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Oberdan Parodi IFC-CNR Pisa, Italy

D ecrease of c O gnitive decline, malnut R ition and sed E ntariness by elderly empowerment in lifestyle M anagement and social I nclusion – DOREMI FP7-ICT-2013-10 GA 611650. Scientific and clinical overview. Oberdan Parodi IFC-CNR Pisa, Italy. DOREMI Consortium. DMU. ACCORD. EXTRACARE.

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Oberdan Parodi IFC-CNR Pisa, Italy

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  1. Decrease of cOgnitive decline, malnutRition and sedEntariness by elderly empowerment in lifestyle Management and social Inclusion – DOREMI FP7-ICT-2013-10 GA 611650 Scientific and clinical overview OberdanParodi IFC-CNR Pisa, Italy

  2. DOREMI Consortium

  3. DMU ACCORD EXTRACARE AGE AIT IMA Si4LIFE UOC UNIPI MYSPHERA CNR

  4. Why the 3 target impairments in DOREMI project? According to several Food and Health Associations, three are the most notable health promotion and disease prevention programs that target the main causes of morbidity and premature mortality, among them obesity, hypertension, and mental disorders. These programs are addressing Malnutrition (obesity/abnormal diet lifestyle), Sedentariness, and Cognitive decline, the main conditions affecting the quality of life of elderly people and driving to the above described diseases.

  5. The perverse linkamong the 3 impairments COGNITIVE DECLINE + + SEDENTARINESS MALNUTRITION discrepancy between needs, intake and utilization of nutrients inappropriate mobilization, CV system impairment

  6. Synergic detrimental effects of Malnutrition, Sedentariness and Cognitive decline • Fluid imbalance hyper/dehydration • Loss of muscular strength/mass • Decrease of basal energy expenditure Cardiovascular deterioration CV EVENTS

  7. The DOREMI project vision is aimed at developing a systemic solutionfor healthy ageing,based on a well-targeted problem definition and model, able to prolong the functional and cognitive capacity by a promotion of the health through a constructive interaction among mind, physical activity, diet and social engagement ICT solution against the 3 impairments

  8. Specialist DOREMI environment: GamifiedScenarios for promotingphysical, mental and social activity Assign Active Ageing Life Style Protocol Engage Lifestyleprotocolgamified Social game Exergame and Diet advice Select protocol or combination of protocols (e.g. ADL, IADL, diet etc.) Cognitive game Community Nutrition Social interaction Monitor Monitor protocol compliance, confirm or assign a revised protocol suggested by the DOREMI Physical activity Dashboard / LS protocol compliance or upgrade How elderly respond to protocol Analyse

  9. Recognition of impairments, profiling the lifestyles • Validated scales for disease characterization • Criteria for eligibility of users’ enrolment • Degree of impairment • Profiling lifestyle solution

  10. Specialist DOREMI environment: GamifiedScenarios for promotingphysical, mental and social activity Assign Active Ageing Life Style Protocol Engage Lifestyleprotocolgamified Social game Exergame and Diet advice Select protocol or combination of protocols (e.g. ADL, IADL, diet etc.) Cognitive game Community Nutrition Social interaction Monitor Monitor protocol compliance, confirm or assign a revised protocol suggested by the DOREMI Physical activity Dashboard / LS protocol compliance or upgrade How elderly respond to protocol Analyse

  11. DOREMI Environment: ENGAGE • “SERIOUS GAMES” • DIETARY PROTOCOL • PHYSICAL ACTIVITY PROTOCOLS TO INCREASE: • Muscle Mass • Strength • Physical Performance

  12. Specialist DOREMI environment: GamifiedScenarios for promotingphysical, mental and social activity Assign Active Ageing Life Style Protocol Engage Lifestyleprotocolgamified Social game Exergame and Diet advice Select protocol or combination of protocols (e.g. ADL, IADL, MMSE etc.) Cognitive game Community Nutrition Social interaction Monitor Monitor protocol compliance , confirm or assign a revised protocol suggested by the DOREMI Physical activity Dashboard / LS protocol compliance or upgrade How elderly respond to protocol Analyse

  13. DOREMI Environment: MONITOR • MALNUTRITION: • Test Scores during intervention (MNA) • Anthropometric data sensorized bed carpet • Intake and quality of food during the day

  14. DOREMI Environment: MONITOR • SEDENTARINENESS: • Test Scores during intervention (PASE, BERG) • Anthropometric data sensorized bed carpet • Bracelet/WSN • ExerGames • Social Games

  15. MonitoringDOREMI parameters • Monitoring: • Heart Rate • Physical Activity • Kcal intake by food • Kcal consumption by PA • Compliance to DOREMI

  16. DOREMI Environment: MONITOR • COGNITIVE DECLINE: • Test Scores during intervention (MMSE, Token,…) • Cognitive Games (specifically designed) • Social Games • QoL assessment

  17. Specialist DOREMI environment: GamifiedScenarios for promotingphysical, mental and social activity Assign Active Ageing Life Style Protocol Engage Lifestyleprotocolgamified Social game Exergame and Diet advice Select protocol or combination of protocols (e.g. ADL, IADL, diet etc.) Cognitive game Community Nutrition Social interaction Monitor Monitor protocol compliance, confirm or assign a revised protocol suggested by the DOREMI Physical activity Dashboard / LS protocol compliance or upgrade How elderly respond to protocol Analyse

  18. DOREMI Environment: ANALYZE Activity Recognition Process “Reasoning” on the performance of the user Presentation to the specialist of the LS protocol compliance (DASHBOARD)

  19. Quando il progresso allunga la vita

  20. WP6:Validation of integrated system and refinement * Control Group = untreated patients with impairments

  21. Key Performance Indicators of DOREMI effectiveness • Improvements of the scores adopted • for definition of each impairment • Improvement of CV performance • (HR, PB, RPP) during a 6 min. walking test • Improvement of hydration • Increase of muscle mass, improvement of BMI • Metabolic improvement • (glycemia, total CHOL, LDL, Albumin, etc…)

  22. Fulfill the end-user acceptance & their privacy • Personalized regime for PA and diet high • degree of lifestyle characterization • Development of unobtrusive monitoring • Empowering, stimulating, collecting habits and • data by authorized and specialized personnel • Respect of all SPIRIT 2013 Statements* • *Defining Standard Protocol Items for Clinical Trials. Annals of Internal Medicine 2013

  23. & partners …

  24. 10 days 5 days 15 days 60 days Training Training Baseline Final evaluation TRIAL STRUCTURE & TIMESCALE A = 90 days B PILOT STUDY TIMESCALE M31 M24 M24 M29 M28 M28 M25 M27 May 31 Mar 1 Oct 16 Oct 31 Feb 29 Feb 1 Jan 31 Nov 1 2016 2015 May Mar Oct Oct Nov Feb Feb Jan 90 days Site Preparation N. 10 EXTRA N. 10 ACCORD Hardware Transfer and Site Preparation 90 days N. 10 SI4LIFE - Seregno N.= number of participants N. 10 SI4LIFE - Genoa

  25. Kick Off Meeting Pisa, December 2, 2013

  26. Bioelectrical Impedance Analysis as follow-up tool for malnutrition correction: BIA Kick Off Meeting Pisa, December 2, 2013

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