Role of non-pharmacological interventions for healthy ageing.

The range of non-pharmacological interventions (NPIs) available for people over 60 years of age is continuously expanding, both in terms of prevention and therapy. They have been empirically selected for centuries and more recently developed through epigenetic studies, clinical trials and technological innovations, and their development has increased and diversified around the world. Residual questions concern: 1) the scope of such treatments which appears to overlap with alternative medicines, 2) their evaluation, which some researchers say is impossible, and 3) their implementation in the elderly, which appears to be overly complicated. This article addresses these three questions and presents digital tools developed by the CEPS University Platform facilitating the evaluation of NPIs in the field of healthy aging. The transformation of the health system, which has become necessary to meet the needs of baby boomers, will widen the arsenal of health-related solutions. The combination of approaches to medicine and health has become personalised, comprehensive and integrative. NPIs will play a major role in the coming century. These practices differ from alternative medicines, general public health messages and socio-cultural approaches through continuous research, a quality approach and traceability of use. NPIs today constitute a complementary ecosystem for biomedical treatments which are increasingly becoming economically and legally consolidated.

[Role of non-pharmacological interventions for healthy aging]. / Rôle des interventions non médicamenteuses pour vieillir en bonne santé.

Non-pharmacological interventions (NPIs) are continuously expanding for people over 60, both in terms of prevention and therapy. Selected empirically for centuries or recently appeared with the help of epigenetic studies, clinical trials and technological innovations, their development increase and are diversified around the world. Residual questions concern 1) their perimeter which seems to overlap with alternative medicines, 2) their evaluation which seems impossible according to some researchers, and 3) their implementation in the elderly which seems too fastidious. This article answers these three questions and then presents digital tools developed by the CEPS University Platform facilitating the evaluation of NPIs in the field of successful aging. The transformation of the health system, which has become necessary to meet the needs of baby-boomers, will widen the arsenal of solutions relevant to health, their combination of medicine and health approach that have become personalized, comprehensive and integrative. NPIs will play a major role there during the century. These practices are distinguished from alternative medicines, general public health messages and socio-cultural offers by continuous research, a quality approach and traceability of use. NPIs today constitute a complementary ecosystem for biomedical treatments whose economic and legal consolidation is increasing.

A novel approach to integrated care using mobile technology within home services. The ADMR pilot study.

BACKGROUND: The care model for supporting elderly people living independently at home relies on the informal and formal assistance of caregivers. Information and communication technology (ICT) offers new approaches for informal care services for this group. METHODS: A longitudinal observational pilot study was carried out in home services in France. Employees of the ADMR home services followed 130 elderly people living at home and who were no more than moderately impaired. A single visual analogue scale (VAS) was used on a smartphone to assess global health every time a person was visited. An alert system was devised to inform the elderly person and/or a responsible person of any deterioration in health status. All medical and social events were recorded throughout the 9-month study. RESULTS: 138 people were enrolled and 106 were evaluated. 37 alerts were observed. 21 were confirmed and 16 were false positives. Only employees untrained in the use of the system generated false positive alerts. Six severe medical alerts were observed, including one cancer undetected by the physician, one hospitalization for diabetes, one hospitalization which led to death 6 months later and one hospitalization which resulted in follow-up care. CONCLUSIONS: Social workers can participate in the health system with all the ethical criteria of medicine. To our knowledge, this is the first ICT-based alert system that has been found to produce severe medical alerts by employees of home services.

Integrated platform for home services using new products and services for senior citizens Call CNAV-CARSAT 2015.

This project is part of: i) the risks of ageing prevention policy of the French retirement and occupational health insurance agency of Languedoc Roussillon (Carsat-LR) and ii) the European innovation partnership on active and healthy ageing (EIP on AHA). It aims to support senior citizens who live independently and have been identified at risk of frailty on a social or health level. The purpose is to increase legibility as well as technical and financial access to innovations for vulnerable seniors who are remote from the digital era, through a multiservice user-friendly platform. Launched at the end of 2015, the project rallies over 10 actors of the silver economy currently developing personalised ICT tools to improve the safety and comfort of seniors and the coordination between health and social care. The objective is threefold: i) developing new adapted technologies, ii) having them evaluated by retirees and professionals and iii) making them accessible to the ICT web platform which will provide tutorials and prices and collect opinions from users and professionals. 500 retirees selected by CARSAT-LR will be testing these new devices and solutions which will be provided without charge. The following will be evaluated: i) feedback from users; ii) benefits gained through accessing comprehensive and appropriate information; iii) coordination of caregivers and professionals; iv) enjoyment from using the products (access to games, social links, customer confidence, sense of safety). This is a unique opportunity to mobilise solutions in a structured manner, bringing together competing businesses under a consortium agreement. Advantages for these businesses include acceleration of development and availability of their adapted solutions as well as the possibility to test their products on a significant panel of people. Professional caregiver's data follow-up will identify seniors at risk of frailty, proposing preventive actions and local services tailored to their needs.

Operational Definition of Active and Healthy Aging (AHA): The European Innovation Partnership (EIP) on AHA Reference Site Questionnaire: Montpellier October 20-21, 2014, Lisbon July 2, 2015.

A core operational definition of active and healthy aging (AHA) is needed to conduct comparisons. A conceptual AHA framework proposed by the European Innovation Partnership on Active and Healthy Ageing Reference Site Network includes several items such as functioning (individual capability and underlying body systems), well-being, activities and participation, and diseases (including noncommunicable diseases, frailty, mental and oral health disorders). The instruments proposed to assess the conceptual framework of AHA have common applicability and availability attributes. The approach includes core and optional domains/instruments depending on the needs and the questions. A major common domain is function, as measured by the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). WHODAS 2.0 can be used across all diseases and healthy individuals. It covers many of the AHA dimensions proposed by the Reference Site network. However, WHODAS 2.0 does not include all dimensions proposed for AHA assessment. The second common domain is health-related quality of life (HRQoL). A report of the AHA questionnaire in the form of a spider net has been proposed to facilitate usual comparisons across individuals and groups of interest.