Monitoring older citizens@risk for optimal interventions

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  Bart Verkerke on: October 15, 2015 at 6:21 pm #379453

  The consequences of demographic ageing are higher population proportions of

  physical frailty, cognitive impairment and social exclusion. This can lead to

  transforming citizens from being active, productive members of society to becoming

  increasingly dependent on health and social care.

  We need a paradigm shift to prevention strategies, a new approach that puts the

  citizen at the centre of their wellbeing and more responsible for it. The philosophy of

  SPRINT is early risk detection and intervention for Active Ageing using self-

  management supported by ICT. SPRINT aims to implement, test and evaluate a

  prevention solution, minimizing the effects associated with normal ageing by early

  sensing and intervention based on ICT solutions for declining physical and cognitive

  conditions and hence promoting social inclusion. But prevention must begin earlier

  than 65, ‘downstream’ from expensive care, so we target people from the age of 50.

  So how can ICT help? Technology has advanced to allow unobtrusive sensing and

  feedback of the vital information necessary to promote healthy living. But alone

  sensing is insufficient; a paradigm change is needed with the individual as a self-

  manager of his or her own health, encouraged and empowered by behaviour change

  therapy and delivered by ICT tools. This solution must be fuelled by appropriate

  nutrition and healthy lifestyle support to assist with prevention.

  SPRINT will produce, evaluate and disseminate sensing and intervention prototypes

  to promote physical and cognitive wellbeing, social inclusion and better nutrition.

  Integrating the data from these domains will provide a holistic viewpoint of normal

  ageing by determining features that contribute to physical and cognitive wellbeing.

  We already know that proper nutrition is a key factor that has direct influence on

  both physical and cognitive wellbeing. Indeed, poor diet leads from malnutrition at

  one extreme to over-eating and eventual diabetes at the other. The consequence to

  the individual and society in the longer term are significant and costly. On the other

  hand, by utilizing behaviour change to enhance physical and cognitive wellbeing,

  social inclusion will be positively affected. For example, the older person will have

  the confidence in their physical and cognitive capability to continue to leave the

  home, to continue longer in the workplace, to maintain a wide circle of friends and

  hence to contribute positively to the economy and society. This approach will

  directly benefit Carers and relatives.

  Of course as the older person’s physical and cognitive abilities naturally decline over

  time then it is inevitable that they may wish to stay at home more. Such decline

  should be graceful, personalized, context-aware and managed by the individual in

  association with a carer or relative, if appropriate. Software has advanced to

  provide this context- aware and personalized support, providing we can gain an

  understanding of the complex data that makes up an older person’s interaction with

  their environment. In such a case SPRINT can assist with maintaining social contact

  through the traditional means of telephone and social media, encouraging

  acquaintances to continue to visit, in line with the ‘more years, better lives’

  philosophy. An ethical approach is paramount. SPRINT cannot be overly intrusive; it

  cannot override the rights of the individual to self-determination. SPRINT can assist

  all the stake-holders: the older person, their relative or carer, the health care

  system, the future economy and society in general.

  SPRINT will use behaviour change approaches to improve physical and cognitive

  wellbeing, social inclusion and nutrition. SPRINT will investigate the relationship

  between these components and with behaviour change theory, to provide significant

  advances in the ‘state of the art’ (SOA). These advances will be in sensing and

  intervention of the attributes; feedback using a Dashboard (which we have named

  ‘Health E-Dashboard’) to improve self-management and in the understanding the

  interaction, by data interpretation. Early risk identification is key; it is associated

  with insufficient physical and cognitive activity, poor nutrition and potential

  exclusion from society.

  By adopting an approach of risk identification and intervention, SPRINT

  will significantly impact on the quality of life of older people and ameliorate the

  effects of Demographic ageing on the health system, economy and society.

  SPRINT will deliver impact in both research and innovation. The research will focus

  on how behaviour change strategies can promote health by allowing the individual

  to self-manage their physical and cognitive wellbeing, supported by appropriate

  nutrition. Adherence to these positive lifestyle approaches should improve social

  inclusion. Big data analysis will investigate the effectiveness of the approach across

  three regions in Europe, with contrasting health systems. Innovation will be in the

  form of the creation of bespoke apps for user devices, supported by a cloud-based

  Dashboard service delivered to people in their own homes using ICT appropriate to

  need and user choice (e.g., connected television, smartphone, and tablet).

  Commercial sensing devices will be used which have emerged from the burgeoning

  Ambient Assisted Living marketplace (AAL marketplace 2015).

  Hitherto, the important areas of physical, cognitive, nutrition and social inclusion

  have been studied separately in national and European research projects. They

  constitute many of the activities within the European Innovation Partnerships on

  Active and Healthy Ageing (EIP 2015). However an understanding of the

  multivariate factors associated with successful active ageing is an ambitious

  objective, which begins with sensing and intervention, uses behaviour change

  theory and needs the power of big data analysis. Self-management of these

  components and their interaction based on an accessible Dashboard that is

  delivered to the user by appropriate ICT constitutes a novel concept. SPRINT will

  accomplish this objective by bringing together the stakeholder disciplines that are

  vital for active ageing research: experts in behaviour change, computing science

  and artificial intelligence, engineering, nutrition; supported by clinicians, industrials,

  economists and of course older people that contribute to a user-centred,

  participatory design philosophy.

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