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Report

Teaser, summary, work performed and final results

Periodic Reporting for period 2 - my-AHA (My Active and Healthy Aging)

Teaser

Summary

By 2060 1/3 Europeans will be >65y, with an associated large increase in the ratio of inactive over working people (from 1:4 to 1:2) (EU, 2015). The proportion of the population >65 years (general retirement age) will increase from 90 in 2012 to 155 million in 2060, with a dramatic increase in the proportion aged over 80y. The resulting cost of aged care is rising daily, and soon will become unaffordable. Innovative solutions will take advantage of new ICT products and services to provide better and more affordable care. A major benefit of ICT based products in aged care is the capacity of these systems to enable the older adult to remain in their own home and to delay/negate the need to relocate to an aged care facility.
The progressive increase of life expectancy does not correlate with improved physical and mental capacity in the individual: it is increasingly evident that any kind of intervention has very limited chances of success when disease is established, the focus has moved from care to prevention before the onset of clinical disease states. Prevention of disease comorbidities and promotion of healthy lifestyle factors (physical activity, cognitive stimulation, social interaction and diet) may prevent cognitive decline (FINGER study, Lancet. 385:2255).
The overall objective of the My-AHA project is to develop and validate an ICT-based solution for early risk detection and intervention (i.e. prevention), in order to support active and healthy ageing and prevent cognitive impairment, frailty, depression and falls. The My-AHA project will achieve this objective by unobtrusive longitudinal behavioural sensing of the daily living environment of a large group of older adults. Additionally, the My-AHA solution supports active and healthy ageing by enabling early detection and minimization of risks associated with ageing, and in particular for Dementia (MCI), Depression (Mood), Falls and Frailty. In these terms the early risk detection considers four fundamental aspects of the life of older adults, physical (by considering vital data, gait, quality of sleep and in general, movements activities, and fall risk), cognitive (by monitoring the cognitive level, e.g in exergames), mood (depression and anxiety), and social activities. Further, the My-AHA platform is designed to deliver individually tailored ICT-based interventions targeted to the early identified risk factors identified for each individual to the behaviour in a sustainable and long-manner so as to reduce their risk for future chronic diseases.

Work performed

During the RP1 the project underwent to two parallel tracks, in close coordination. One involved preparation for the two phases of the experimentation on humans, the second involved preparation of the dashboard and integration of the different technical components of My-AHA. There two major parts of the project were strongly intertwined and mutually interactive involving clinical and technical members to enable a continuous adaptation of system development to meet the needs of the user and the project objectives.
During the first reporting period the following work has been performed:
1. Ethical issues were discussed and protocols for the alpha wave were submitted to and authorized by the Ethical Committee of the University of Turin, and transferred to other testing sites.
2. Development of the Randomized Controlled Trial (RCT) protocol commenced and was adjusted to the needs of the different countries. The RCT protocol is now in the final phase of preparation having been accepted by EU-partners and the Australian external partner, and is now under examination by the Asian external partners (South Korea and Japan). The RCT protocol will be registered as a clinical trial and published in a peer reviewed international journal.
3. During the alpha wave data from participants regarding system portability and usability was collected and is being analysed.
4. RCT trial sites are commencing processes to recruit participants into the study (local ethical board approval).
5. Risk models have been developed and analysed with a set of physical, cognitive, nutritional and social interventions having been designed and entering final development ahead of deployment.
6. The resulting My-AHA system architecture has been inspired on a message-driven solution that is typical in Internet-of-Things scenarios. This reflects the project aim to target multi-dimensional aspects of frailty (physical, cognitive, social, nutritional) in conjunction with the large number of project partners and diverse range of original platforms to be integrated. To meet these demands a highly modular development of the My-AHA platform was utilised.
7. Through the connectors developed with the original platforms (also the Cognitive Platform developed into the project is managed as an Original Platform) and through the message broker, My-AHA Middleware manages all the exchanges of data among the devices and the users, both for the frailty assessment and the intervention and the motivational program.
8. In order to interact with all the My-AHA components developed, the entry point for My-AHA system is the â€œdashboardâ€. The dashboard enables the senior user to register on the My-AHA platform and then connect with and use My-AHA apps, to see the risks associated with their individual data and to monitor data collected across different platforms, to follow individually tailored intervention plans and to track their progress over time. The My-AHA system dashboard are fully cross-device compatible (smartphones, TVs, PCs).

Final results

My-AHA is using commercial and non-stigmatizing devices to collect data from all frailty domains and to allow a robust detection of pre-frailty and frailty situations. My-AHA analyses all main domains and stages of frailty including pre-frailty and non-frailty. My-AHA allows real time tracking of behaviour and will use machine learning to develop algorithms for early detection of pre-frailty. My-AHA provides personalized intervention depending on detailed user characteristics (data collected by the system) and individual risk, and enhances solutions targeting the interaction among the key domains of frailty. My-AHA is developing middleware to connect end users and health care providers enabling the inclusion of new services and products in the future.
The global ageing telehealth/telemedicine market has grown at a compound annual growth rate of 18.6%. At the same time, relevant figures from the telecare services sector suggest a current market value of â‚¬2.5-3 billion in providing services to around 7 million older people (60+) in Europe, project to reach â‚¬5 billion by 2020, due to the ageing population and the rising demand for higher quality of life. In addition to telecare, professional provision of home care will be another market for the My-AHA platform. Solutions such as the My-AHA platform will support of home/domiciliary care and reduce this workforce gap, indicating there are significant opportunities for penetration of the My-AHA platform into this market.
Welfare and health systems are increasingly aware of the possibilities of ICT to solve the needs of ageing persons in a more accurate, comfortable, and cost-effective way. Prospective analyses indicate that a moderate penetration of telecare services in EU27 will result in a reduction of 12.5 million bed days of hospital admissions and reduce the rate of over 40 million in care home admissions.