European Innovation Partnership On Active And Healthy Ageing Research Articles

Impact of chronic stress exposure on cognitive performance incorporating the active and healthy aging (AHA) concept within the cross-sectional Bern Cohort Study 2014 (BeCS-14)

PurposeThis study aims to verify that the mental-cognitive domain of the validated generic bio-functional status (BFS)/bio-functional age (BFA) assessment tool, incorporating the concept of Active and Healthy Ageing (AHA), reflects cognitive performance. In addition, the effects of chronic stress exposure on the mental-cognitive BFS/BFA should be investigated.MethodsThe study was carried out as a monocenter, cross-sectional, observational, non-interventional trial (Bern Cohort Study 2014, BeCS-14) with the participation of 147 non-pediatric, non-geriatric subjects. All participants followed a standardized battery of biopsychosocial assessments consisting of BFS/BFA, a validated cognitive performance test battery (Inventar zur Gedächtnisdiagnostik; IGD) and a validated questionnaire for the assessment of chronic stress (Trier Inventory for the assessment of Chronic Stress; TICS), respectively.ResultsMean cognitive performance was average and higher in younger or better educated individuals. The BFA of the participants was 7.8 ± 7.8 year-equivalents below their chronological age. The mental-cognitive BFS/BFA assessment correlated well with the validated questionnaire for cognition assessment, the IGD. Further, three TICS subdomains (work overload (r = − 0.246, p = 0.003), work discontent (r = − 0.299, p = 0.006) and pressure to succeed (r = − 0.274, p < 0.001)), reflecting mainly work-related stress, showed a significant negative correlation with the mental-cognitive BFS/BFA.ConclusionsOur study shows that the BFS/BFA assessment tool follows European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) requirements. Further, we could demonstrate that higher levels of chronic work-related stress may be associated with poorer mental-cognitive performance and a pro-aging state indicating that cognitive impairments can be reduced by stress management interventions.

From the bench to practice - Field integration of community-based services for older citizens with different levels of functional limitation across European Regions.

The meeting of the European Innovation Partnership on Active and Healthy Ageing (EIPonAHA) action group A3 together with members of the Reference site collaborative network (RSCN) in December 2019 in Rome focused on integration of evidence-based approaches on health and care delivery for older citizens at different levels of needs with expertise coming from stakeholder across Europe. It was the final aim of the group to co-create culturally sensitive pathways and facilitate co-ownership for further implementation of the pathways in different care systems across Europe.The study design is a mixed method approach. Based on data analysis from a cohort of community-dwelling over-65 citizens in the framework of a longitudinal observational study in Rome, which included health, social and functional capacity data, three personas profiles were developed: the pre-frail, the frail and the very frail personas. Based on these data, experts were asked to co-create care pathways due to evidence and eminence during a workshop and included into a final report.All working groups agreed on a common understanding that integration of care means person-centered integration of health and social care, longitudinally provided across primary and secondary health care including citizens’ individual social, economic and human resources.Elements for consideration during care for pre-frail people are loneliness and social isolation, which, lead to limitation of physical autonomy in the light of reduced access to social support. Frail people need adaption of environmental structures and, again, social resource allocation to maintain at home. Very frail are generally vulnerable patients with complex needs. Most of them remain at home because of a strong individual social support and integrated health care delivery.The approach described in this publication may represent a first approach to scaling-up care delivery in a person-centered approach.

The bio-psycho-social frailty: a key to the integrate territorial and hospital care in Europe

Abstract Demographic changes have forced communities and people themselves to reshape ageing concepts and approaches and try to develop actions towards Active and Healthy Ageing (AHA). The prevalence of frailty at population-level is expected to increase in Europe, changing the focus of Public Health. The European Innovation Partnership on Active and Healthy Ageing (EIPonAHA), a private public partnerships (PPP) launched by the European Commission (EC) is aimed at developing new solutions to facilitate AHA. The partnership combined the view on frailty coming from public health as well as the clinical management, and managed to overcome barriers between these two worlds. Bio-Psycho-Social frailty represents a synthetic indicator providing an effective basis to overcome a silos approach that is often performed by health and social professionals working in the field. The A3-Action Group on ' Lifespan Health Promotion &amp; Prevention of Age-Related Frailty and Diseases” proposes good practice models to achieve and support the healthy ageing of European citizens using a bottom-up approach targeting the prevention of frailty and subsequent functional decline. Multiple factors were highlighted by the group as useful for healthcare planning: malnutrition, polypharmacy, impairment of physical function and social isolation were targeted to mitigate frailty and its consequences. Integrated health and social care is a key factors to affect ageing positively either in the field of prevention of functional decline and in the field of care. Studies focused on the management of frailty highlighted that tailored interventions can improve physical performance and reduce adverse outcomes. A crucial role is played by training of health personnel and education at population level in order to achieve a new awareness about AHA trajectory.

Measuring cognitive performance in way that incorporates the concept of active and healthy ageing (AHA)

ObjectivesTo demonstrate that the mental-cognitive domain of the validated generic bio-functional status (BFS)/bio-functional age (BFA) assessment tool reflects cognitive performance, and so meets the needs of the European Innovation Partnership on Active and Healthy Ageing (EIP-AHA). Study designMonocenter, cross-sectional, observational, non-interventional trial (Bern Cohort Study 2014, BeCS-14) (Cantonal Ethics Committee, KEK-BE 023112).Main outcome measures: Ratings on the mental-cognitive BFS domain and on a validated cognitive performance test battery (Inventar der Gedächtnisdiagnostik; IGD) in 47 healthy, educated, middle-class, midlife men and women. ResultsMean cognitive performance was average in younger, and higher in better-educated individuals. Participants’ BFA was 8.9 ± 6.6 year-equivalents below their chronological age. Subjects who performed better in the IGD (sub)domains also performed better in the BFS cognitive-mental function subdomain. Correlation analysis of the ratings in the BFS cognitive-mental function subdomain and total score on the IGD revealed that the highest correlations were achieved by the BFS parameters cognitive switching capability (r=−0.56, p < 0.001), strategic thinking (r=−0.49, p < 0.001), changeover capability (r=−0.50, p < 0.001) and stepping-stone-maze test (r=−0.51, p < 0.001). ConclusionsRatings on the BFS cognitive-mental function subdomain correlated well with scores on a validated questionnaire for cognition assessment, the IGD. Therefore, the BFS/BFA assessment tool meets the needs of the EIP-AHA.

Smart Healthy Age-Friendly Environments - Policy Recommendations of the Thematic Network SHAFE.

The European Commission (DG SANTE) launched a call for proposals in November 2017 on strategic initiatives for a Joint Statement in 2018. Ten proposals were voted until December 7th in the European Union Health Policy Platform[1]; the proposal under the theme Smart Healthy Age-Friendly Environments (SHAFE)[2] was the most voted and was confirmed by the European Commission in March 2018. In this context, since March 2018, Cáritas Coimbra and AFEdemy Ltd are thus coordinating one of the three Thematic Networks for 2018, SHAFE, in close cooperation with main partners, such as the European Innovation Partnership on Active and Healthy Ageing (EIP-AHA), the European Innovation Partnership on Smart Cities and Communities (EIP-SCC), the Reference Sites Collaborative Network, the European Covenant on Demographic Change, Eurocities, the European Health Telematics Association (EHTEL), the European Connected Health Alliance (ECHAlliance), the European Construction, Built Environment and Energy Efficient Building Technology Platform (ECTP) and the European Centre for Social Welfare Policy and Research. SHAFE aims to facilitate the creation of healthy and friendly environments for all ages through the use of new technologies, towards the production of a comprehensive and participatory Joint Statement. This document was presented to the European Commission on 12 November 2018, with five main areas of recommendations to the EC, Member States and other local, regional and national organisations and is open for endorsement and implementation from this date onwards.

Perceptions and experiences of frailty interventions: quantitative and qualitative results from a survey of partners within the European Innovation Partnership on Active and Healthy Ageing (EIP-AHA)

ABSTRACTThe European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) was launched by the European Commission in 2011 to promote innovation in ageing research. This paper explores the experiences of partners delivering frailty interventions within Europe, registering their programmes with the EIP-AHA. Data were collected using an online survey from 21 partners in seven countries. A mixed-method approach was used with inductive thematic analysis of free-text responses to improve data richness. Responses indicated that there was a lack of consistency between EIP-AHA partners in methods of defining, screening and measuring for frailty and pre-frailty. Open responses to survey questions about intervention facilitators, moderators and barriers were coded into two themes: working with stakeholders and project management. We concluded that EIP-AHA partners are providing interventions addressing physical, cognitive and wellbeing elements of frailty. However, there needs to be an increase in the proportion of interventions that consistently apply valid methods of screening and/or measuring frailty and pre-frailty. Most, but not all projects are targeting pre-frail older adults, suggesting an appropriate balance of prevention in a useful ‘intervention window’ but also a growing understanding that frailty at later stages is amenable to intervention. Findings suggest design manipulations to improve outcomes and adherence to interventions, specifically inclusion of a perceived benefit/reward for older adults, e.g. a social aspect or health-care promotion.

The Italian reference sites of the European innovation partnership on active and healthy ageing: Progetto Mattone Internazionale as an enabling factor.

Ageing population implies an increasing demand for health care services and resources, unsustainable according to current previsions. The European Commission is tackling this challenge throughout initiatives such as the European Innovation Partnership on Active and Healthy Ageing (EIP-AHA), where all the efforts are aligned to the common goal of adding two active and healthy years to the life of European Union (EU) citizens. We presented the collaborative efforts of Italian Reference Site Collaborative Network 2012-2015. Italian regions joined forces through the "Progetto Mattone Internazionale" of the Ministry of Health developing several national and international collaborations. Activities from all five Italian reference sites are presented with different good practices and scale-up approaches for improving health in ageing population. The simultaneous development of these activities allowed the strengthening of the coordination of Italian stakeholders in the European arena fostering collaboration and supporting the streamlining of the Italian regions still outside these projects.

FOCUS: Frailty Management Optimisation through EIPAHA Commitments and Utilisation of Stakeholders’ Input – an innovative European Project in elderly care*

The goal of FOCUS, which stands for Frailty Management Optimization through EIPAHA Commitments and Utilization of Stakeholders’ Input, is to reduce the burden of frailty in Europe. The partners are working on advancing knowledge of frailty detection, assessment, and management, including biological, clinical, cognitive and psychosocial markers, in order to change the paradigm of frailty care from acute intervention to prevention. FOCUS partners are working on ways to integrate the best available evidence from frailty-related screening tools, epidemiological and interventional studies into the care of frail people and their quality of life. Frail citizens in Italy, Poland and the UK and their caregivers are being called to express their views and their experiences with treatments and interventions aimed at improving quality of life. The FOCUS Consortium is developing pathways to leverage the knowledge available and to put it in the service of frail citizens. In order to reach out to the broadest audience possible, the FOCUS Platform for Knowledge Exchange and the platform for Scaling Up are being developed with the collaboration of stakeholders. The FOCUS project is a development of the work being done by the European Innovation Partnership on Active and Healthy Ageing (EIPAHA), which aims to increase the average healthy lifespan in Europe by 2020 while fostering sustainability of health/social care systems and innovation in Europe. The knowledge and tools developed by the FOCUS project, with input from stakeholders, will be deployed to all EIPAHA participants dealing with frail older citizens to support activities and optimize performance.

Screening and assessment of the risk of fall—an initiative to prevent falls in community dwelling older adults

Background: The European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) has developed an array of documents with commitments in order to entail its partners within a program of activities whose main goal is to increase, by the year 2020, two years of active healthy life of the European citizens. This major action will be pursued by implementing programs directed to contribute to the sustainability of social and health care systems is one of the these actions. Purpose: To deliver by the year 2015 across the EU, evidence based validated and operational programs for prevention, early identification and minimization of risk and management of falls (Action group A2). The first essential step in deciding to use PhysioSensing® in the clinic, particularly for screening and assessing risk of fall and using the visual feedback to empower individuals for active participation in a program for fall prevention by assessing feasibility of utilizing PhysioSensing® as a balance monitor and feedback device. Second aim of this study was to assess the validity of the PhysioSensing® as a balance monitor device to identify risk of fall, identifying the best exercises, from a set of eight, to administer in 2–3minutes, with good sensitivity and specificity. Methods: Pilot study design, which included testing procedures for acceptability, estimating the likely rates of recruitment of subjects, missing values and inappropriate responses were conducted. Ensuring that the equipment must be safe, requiring little time, easy tomanipulate and calculate, and easy to interpret, based on published norms. To verify the agreement between exploratory measures – eight exercises PhysioSensing® protocol – and golden standard measures for screening risk of fall – 10 Meters Walking Speed Test, Timed Up & Go Test, Step Test and Hand Grip – correlations were tested, as well as analysis by groups–use/no-use of cane, history of fall(s), vision and hearing problems, number of medications and frailty criteria. Results: The study conducted from April 2013 to June 2014, comprised a sample of 307 community dwelling adults aged 55 years and older with mean age 67.74± 8.38 (65,5% women). Cut-off points, for particular age groups, were estimated by ROC Curves. Ex4 and Ex6 were identified as the best protocol. Exercise programwith/without education component were implemented and assessed, with cost-effective results. An educational manual on preventing falls for the Portuguese elderly population was developed and tested. Conclusion(s): Evaluation of data has demonstrated that PhysioSensing® is a feasible balance monitor and feedback device for screening and assessing the risk of fall; and from a set of eight exercises, two proved to have good sensitivity and specificity to identify the risk of fall. This work is identified as a Good Practice by the European Reference Region for Active and Healthy Ageing, Ageing@Coimbra Consortium. Implications: To promote a systematic approach in identifying individuals who are at higher risk of falls and harm of fall, rather than their first fall, and who will benefit from a tailored intervention.