ENCONTRO COM A CIÊNCIA E
TECNOLOGIA EM PORTUGAL
Promoting independent living in frail older
adults by improving cognition and gait
ability and using assistive products
João Apóstolo
Unidade de Investigação em Ciências da Saúde: Enfermagem
INTRODUCTION - SOCIODEMOGRAPHIC TRENDS
OLD-AGE DEPENDENCY
INTRODUCTION - SOCIODEMOGRAPHIC TRENDS
Ageing indicators,
Portugal, 1961-2016
(source: PORDATA)
Current expenditure
on healthcare per
capita, Portugal,
2000-2016
(source: PORDATA)
INTRODUCTION - FRAILTY
Frailty
! Prevalence in community-dwelling adults aged ≥ 65Y:
frailty: 4-17% / pre-frailty: 19-53%
- predisposes the individuals to progressive decline in different
functional domains
COSTS
- is an age-related state of high vulnerability to adverse health
outcomes after a stressor event
- contributes to the onset of geriatric syndromes
(Clegg et al., 2013; Fried et al., 2004)
INTRODUCTION – NEEDS AND SOLUTIONS
SOCIODEMOGRAPHIC
CONTEXT
Aged and frail population
Increased ratio of falls
and old-age dependency
Increased morbidity and
prevalence of dementia
ARISING NEED
Integrated, creative and dynamic strategy to prevent
frailty in older adults
PROPOSED
SOLUTION
Promotion of independent living in frail older adults by
improving cognition and gait ability by provision of
specific equipment
INTRODUCTION – INTERVENTIONS ON FRAILTY
The recent systematic review by Apóstolo et al. have shown that the favorable
effects on frailty indicators may be observed after the interventions based on:
-
physical exercise (mainly conducted in group)
physical exercise with nutritional supplementation
nutritional supplementation alone
cognitive training
combined treatment.
The interventions need to be adapted to the personal characteristics and
contexts.
MIND&GAIT PROJECT
Project accepted for funding in the IC & DT Projects
Competition in Polytechnic Institutes and Schools
AVISO N.º 02/SAICT/2016
MIND&GAIT PROJECT
OBJECTIVE
To develop innovative initiatives and systems to facilitate
an early intervention in the health condition of frail older
adults
1. Development of a structured and integrated combined
intervention consisting of
(I) Computer-Based Cognitive Stimulation Program
(ii) Physical Activity Program
STRATEGY
2. Development of auto-blocking mechanism for rolling
walkers (ABMRW)
3. Use of a web platform as a repository and for
dissemination of results and resources
MIND&GAIT ACTIVITIES
Update and test
the cognitive
stimulation
program (1-7M)
Develop and test
the physical
activity program
(1-7M)
Upgrade the
ABMRW (1-4M)
Assess the effectiveness of the
combined intervention in old adults
with frailty (9-14M)
Analyze participant perception of the
interventions (3-18M)
Test the
ABMRW (5-8M)
Project reports Identification of barriers and opportunities,
monitoring and review of milestones and deliverables and
review of objectives achievement (3-18M)
Develop a web
platform to support
the material and
disseminate the
intervention
materials (9-18M)
Promote scalability
MIND&GAIT IMPACT
KNOWLEDGE TRANSFER
INTO CLINICAL PRACTICE
PRACTICE-BASED
RESEARCH
EDUCATION AND
INNOVATION
Innovate applications to be implemented as a response to societal challenges:
1. Health, demographic change, and wellbeing
6. Europe in a changing world - Inclusive, innovative and reflective societies
RIS 3 Action Lines - NUTS II Center region Technologies for QL:
- Development of innovative actions and systems that promote active and healthy
aging and lead to independent living that cross the different care networks
- Development of new treatments and therapies
MIND&GAIT MERIT
SCIENTIFIC-TECHNICAL
MERIT OF THE PROJECT
INTERDISCIPLINARITY
ORIGINALITY
QUALITY OF THE PROJECT TEAM
INTERDISCIPLINARITY
exercise science specialists, nurses, occupational
therapists, mechanics and computer engineers
TECHNICAL AND SCIENTIFIC EXPERIENCE
RESEARCH AWARDS
PATENTS SUBMITTED
BASED ON CLINICAL DAILY
PRACTICE
RESEARCHERS
TESTED IN CLINICAL DAILY
PRACTICE
COMMUNITY
HEALTHPROFESSIONALS
STUDENTS
REFERENCES
Apóstolo, J., Cooke, R., Bobrowicz-Campos, E., et al. Predicting risk and outcomes for frail older adults:
an umbrella review of frailty screening tools. JBI Database of Systematic Reviews &
Implementation Reports 2017; 15(4):1154-1208.
Apóstolo, J., et al. Effectiveness of the interventions to prevent progression of pre-frailty and frailty in
older adults: a systematic review. JBI Database of Systematic Reviews & Implementation
Reports. Submitted.
Clegg A, Young J, Iliffe S, et al. Frailty in elderly people. Lancet 2013; 381:752-762.
Fried LP, Ferrucci L, Darer J, et al. Untangling the concepts of disability, frailty, and comorbidity:
implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004;59:255-263.
Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J
GerontolBiol Med Sci 2001;5 6:M146–M156.
Lang PO, Michel JP, Zekry D. Frailty Syndrome: A transitional State in a Dynamic Process.
Gerontology 2009;55:539-549.
Rodriguez-Manas L, Feart C, Mann G, et al. Searching for an operational definition of frailty: a
Delphi method based consensus statement: the frailty operative definition-consensus
conference project. J Gerontol A Biol Sci Med Sci 2013; 68(1):62–7.
Rockwood K, Hogan D, Macknigth C. Conceptualisation and measurement of frailty in elderly
people. Drugs Aging 2000;17(4):295-302.