Leader: Carlo Ruosi ; Other collaborator(s): Angela Palomba, Antonio Picone
The aim of our work is to develop a model for the prevention of falls in the elderly through the characterization and identification of individuals at risk of falling, as well as mapping their needs; identifying innovative solutions and their applications in this population; developing and implementing fall risk prevention interventions; clinically and functionally evaluating the effectiveness of fall risk prevention protocols; and processing data and economic-health models for the prevention of fall risks in older adults.
We have adopted a person-centered approach to design, validate and implement an integrated approach to falls prevention, which will take into account, among others, the following elements that influence the risk of falls and subsequent adverse health outcomes: Osteoarticular conditions and risk assessment (using specific scores such as WOMAC, KOOS, Lequesne, etc.); Multimorbidity and polypharmacy; Visual impairment; Osteoporosis; Environmental risk of falls; Gait analysis; Isokinetic test; Blood tests (such as sodium, vitamin D, etc.); Outpatient screening visits within the “Campus Salute” program; Specific digital support tools will be used to enable data collection, integration and analysis.
Brief description of the activities and of the intermediate results
In this phase, we outlined the study model for mapping the population at risk of falling through:
Our prevention model has the following objectives: awareness of the importance of prevention; identification and evaluation of risk factors and determinants of frailty (e.g. nutrition, physical function, etc.); identification and implementation of realistic and effective interventions (multi-domain); integration of rehabilitation programs with APA (adapted physical activity) and correct diet
Main policy, industrial and scientific implications
In this step, we analyzed all the possible ICT that could be of support to the patient at risk of falling. The goal was to find devices that could help the patient both at home and in the clinic.
Brief description of the activities and of the intermediate results:
In the context of the patient at risk of falling, attention has focused on sarcopenia. Age-related reductions in muscle strength lead to a progressive loss of function as well as an increase in morbidity and mortality secondary to falls, reduced quality of life, depression and hospitalization.
Sarcopenia leads to a quantitative and qualitative reduction involving muscle tissue, with progressive replacement of the same with non-contractile and fibrous tissue and, subsequently, adipose tissue.
The European Working Group on Sarcopenia in Older People (EWGSOP) has recognized, in a recent update (EWGSOP2), as a characterizing component of sarcopenia, the coexistence of a deficit in muscle strength, understood as a primary parameter, associated with a significant and global reduction in muscle mass closely related to it.
The use case dedicated to patients affected by sarcopenia reflects a typical patient case, presenting their demographic, social and comorbidity characteristics, and highlighting their needs in order to highlight the solutions and paths best suited to their needs.
Main policy, industrial and scientific implications:
We have defined the needs of elderly sarcopenic patients using the "person blueprint" tool. In this step, the goal is to seek support from new technologies for different aspects related to the prevention of the risk of falling in elderly sarcopenic patients.
Nutritional support
To prevent the risk of falling in the elderly, the nutritional supplement that we can adopt is an increase in protein intake with particular attention to essential amino acids such as Leucine capable of activating protein synthesis and preventing the phenomenon of sarcopenia. Further help in preventing muscle and bone weakening comes from calcium, vitamin D and omega 3 supplementation
Psychological support
The short intervention technique - of a collaborative nature - of the person-centered motivational interview will be used, aimed at working on the patient's motivation, thus contributing to behavior change
Physical activity
After completing the personalized treatment for the prevention of the risk of falling, patients are directed towards an adapted physical activity
Management of polypharmacy
With particular attention to the monitoring of drugs that increase the risk of falling, FRID
Environment
Assessment of the risk of falling in indoor/outdoor environments through specific questionnaires and information leaflets
Brief description of the activities and of the intermediate results:
The activities of WP3 have focused on developing interventions to enhance physiological outcomes and manage disease-related conditions in middle-aged and older adults. Specifically, Task 3.2 has worked on designing models for fall prevention among older adults. Key progress includes the characterization of older adults at risk of falling, identification of innovative solutions to integrate in diagnostic therapeutic pathways, and the development of prevention protocols. The protocol design for an ICT-based intervention for healthy ageing is nearing completion and its submission to the medical ethical committee is in progress (80%). Additional outputs include ongoing clinical studies and the development of fall prevention guidelines.
Main policy, industrial and scientific implications:
The integration of ICT in healthcare services provides opportunities for developing interventions targeting older adults, further developing innovative products and services. Scientifically, the work contributes to the understanding of sarcopenia and fall prevention, advancing knowledge in geriatric rehabilitation and functional health in older adults avoiding the burden of falls on individuals, families and society.
Brief description of the activities and of the intermediate results:
The activities of WP3 have focused on developing interventions to enhance physiological outcomes and manage disease-related conditions in older adults at risk of falling. Specifically, the protocol design for an ICT-based intervention for healthy ageing has been completed and submitted to the medical ethical committee. Additional outputs include ongoing research studies and the development of fall prevention guidelines.
Main policy, industrial and scientific implications:
The integration of ICT in healthcare services opens new avenues for designing targeted interventions for older adults and driving innovation in related products and services. Scientifically, this work deepens the understanding of sarcopenia and fall prevention, supporting progress in geriatric rehabilitation and functional health. By doing so, it helps reduce the burden of falls on individuals, their families, and society as a whole.
Systematic Review on Rehabilitation for Fall Prevention
Currently in progress, nearing completion.
Cohort Study on Technology-Based Rehabilitation for Fall Prevention in the Elderly
Study in its final stages.
Preventing Falls in Older Adults: Innovative Strategies for a Safer Life"
We are currently developing a lay summary that will provide clear, accessible information on fall prevention strategies for older adults. This document will outline key risk factors, innovative interventions, and practical recommendations to enhance safety and well-being.