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My Active and Healthy Aging

Periodic Reporting for period 3 - my-AHA (My Active and Healthy Aging)

Reporting period: 2019-01-01 to 2020-03-31

By 2060 1/3 Europeans will be >65y (EU, 2015). The population >65 years (retirement age) will increase to 155 million in 2060, with a dramatic increase in the proportion >80y. The resulting cost of aged care is rising daily, soon 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 is the capacity to enable the older adult to remain at 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: 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. Prevention of disease comorbidities and promotion of healthy lifestyle factors may prevent cognitive decline.
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 achieves 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 cognitive, psychological, physical and social frailties. 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 to reduce their risk for future chronic diseases.
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 authorized
2. Development of the Randomized Controlled Trial (RCT) protocol commenced
3. During the alpha wave data from participants regarding system portability and usability was collected and analysed
4. RCT trial sites recruited participants into the study (ethical board approval)
5. Risk models were developed and analysed with a set of physical, cognitive, nutritional and social interventions having been designed
6. The resulting My-AHA system architecture was inspired on a message-driven solution that is typical in Internet-of-Things scenarios.
7. Through the connectors developed with the original platforms, My-AHA Middleware managed all the exchanges of data among the devices and the users
8. In order to interact with all the My-AHA components developed, the entry point for My-AHA system is the “dashboard”.

During the RP2 the consortium performed a revision of the literature for the risks of frailty in the different domains to develop an ICT platform (the My-AHA platform) for the users that detects individual risks for frailty. The My-AHA platform comprises an interface dashboard for users to interact with the system and a middleware software platform running the background that connects different existing platforms (Smart Companion, Medisana, and VitalinQ) to be connected to the My-AHA platform. In the second RP the RCT was launched and the intervention group of subjects experimented personalized intervention. The My-AHA platform confirmed to be sufficiently flexible and usable to answer to the needs of the older adults from different cultures and languages across European and Extra-European countries. Detailed planning of the RCT has been approved by ethical committees, registered as a Clinical Trial, with the RCT protocol publisked in a high impact scientific medical journal.
During the RP2 My-AHA partners, and in particular Johanniter International through its European network provided intensive dissemination, to lay the foundation to create partnerships and collaborations with relevant stakeholders (incl. policy makers), SME & NGO service providers and insurance companies that will be interested to engage in the my-AHA platform.

During the RP3 the system allowed to collect data from pre-frail elderly subjects during the last period of the RCT, which were analysed statistically. WP3 could design new models of frailty in the different domains. We propose a new cumulative frailty index derived from the results of the My-AHA protocol (My-AHA FI). Usability and accessibility of ICT tools were extended to all participants to the RCT. During the whole period of the project the acceptance and compliance of the participants to the project and the technology proposed was constantly monitored, and updates regarding these aspects were issued at regular time intervals in WP7. The scalability of the system has proven to be possible. At no time, the servers had a problem in dealing with the access rates of participants. Also the local administration of trial sites showed that small, agile teams can run the full system including interventions autonomously. With significant results from the RCT for the cognitive domain and on the Quality of Life and the similar results at different trial sites across the world, the impact is now possible to be quantified and proven for the main stakeholders in health care.
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 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 €5 billion by 2020, due to the ageing population and the rising demand for higher quality of life. 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.
Fig. 2. Scheme of the different platforms integrated in the middleware of My-AHA.
Fig. 1. Worldwide distribution of the partners involved in the project.