LETHE: A Digital Intervention for Cognitive Decline.

Dementia is the main cause of disability in elderly populations. It has been shown that the risk factors of dementia are a mixture of pathological, lifestyle and heritable factors, with some of those being provably modifiable. Early diagnosis of dementia and approaches to slow down its evolution are currently the most prominent management methodologies due to lack of a cure. For that reason, a plethora of home-based assistive technologies for dementia management do exist, with most of them focusing on the improvement of memory and thinking. The main objective of LETHE is prevention in the whole spectrum of cognitive decline in the elderly population at risk reaching from asymptomatic to subjective or mild cognitive impairment to prodromal Dementia. LETHE will provide a Big Data collection platform and analysis system, that will allow prevention, personalized risk detection and intervention on cognitive decline. Through the subsequent 2-year clinical trial, the LETHE system, as well as the respective knowledge gained will be evaluated and validated. The scope of the current paper is to introduce the LETHE study and its respective novel platform as a holistic approach to multidomain lifestyle intervention trial studies. The present work depicts the architectural perspective and extends beyond state-of-the-art guidelines and approaches to health management systems and cloud platform development.Clinical Relevance - Patient Management Systems as well as lifestyle management platforms have significant clinical relevance as they allow for remote and continuous monitoring of patients' health status. LETHE aims to improve patient outcomes by providing predictive models for cognitive decline and patient adherence to the multimodal lifestyle intervention, enabling prompt and appropriate medical decisions.

The Evolution of mHealth Solutions for Heart Failure Management.

In the last decade, the uptake of information and communication technologies and the advent of mobile internet resulted in improved connectivity and penetrated different fields of application. In particular, the adoption of the mobile devices is expected to reform the provision and delivery of healthcare, overcoming geographical, temporal, and other organizational limitations. mHealth solutions are able to provide meaningful clinical information allowing effective and efficient management of chronic diseases, such as heart failure. A variety of data can be collected, such as lifestyle, sensor/biosensor, and health-related information. The analysis of these data empowers patients and the involved ecosystem actors, improves the healthcare delivery, and facilitates the transformation of existing health services. The aim of this study is to provide an overview of (i) the current practice in the management of heart failure, (ii) the available mHealth solutions, either in the form of the commercial applications, research projects, or related studies, and (iii) the several challenges related to the patient and healthcare professionals' acceptance, the payer and provider perspective, and the regulatory constraints.