Un Robot assistivo per pazienti con demenza: il progetto europeo MARIO.

<p>Un Robot assistivo per pazienti con demenza: il progetto europeo MARIO.</p

Managing active and healthy aging with use of caring service robots (MARIO)

<p>Europe has the highest prevalence of dementia in the world; seven million people are currently affected and this is projected to increase to 13.4 million by 2050. Across EU countries, participation of people with dementia in family and civic life is diminished by cultures of exclusion and stigmatisation. Dementia is characterised by impaired mental functioning, language and thinking. These impairments are often accompanied by personality, functional and behavioural changes. To fight loneliness and the effects suffered by people with dementia, effective techniques include those that target change of a person’s perception of loneliness and those that increase a person’s resilience.</p> <p>ICT solutions can be used to increase psychological skills like resilience, and to manage active and healthy aging with the use of caring service robots as will be explored with the EU funded MARIO project that involves 10 partners from 6 EU countries. In this project specific technological tools are adopted that try to create real feelings and affections making it easier for the patient to accept assistance from a robot when - in certain situations - in return the human can also support the machine. The approach targeted in MARIO is the Comprehensive Geriatric Assessment (CGA) on which the Multidimensional Prognosis Index (MPI) is based. Used effectively, the MPI can improve dramatically diagnostic accuracy, optimize medical treatment and health outcomes, improve function and quality of life, reduce use of unnecessary formal services, and institute or improve long-term care management. In MARIO, the service robot will provide information to MPI survey and evaluation process based on its observation of the instrumental activities of daily living and detection of changes regarding them. MARIO aims to address and make progress on the challenging problems of loneliness, isolation and dementia in older persons through multi-faceted interventions delivered by service robots.</p

Pre-matching baseline characteristics of community-dwelling older patients with diabetes mellitus according to statin use.

<p>VCOG: cognitive status; VIP: Nursing Care Needs; VPIA: pressure sores risk; VADL: activities of daily living; VMOB: mobility; VSOC: social support; MPI: Multidimensional Prognostic Index</p><p>MPI-SVaMA: Multidimensional Prognostic Index based on the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons</p><p>* Number of all medications prescribed within one year before patient’s enrollment</p><p>Pre-matching baseline characteristics of community-dwelling older patients with diabetes mellitus according to statin use.</p

Summary of the methodological constructs of the four frailty indexes compared.

<p>FI-SOF: Frailty Index derived from the Study of Osteoporotic Fractures;</p><p>FI-CD: Frailty Index based on cumulative deficits;</p><p>FI-CGA: Frailty Index based on a Comprehensive Geriatric Assessment;</p><p>ADL: activities of daily living;</p><p>IADL: instrumental activities of daily living;</p><p>SPMSQ: Short Portable Mental Status Questionnaire;</p><p>CIRS: Cumulative Illness Rating Scale;</p><p>MNA: Mini Nutritional Assessment;</p><p>ESS: Exton-Smith Scale;</p><p>MPI: Multidimensional Prognostic Index.</p

Subgroups of hospitalized older patients where different frailty indexes showed a significant different predictive discriminatory power for one-year all-cause mortality.^*

<p>AUC: areas under curve; SE: standard error; CI: confidence interval; ADL: activities of daily living; MPI: Multidimensional Prognostic Index; FI-SOF: Frailty Index derived from the Study of Osteoporotic Fractures; FI-CD: Frailty Index based on cumulative deficits; FI-CGA: Frailty Index based on a Comprehensive Geriatric Assessment; IADL: instrumental activities of daily living; SPMSQ: Short Portable Mental Status Questionnaire; CIRS: Cumulative Illness Rating Scale;</p><p>MNA: Mini Nutritional Assessment.</p><p>*AUCs were assessed by crude and adjusted logistic regression models, accounting for clustering due to centre effect.</p

Baseline characteristics of hospitalized older patients according to gender.

<p>*continuous variables;</p>†<p>categorical variables; pm = person-month; py = person-years; ir = incidence rate.</p><p>**p-values obtained fitting generalized linear mixed-effects models, using variable rank values, accounting for clustering due to centre effect.</p>††<p>Excluding cerebrovascular disease.</p><p>FI-SOF: Frailty Index derived from the Study of Osteoporotic Fractures; FI-CD: Frailty Index based on cumulative deficits; FI-CGA: Frailty Index based on a Comprehensive Geriatric Assessment; ADL: activities of daily living; IADL: instrumental activities of daily living; SPMSQ: Short Portable Mental Status Questionnaire; CIRS: Cumulative Illness Rating Scale; MNA: Mini Nutritional Assessment;</p><p>ESS: Exton-Smith Scale; MPI: Multidimensional Prognostic Index.</p

Comparison of the areas under the receiver operating characteristic (ROC) curves of the four frailty instruments compared.^*

<p>AUC: areas under curve; SE: standard error; CI: confidence interval; MPI: Multidimensional Prognostic Index; FI-SOF: Frailty Index derived from the Study of Osteoporotic Fractures; FI-CD: Frailty Index based on cumulative deficits; FI-CGA: Frailty Index based on a Comprehensive Geriatric Assessment.</p><p>*AUCs were assessed by crude and adjusted logistic regression models, accounting for clustering due to centre effect.</p

Baseline characteristics of community-dwelling older patients with diabetes mellitus divided according to their Multidimensional Prognostic Index (MPI) grade based on the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons (SVaMA).

<p>VADL: activities of daily living; VCOG: cognitive status; VIP: Nursing Care Needs; VMOB: mobility; VPIA: pressure sores risk; VSOC: social support</p><p>* Number of all medications per month, taken before the patient’s enrollment</p><p>^ ev/py: events/person-years, ir%: incidence rate (number of events per 100 person-years)</p><p>Baseline characteristics of community-dwelling older patients with diabetes mellitus divided according to their Multidimensional Prognostic Index (MPI) grade based on the Standardized Multidimensional Assessment Schedule for Adults and Aged Persons (SVaMA).</p

Risk of one-month and one-year all-cause mortality according to the four frailty instruments in hospitalized older patients.

<p>*continuous variables.</p><p>**p-values obtained fitting univariate proportional hazard regression models, accounting for clustering due to centre effect.</p><p>HR: hazard ratio; CI: confidence intervals; FI-SOF: Frailty Index derived from the Study of Osteoporotic Fractures; FI-CD: Frailty Index based on cumulative deficits; FI-CGA: Frailty Index based on a Comprehensive Geriatric Assessment; MPI: Multidimensional Prognostic Index.</p