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Elderly-friendly City services for active and healthy ageing

Periodic Reporting for period 2 - City4Age (Elderly-friendly City services for active and healthy ageing)

Reporting period: 2017-03-01 to 2018-11-30

The problem addressed by City4age is how to make prevention services more data-driven, effective and sustainable. The specific field of action is that of Mild Cognitive Impairment (MCI) and Frailty, which affect a large segment of the elderly population in Europe.
Prevention services, based on early detection, are important for various reasons:
• to improve the quality of life of elderly citizens
• to reduce the costs for taking care of the elderly (delaying treatment for more serious syndromes)
• to better use the resources of the society and reduce the pressure on Health Systems
The overall objective of City4Age was to demonstrate that prevention services can be organized around innovative approaches:
• focusing on extensive data collection and data-driven interpretation for early risk detection
• harvesting data from a variety of sources, including data-sets from smart cities
• creating an effective technology-based communication channel between cities and the elderly population
• creating an effective intervention system, for influencing the behaviour of targeted segments of population
• creating new organizational solutions for managing prevention in a flexible and effective manner, differentiating clusters of the elderly population (screening tonight those who do not need immediate attention)
• mobilizing various local actors that, coordinated by cities, can enact a “social prevention” model
• making data (after proper anonymization) available also to managers, city planners and researchers

Additional general goals were flexibility and ability to evolve. Flexibility implies that each city wishing to create a prevention service should be able to select, within a common framework, the most suitable organization, pool of technologies and way of financing the service. Ability to evolve means being able to continually accommodate new technologies (for data collection and/or communication/intervention) into the framework.
The deployment of the solutions in 6 different cities, was meant to demonstrate the validity of the approach: Athens (GR), Birmingham (UK), Lecce (IT), Madrid (ES), Montpellier (FR), Singapore.
City4Age has achieved in 3 years (December 2015-November 2018) a number of important results:
• Overall approach and modelling: an original model has been developed, based on well-established geriatric instruments. The model allows making a “geriatric sense” of the elementary data (collected through various technologies), leading them back to 10 main geriatric factors. The model allows going from raw data, their translation into daily/monthly “measures”, to a number of sub-factors (43) and eventually (10) geriatric factors.
• Data collection: various technologies have been either developed or adapted from market solutions. Sensors, beacons, mobile devices, wearable, smart-meters, existing data sets, etc., have been deployed. The original contribution by City4Age is an “harmonization” middle layer, allowing to translate data collected in various ways into measures and then geriatric factors.
• Shared Repository: after proper anonymization, data were replicated in a common repository where millions of elementary data and more than 1 million of “measures” have been collected and made available to outside researchers.
• Data Interpretation: various tools have been developed for interpreting behavioural data in a geriatric sense (in view of MCI/Frailty). Interpretation can be performed at various levels, from basic measures, to geriatric (sub-)factors, to overall conditions. An interactive dashboard allows an effective in-depth analysis. Data analytics support general understanding of data.
• General Intervention: City4Age has developed an original approach and an original piece of technology to deliver profiled and persuasive intervention messages. A comprehensive behavioural model (about how to influence behaviour of elderly subjects) has led to the development of various tools, covering all aspects: design, library of resources, intervention creation and customization, delivery. When intervention was fully deployed (more than 150 mgs per individual, per month), it was highly appreciated by the elderly care-recipients.
• Data-Driven Intervention: also data, at proper level of interpretation, have been incorporated in the intervention. Individuals and their families receive basic data; their social networks (e.g. friends, social assistants, local pharmacies, …) receive warnings on relevant behaviour changes; care-givers receive only risk notifications.
• Social prevention: An original approach to prevention has been developed where various actors are involved, with different roles and capacities.
• Library of Solutions: all the solutions generated by the project have been collected in a library that can be used by any city wishing to develop a “City4Age installation”.
• Deployment: City4Age has been deployed in Athens, Birmingham, Lecce, Madrid, Montpellier and Singapore. They have collected millions of data within a common framework. Each city was able to adapt the installation to its specific context and requirements.
• User Involvement and validation: elderly citizens have been involved by the pilot installations. Their participation was very active and they have highly appreciated the work done. Local geriatricians and staff were also actively involved, contributing to the evolution of the project.
• Exploitation solutions: various business models for prevention services have been developed, showing that prevention is possible and feasible in a sustainable way for Europe.
City4Age has generated innovative results with high potential for significant impact.
Impact towards society
Data-Driven Prevention services are difficult to organize and deploy in Europe, for various reasons.
City4Age has provided an important step for demonstrating the usefulness of a data-driven approach, creating a set of technological solutions, defining and demonstrating various organizational solutions, providing the proof-of-concept that modern technologies can be adapted to the needs of elderly citizens.
The deployment of the prevention in 6 different cities has shown that the framework is flexible and can be adapted to (quite different) local contexts.
Progress beyond the state of art
• The data-driven computational model for MCI/Frailty is original and paves the ground for a new approach to data-drive geriatrics. Work is needed to make it acceptable to the whole community of geriatricians.
• The ability of easily accommodate various data sources into a unified data model is important and could be applied in a variety of cases.
• The layered interpretation of behavioural data is innovative and promises important evolutions.
• The shared repository, with millions of anonymized data made available, is an important step towards sharing data for research and the European society as a whole.
• The approach and technology suite supporting intervention is an original development and a contribution to the state of art.
• The tools for data analysis and activity recognition, are an innovative piece of technology.
Participation at International Workshop (IPAL)
Project logo
City4Age Recruitment of elderly participants in Birmingham
Smart Cities Serbia
Participation at Mobile World Congress