july 2015 - doremi-fp7.eu · july 2015 all countries in europe are experiencing ageing of their...
TRANSCRIPT
DOREMI NEWSLETTER
Doremi has received funding from the European Union under the Seventh Framework Programme (FP7), grant agreement n° 611650.
The contents of this newsletter are the sole responsibility of Doremi and can in no way be taken to reflect the views of the European Commission.
July 2015
All countries in Europe are experiencing ageing of their populations. Health trends show that mild disability and chronic disease are generally increasing. As a consequence, ageing of the population will negatively impact on long-term care costs unless appropriate measures are implemented in time.
To be effective, these measures should reduce risk factors linked to functional decline and chronic diseases and provide personalised training to stimulate older people to keep an active lifestyle.
The DOREMI project focuses on three main health aspects related to frailty in older people: unhealthy nutrition, sedentariness and cognitive decline.
These aspects are the main items at the basis of the DOREMI environment: a context-aware and smart system able to learn and reason about older people, their intentions, preferences and aims. The system is able to provide feedback and propose solutions to improve their lifestyle.
The specialist will be able to select and assign a personalised lifestyle protocol that will be associated
to a set of game typologies (cognitive games, social games or exergames). At home, the old person will be able to select the game scenario which best corresponds to personal preferences and habits. Subsequently, the system will follow a monitor-learn loop to understand how the old person evolves according to the compliance of the assigned protocol.
In the first 18 months, the DOREMI partners were involved in the definition of an active ageing lifestyle protocol to be applied during experimental trials in the UK and Italy pilot sites, and in all the technical (hardware and software) solutions to support it.
G
Contents in this newsletter DOREMI focuses on unhealthy nutrition, sedentariness and cognitive decline page 1-2
DOREMI activity recognition and reasoning systems page 3
Game-based active ageing page 4
Validation of the DOREMI intervention model page 5-6
DOREMI focuses on unhealthy nutrition,
sedentariness and cognitive decline
2 DOREMI NEWSLETTER
In particular the partners have carried out an extensive literature analysis of unhealthy nutrition, sedentariness and cognitive decline, and focused on strategies to control these impairments, and on the definition of the protocol to be applied during experimental trials. Active lifestyle, especially physical activity, healthy dietary habits and cognitive stimulation all play a fundamental role in preserving a healthy state. This approach, acting on well-being, can reduce and postpone the natural psychological decline in older people.
Nutrition Prospects for healthy ageing are characterised at first
by “a proper nutrition”. Appropriate knowledge of
food components is much more effective than
prescriptions of multivitamin and mineral
supplementation in lowering major health diseases
affecting older people.
With the support of the Mini-Nutritional Assessment
(MNA) test, we will have a validated nutrition
screening and assessment tool able to identify
geriatric patients aged 65 and over who are at risk of
unbalanced nutrition intake (excess or defect). During
the trial, thanks to the continuous evaluation of
weight and the support of a diet app (Metadieta®),
we will be able to remotely make changes to our
users’ food intake and to detect the effectiveness of
personalised diet prescriptions on weight. This will
create a dietary loop which can monitor, stimulate
and involve older people to reach a satisfying
nutrition level.
Physical activity No age group gets more benefits from fighting sedentariness with regular exercise than older people. Research and trials provide specific recommendations on how to keep an active, physically correct daily lifestyle that includes exercises promoting endurance and flexibility, strengthen muscles, and improve balance.
DOREMI will use the Physical Activity Scale for the Elderly (PASE) test, which will help the user profiling in terms of activity quantification (time and type of actions). Through the bracelet, developed by one of the technical partners in the project, we will be able to monitor users’ activities, especially physical exercises, and have a continuous check of their heart rate. The bracelet will be used to check the exercise safety and monitor physiologically the cardiac performance of our users. Moreover, with the DOREMI virtual companion, our users will be stimulated to follow prescribed daily activities to fight sedentariness and improve their health status.
Cognitive decline Unhealthy dietary and sedentary habits influence cognitive decline, which in turn has an impact on the independence and the autonomy of older people, and which also plays a primary role in progressively leading to a less and less balanced diet and less and less physical activity.
DOREMI will develop games focusing on the different cognitive functions, which are analysed by Montreal Cognitive Assessment (MoCA) and other cognitive function tests: orientation, registration, attention and calculation, recall, language and praxis. Users will be stimulated to play in order to slow down cognitive decline. The DOREMI platform provides a daily schedule for playing these games and it will give feedback to specialists about users’ cognitive improvements.
The monitor-learn loop enabled by the
DOREMI systemic solution
The DOREMI dietary loop
3 DOREMI NEWSLETTER
The activity recognition and reasoning systems are
key components that enable DOREMI to assess the
daily progress of the user and to adapt the active
ageing lifestyle protocol accordingly. Specifically, the
activity recognition system monitors the user’s
physical activity, social interaction and balance by
means of a number of sensors, some of which are
embedded in a wristband. The reasoner system
exploits the information provided by the activity
recognition to implement the decision making of
DOREMI and support the user who is following the
lifestyle protocol prescribed by the specialist. In turn,
these systems enable DOREMI to give feedback to
the user about his or her lifestyle, and to inform
specialists about users’ conditions.
The last months of activity in DOREMI have
witnessed the finalisation of the architecture and
interfaces of these systems, and the first campaigns
of data collection and analyses necessary to configure
these systems in view of their use in the pilot sites in
the UK and Italy. One of the most important results
achieved in this period is the design and
implementation of an automatic carpet able to assess
the balance of the user, according to the Berg balance
scale. The solution adopted in DOREMI is based on an
innovative setting in which the user performs only
one of the 14 of Berg’s exercises on a balance board,
and an especially crafted artificial intelligence model
estimates the Berg’s balance scale score (a number
ranging from 0-56). The preliminary results, obtained
by experimentation on 20 volunteers (with ages
ranging between 60 and 70), outperform the state of
the art in automatic evaluation of the Berg’s score.
The next important development will concern the
activity recognition components assessing users’
physical activity. For this work, an important
campaign of data collection and analysis will start in
July with the participation of 15 volunteers aged 60-70.
DOREMI activity recognition and reasoning systems
4 DOREMI NEWSLETTER
Italian serious games specialist and DOREMI partner Imaginary
has developed the video games environment that supports the
physical and cognitive stimulation aspects of the DOREMI
project. The game environment along with four games that
stimulate cognitive activity are ready. On the physical activity
stimulation side, Imaginary has completed an exercise area
which contains videos for both indoor and outdoor exercises. A
virtual social area where users can interact is also being
finalised. These games, activities and the environment
incorporate what are known as gamification mechanics which
means that they use the same psychology and methods that
gameplay uses to engage and motivate users.
The games are designed in collaboration with specialists and
user groups using a so-called participatory design approach
which means that during the development phases each step is
checked periodically by both groups. Thus they are not only
clinically appropriate according to experts’ indications, but they
also include aspects of users’ expectations. This is the only way
to ensure that medical games and exercises are welcomed by
those who are supposed to use them and that they include
exactly those aspects which are motivational for the specific
users.
Imaginary’s experience and international network of
connections is creating great interest and potential collaboration
opportunities both within and outside Europe. Imaginary’s
technology consultant, David Wortley, who has been supporting
the concepts and strategies behind some of Imaginary’s DOREMI
games has been collaborating on Ageing Society issues with
leading experts in Korea, USA, Singapore and the UK to not only
bring international best practices to DOREMI products and
services but also raise awareness of the DOREMI project
internationally.
Two examples of games that project partner
Imaginary is designing and developing in
collaboration with specialists and user groups.
Game-based active ageing
5 DOREMI NEWSLETTER
We have now started to integrate the technologies
developed previously in the project and to validate
the DOREMI intervention model. The validation
process is divided in three steps that progressively are
advancing during the second and the third years of
the DOREMI project.
We will begin with testing and validating the single
components of the DOREMI package.
During the second phase the wireless sensor network
and the gamification environment will be validated
separately and finally we will conduct an overall
validation of the DOREMI global package by means of
a longitudinal and multicentric pilot study in the UK
and Italy.
The DOREMI balance board, which is one of the
components of the DOREMI package, will allow us to
collect data about balance and weight. Having a good
balance is particularly important when one grows old.
It means that one is able to maintain the position of
the body when one is standing, walking and moving
around. Balance disorders are quite common,
affecting almost 40% of the older adults.
Besides causing uncomfortable sensations such as
vertigo and unsteadiness, balance disorders can be
related to higher risk of falls. Falls can cause injuries,
such as hip fractures and traumas, and increase risk of
early death. At the moment we are starting to test
the DOREMI balance board involving volunteer users
who kindly make themselves available to participate
in the project.
Data from the DOREMI balance board will give
information about balance and weight to healthcare
specialist so that they will be able to detect balance
disorders at an early stage to prevent falls.
DOREMI balance board
Validation of the DOREMI intervention model
DOREMI coordinator Oberdan Parodi testing a volunteer’s balance
6 DOREMI NEWSLETTER
Two of the age related issues that the DOREMI
project addresses are cognitive decline and social
isolation. Cognitive decline is a progressive loss of the
cognitive capacity and it gives rise to a wide range of
symptoms such as difficulty in focusing attention and
forgetfulness. Cognitive decline can if not detected in
time progress into severe conditions such as
dementia and depression. Lifestyle can affect the
progression of cognitive decline, in fact cognitive
training, social relationships and healthy nutrition
can improve the cognitive abilities, preventing
dementia and other mental diseases. The DOREMI
platform includes a wide range of social and cognitive
games to stimulate the subject to maintain an active
and healthy lifestyle. We are testing these tools with
end users to verify the accessibility and usability and
to collect data to test the efficacy of the
interventions.
G
Subscribe to this newsletter To subscribe to the DOREMI newsletter, please contact: [email protected]
Contact the coordinator The Italian National Research Council (CNR-IFC) is the coordinator of the DOREMI project.
Contact: [email protected]
Daniele Musian of Si4Life and Antonio Ascolese of Imaginary
are testing the cognitive and social games with a user group.
Contact and partners