A Holistic Infrastructure to Support Elderlies' Independent Living

A Holistic Infrastructure to Support Elderlies' Independent Living

Marco Nalin (Telbios, Italy), Ilaria Baroni (Telbios, Italy) and Manuel Mazzara (Service Science and Engineering Lab, Innopolis University, Russia)
Copyright: © 2016 |Pages: 15
DOI: 10.4018/978-1-4666-9978-6.ch046
OnDemand PDF Download:
List Price: $37.50
10% Discount:-$3.75

Chapter Preview



In a common medical sense, the frail elderly have an advanced age, chronic pathologies, clinical instability, social isolation and a certain degree of disability. The condition of “pre-frailty” is present when only a few frailty factors are observed.

In Italy, there are one million of frail patients, and this number will double in next 20 years, with a consequent proportional increase in healthcare spending related to their management. Therefore, it is a fundamental goal for scientific research to define objective and standardized criteria of classification for these patients and for prediction of the temporal evolution of their frailty in order to implement appropriate forms of early diagnosis, monitoring of disease status and of intervention at the local and national level.

Within the framework of the EU initiative “Innovation Partnership on Active and Healthy aging” (EIP-AHA), the document “Prevention of functional decline and frailty”, action plan number 3 “Prevention and early diagnosis of frailty and functional decline, both physical and cognitive, in older people” issued at the 1st Conference of Partners on November 6th, 2012 in Brussels, clearly shifts the objective from “frailty” to “pre-frailty”, revealing the necessity not only to define diagnostic criteria but also prediction models with the “active elderly” population as their target. Moreover, the document reveals the need to add cognitive performance indicators, currently not always included in clinical status scales and in the frailty evaluation models, defining the “multidimensional and functional decline” due to physical and cognitive causes or their combination.

The need to implement indices and clinical practices for the collections of information related to cognitive functions comes from the dramatic increase in the probability of developing Alzheimer’s disease (AD), a neurodegenerative process which extends for several years without any manifestations of cognitive decline (pre-clinical phase). Then, for some years, there is a slight objective cognitive decline, called mild cognitive impairment (MCI). In a remarkable percentage of cases (approximately 50%) amnesic MCI subjects can be considered as prodromal AD that, after a few years, progresses into a serious cognitive impairment and loss of functional autonomy. To diagnose AD in the pre-clinical or prodromal phase, distinguishing it from benign cognitive deficits related to reversible psycho-physical condition, instrumental tests have been developed, such as the examination of beta and tau amyloid proteins in the cerebrospinal fluid, the volume of the hippocampus and of the cerebral cortex through magnetic resonance imaging (MRI), the assessment of cerebral metabolism and of the accumulation of beta amyloid through positron emission tomography (PET).

Key Terms in this Chapter

Ambient Assisted Living: It’s a relatively new ICT trend to embed intelligent objects in the environment to support people (mostly elderly) in living independently and monitored.

MCI: Mild cognitive impairment (MCI) is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia.

Telehealth: Set of telecommunication technologies which support the delivery of health-related services and information.

Telemonitoring: Remote data collection from a patient. Data are usually sent to someone which supervise the patient, being it a Service Centre or directly a doctor.

Fragility: Condition common to many elderly, which are frail from the point of view of health and/or social conditions.

AD: Alzheimer’s disease, also known in medical literature as Alzheimer disease, is the most common form of dementia. There is no cure for the disease, which worsens as it progresses, and eventually leads to death.

Internet of Things: Machine to machine communication among smart objects spread into the environment.

Independent Living: Ability for elderly people to live longer without the need of assistance from other persons.

Complete Chapter List

Search this Book: