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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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Presentation Transcript
slide1

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

slide3

DMU

ACCORD

EXTRACARE

AGE

AIT

IMA

Si4LIFE

UOC

UNIPI

MYSPHERA

CNR

slide4

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.

the perverse link among the 3 impairments

The perverse linkamong the 3 impairments

COGNITIVE DECLINE

+

+

SEDENTARINESS

MALNUTRITION

discrepancy between needs,

intake and utilization of nutrients

inappropriate mobilization, CV system impairment

slide6

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

slide7

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

slide8

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

slide9

Recognition of impairments, profiling the lifestyles

  • Validated scales for disease characterization
  • Criteria for eligibility of users’ enrolment
  • Degree of impairment
  • Profiling lifestyle solution
slide10

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

slide11

DOREMI Environment:

ENGAGE

  • “SERIOUS GAMES”
  • DIETARY PROTOCOL
  • PHYSICAL ACTIVITY PROTOCOLS TO INCREASE:
    • Muscle Mass
    • Strength
    • Physical Performance
slide12

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

slide13

DOREMI Environment:

MONITOR

  • MALNUTRITION:
  • Test Scores during intervention (MNA)
  • Anthropometric data sensorized bed carpet
  • Intake and quality of food during the day
slide14

DOREMI Environment:

MONITOR

  • SEDENTARINENESS:
  • Test Scores during intervention (PASE, BERG)
  • Anthropometric data sensorized bed carpet
  • Bracelet/WSN
  • ExerGames
  • Social Games
monitoring doremi parameters

MonitoringDOREMI parameters

  • Monitoring:
  • Heart Rate
  • Physical Activity
  • Kcal intake by food
  • Kcal consumption by PA
  • Compliance to DOREMI
slide16

DOREMI Environment:

MONITOR

  • COGNITIVE DECLINE:
  • Test Scores during intervention (MMSE, Token,…)
  • Cognitive Games (specifically designed)
  • Social Games
  • QoL assessment
slide17

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

slide18

DOREMI Environment:

ANALYZE

Activity Recognition Process

“Reasoning” on the performance of the user

Presentation to the specialist of the LS protocol compliance (DASHBOARD)

slide20

WP6:Validation of integrated

system and refinement

* Control Group = untreated patients with impairments

slide21

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…)
slide22

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
slide26

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

slide27

Kick Off Meeting

Pisa, December 2, 2013

slide28

Bioelectrical Impedance Analysis

as follow-up tool for malnutrition correction: BIA

Kick Off Meeting

Pisa, December 2, 2013