM curves showed significantly higher risks of MCI occurrence in older residents (p<0.001). The multivariate analysis showed that MMSE scores significantly decreased in “before-COI” (p=0.008), after adjusted the number of checkups receipt of each subject (assumed as the duration of remaining enough healthy to go to checkups). Age and MMSE scores at the first checkup were significant risk factors of the degeneration of cognitive functions (p<0.001). As assuming all residents didn’t participate COI program, estimated MMSE scores showed approximately two times as many “suspected MCI” residents as real MMSE scores.

CONCLUSIONS: Due to COI program, the incidence of MCI was likely to decrease and expected to decrease dementia patients in the future. For all local governments with same economic issues in Japan, this program is considered commonly effective.