The era of 1 million elderly people with dementia is just around the corner. According to the Ministry of Health and Welfare, the number of dementia patients aged 65 and older this year is projected to reach 970,000, and it is expected to exceed 1 million next year. The number of elderly patients with mild cognitive impairment, who may progress to dementia, is also expected to surpass 3 million next year.
Dementia, which robs individuals of their memory, has long been a challenge for the medical community. This is because the precise causes of the disease have not been fully identified, leading to repeated failures in the development of fundamental treatments. To prevent dementia and slow its progression, it is crucial to manage and treat the earlier stage of mild cognitive impairment, but there have been no sharp solutions.
A domestic corporation has developed a medical device that integrates digital technology to improve the memory and train the cognitive functions of early dementia patients. Emocog has successfully commercialized the early screening software for dementia and cognitive dysfunction called "Memory Cock" and a digital therapeutic device (DTx) named "Cogthera."
◇Limits in the medical field, solved through startups
Professor Lee Jun-young from Seoul National University Boramae Hospital's Department of Psychiatry and Professor Noh Yoo-heon, a former anatomy professor at Chung-Ang University, founded Emocog as a university startup in 2021. The two believed that failing to properly manage mild cognitive impairment, the precursor to dementia, is a significant issue in dementia treatment.
The two professors collaborated with artificial intelligence (AI) engineers, data science researchers, and software developers to develop a mild cognitive impairment testing and cognitive training program. The results are Memory Cock and Cogthera.
Memory Cock is a web-based software that allows users to check cognitive health within 5 minutes anytime and anywhere using a mobile device. It determines whether someone has dementia by showing animals and asking questions like whether there was an elephant or selecting numbers associated with specific symbols. Memory Cock was released in November 2023 and has been used for testing by more than 10,000 people so far.
Cogthera is software developed to treat patients diagnosed with mild cognitive impairment and early dementia. It offers cognitive training in a voice conversation format to make it easy for older adults to use.
◇Association training that stimulates visual and auditory senses
As people age, their attention span and associative memory deteriorate first. For example, when mentioning "receipt" or "mobile phone," younger individuals may readily conjure up the image, while older individuals may not do so easily. Cogthera enhances associative memory through a "voice-based meta-memory training method."
CEO Noh noted, "The meta-memory training method applied in Cogthera is the result of ten years of research," adding, "It differs from other associative training programs that involve activities such as card flipping or matching the order of passing animals, as well as addition and subtraction exercises."
The simple associative training method involves showing picture cards and prompting associations with words such as 'receipt' and 'peanut.' The meta-memory training reflects the characteristics of how memories are stored in a systematic neural network by prompting individuals to recall experiences that combine various elements.
Cogthera's meta-memory training stimulates the auditory and visual senses by playing sounds of refreshing waves and describing throwing objects into the ocean. Co-CEO Noh explained, "If a patient with mild cognitive impairment undergoes simple training such as listing 'receipt' and 'peanut', they may not recall them immediately after, but with Cogthera's training, their minds remain occupied with 'receipt' and 'peanut' throughout the day."
Cogthera analyzes users' areas of cognitive decline using AI technology to provide tailored programs. Patients diagnosed with mild cognitive impairment can undergo Cogthera's prescribed therapy alongside medication. CEO Noh stated, "Through Cogthera, we can manage users' continuous participation in treatment and improve effects, as well as comprehensively assess treatment outcomes."
Let's think about the sea. Do you hear the sound of refreshing waves? This sound of waves is what the sea of memory produces. From now on, we will throw objects to remember into the sea. Imagine the scene of throwing objects into the vast sea. Now, I will call out the objects we will throw today: 'receipt', 'peanut'... When you see the microphone, please say 'receipt'. Let's throw the receipt into the sea. The receipt gets wet in the water and the numbers become blurry. Now let's throw the peanut into the sea. When you see the microphone, please say 'peanut'. -A portion of the voice narration from Cogthera's associative training program.
◇First domestic digital therapeutic device approved in Europe
Emocog has proven the therapeutic effects of Cogthera through standardized research and various clinical studies, receiving designation as the 35th innovative medical device (advanced technology group) from the Ministry of Food and Drug Safety in 2023. Additionally, it obtained medical device approval in Europe last year, becoming the first domestic digital therapeutic device to do so.
The company has been preparing for entry into the global market early on. To this end, it established a German branch, Cogthera, in 2022. Europe and the United States officially recognize digital therapeutic devices as medical devices for rehabilitation and interventional therapy, expanding insurance coverage, which creates a favorable market for achieving commercial success. Germany has systems in place for applying insurance benefits to digital therapeutic devices.
CEO Noh mentioned, "Our primary short-term goal is to secure European MDR certification and coverage under German insurance," adding, "We will sequentially proceed with the approval process from the U.S. Food and Drug Administration (FDA) and plans to enter Asian markets to enhance our global competitiveness."
Emocog has received support from major corporations, including not only Seoul National University but also Samsung Electronics, SK Telecom, Naver, Kakao, and GC Biopharma since its establishment. Last year, it raised a total of 22 billion won from major domestic and international investment institutions in the Series B funding round, bringing total investments to approximately 38 billion won. This indicates that the company has been highly regarded for its growth potential in the market.
◇Acceleration of market entry thanks to multi-ministry project support
The support from the multi-ministerial project research and development team has also helped facilitate market entry. Emocog was selected as one of the top ten representative project achievements of the multi-ministry team this year.
CEO Noh stated, "From the early days of establishment, we secured research and development (R&D) expenses through various government-led support programs," adding, "We were able to receive continuous support by being selected for the digital healthcare support programs from the Ministry of Trade, Industry and Energy and the Ministry of Health and Welfare, as well as projects under the multi-ministerial medical device program." He explained, "Government support not only helps with R&D expenses and administrative procedures for market entry but also elevates trust in the company in domestic and international markets."
Emocog expanded its operations this year by merging with Share and Service. This company developed Easy Breed (a respiratory rehabilitation software), which was approved as the 4th digital therapeutic device by the Ministry of Food and Drug Safety last year. Co-CEO Noh explained, "I believe that being able to manage patients' rehabilitation independently at home for daily life is the most suitable structure for digital healthcare, which is why we decided to merge," adding that "administrative procedures are expected to be finalized by June."
CEO Noh emphasized, "Digital therapeutic devices will open a new medical paradigm centered on patient-customized rehabilitation and interventional treatment," stating, "We will continue to strengthen content development and global collaboration to provide digital therapeutic devices that allow patients to maintain healthier lives and reduce medical costs."