Decrease of cOgnitive decline, malnutRition and sedEntariness by elderly

empowerment in lifestyle Management and social Inclusion – DOREMI

FP7-ICT-2013-10 GA 611650

Oberdan Parodi

IFC-CNR Pisa, Italy

Scientific and clinical overview

DOREMI ConsortiumoremiParticipant

no. Participant organisation namePart. short

nameCountry

1 Consiglio Nazionale Delle Ricerche CNR IT

2 Università di Pisa UNIPI IT

3 TSB Real Time Location Systems SL MYSPHERA ES

4 AIT Austrian Institute of Technology GmbH AIT AT

5 Fundació per la Universitat Oberta de Catalunya UOC ES

6 The Extracare Charitable Trust ExtraCare UK

7 Imaginary Srl IMA IT

8 De Montfort University DMU UK

9 Age Platform Europe AISBL AGE BE

10 

SI4LIFE – Scienza e impresa insieme per migliorare la qualità della vita scrl

SI4LIFE IT

11 Accord Housing Association Ltd Accord UK

UOC

IMA

DMU

AGE

CNR

AIT

MYSPHERA

EXTRACARE

UNIPI

Si4LIFE

ACCORD

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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 addressingMalnutrition (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.

Why the 3 target impairments in DOREMI project?

The perverse linkamong the 3 impairments

COGNITIVE DECLINE

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MALNUTRITIONSEDENTARINESS

++

discrepancy between needs,intake and utilization of nutrients

inappropriate mobilization, CV system impairment

Fluid imbalance hyper/dehydration

Loss of muscular strength/mass

Decrease of basal energy expenditure

Synergic detrimental effectsof Malnutrition, Sedentarinessand Cognitive decline

Cardiovascular deterioration CV EVENTS

The DOREMI project vision is aimed at developing a

systemic solution for 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

oremi ICT solution against the 3 impairments

Engage Engage

Monitor Monitor

Analyse Analyse

Active Ageing Life Style Protocol

Specialist

Select protocol or combination of protocols (e.g. ADL, IADL, diet etc.)

Gamified Scenarios for promoting physical, mental and social activity

Social game

Dashboard / LS protocol

compliance or upgrade

Exergame and Diet advice

Lifestyle protocol gamified

Social interaction

How elderly respond to protocol

Cognitive game

Physical activity

DOREMI environment:

Monitor protocol compliance, confirm or assign a revised protocol suggested by the DOREMI

Community

Assign

Nutrition

oremi Recognition of impairments, profiling the lifestyles

Validated scales for disease characterization

Criteria for eligibility of users’ enrolment

Degree of impairment

Profiling lifestyle solution

Engage Engage

Monitor Monitor

Analyse Analyse

Active Ageing Life Style Protocol

Specialist

Select protocol or combination of protocols (e.g. ADL, IADL, diet etc.)

Gamified Scenarios for promoting physical, mental and social activity

Social game

Dashboard / LS protocol

compliance or upgrade

Exergame and Diet advice

Lifestyle protocol gamified

Social interaction

How elderly respond to protocol

Cognitive game

Physical activity

DOREMI environment:

Monitor protocol compliance, confirm or assign a revised protocol suggested by the DOREMI

Community

Assign

Nutrition

oremi DOREMI Environment: ENGAGE

“SERIOUS GAMES”

DIETARY PROTOCOL

PHYSICAL ACTIVITY PROTOCOLS TO INCREASE:

• Muscle Mass

• Strength

• Physical Performance

Engage Engage

MonitorMonitor MonitorMonitor

Analyse Analyse

Active Ageing Life Style Protocol

Specialist

Select protocol or combination of protocols (e.g. ADL, IADL, MMSE etc.)

Gamified Scenarios for promoting physical, mental and social activity

Social game

Dashboard / LS protocol

compliance or upgrade

Exergame and Diet advice

Lifestyle protocol gamified

Social interaction

How elderly respond to protocol

Cognitive game

Physical activity

DOREMI environment:

Monitor protocol compliance , confirm or assign a revised protocol suggested by the DOREMI

Community

Assign

Nutrition

oremi DOREMI Environment: MONITOR

MALNUTRITION:

Test Scores during intervention (MNA)

Anthropometric data sensorized bed carpet

Intake and quality of food during the day

oremi DOREMI Environment: MONITOR

SEDENTARINENESS:

Test Scores during intervention (PASE, BERG)

Anthropometric data sensorized bed carpet

Bracelet/WSN

ExerGames

Social Games

MonitoringDOREMI parameters

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Monitoring:

Heart Rate

Physical Activity Kcal intake by food Kcal consumption by PA

Compliance to DOREMI

oremi DOREMI Environment:MONITOR

COGNITIVE DECLINE:

Test Scores during intervention (MMSE, Token,…)

Cognitive Games (specifically designed)

Social Games

QoL assessment

Engage Engage

Monitor Monitor

Analyse Analyse Analyse Analyse

Active Ageing Life Style Protocol

Specialist

Select protocol or combination of protocols (e.g. ADL, IADL, diet etc.)

Gamified Scenarios for promoting physical, mental and social activity

Social game

Dashboard / LS protocol

compliance or upgrade

Exergame and Diet advice

Lifestyle protocol gamified

Social interaction

How elderly respond to protocol

Cognitive game

Physical activity

DOREMI environment:

Monitor protocol compliance, confirm or assign a revised protocol suggested by the DOREMI

Community

Assign

Nutrition

DOREMI Environment:ANALYZE

Activity Recognition Process

“Reasoning” on the performance of the user

Presentation to the specialist of the LS protocol

compliance (DASHBOARD)

Quando il progresso allunga la vita

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Validation Subjects Extracare Accord SI4LIFE Total

Location Milton Keynes (UK) West Midlands (UK) Genoa (Italy) Seregno (Italy)

Research Group 7 7 5 11 30

Control Group* 3 3 2 2 10

WP6:Validation of integrated system and refinement

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* Control Group = untreated patients with impairments

oremi Key Performance Indicatorsof 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…)

oremi 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

& partners …

Baseline

10 days

Training

15 days

Training

60 daysFinal

evaluation

5 days

TRIAL STRUCTURE & TIMESCALE

= 90 days

A

N. 10

2015

Nov Jan

Nov 1M28M27M25

90 days

EXTRA

Hardware Transferand Site Preparation

2016

Feb

N. 10ACCORD

N. 10SI4LIFE - Seregno

N. 10SI4LIFE - Genoa

90 days

Jan 31 Feb 1 Feb 29M28

Mar

M29Mar 1

Feb May

M31May 31

N.= number of participants

PILOT STUDY TIMESCALE B

Oct 16M24

Site Preparation

Oct 31M24

Oct Oct

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Kick Off MeetingPisa, December 2, 2013

Bioelectrical Impedance Analysisas follow-up tool for malnutrition correction: BIA

Kick Off MeetingPisa, December 2, 2013