A Digital-Health Program Based on Comprehensive Geriatric Assessment for the Management of Older People at Their Home: Final Recommendations from the MULTIPLAT_AGE Network Project
Abstract
:1. Introduction
2. Materials and Methods
2.1. The MULTIPLAT_AGE Network Project
2.2. The Multidimensional Prognostic Index (MPI)
- Activities of Daily Living (ADL);
- Instrumental Activities of Daily Living (IADL);
- Short Portable Mental Status Questionnaire (SPMSQ);
- Mini-Nutritional Assessment—Short Form (MNA-SF);
- Exton-Smith Scale (ESS);
- Cumulative Illness Rating Scale—comorbidity index (CIRS-CI);
- Number of drugs;
- Co-habitation status: in family, in institution, alone.
2.3. The Digital Platform
2.4. Definition of the Recommendations
3. Results
MULTIPLAT_AGE Recommendations
PRO-HOME Study |
|
EASYDOM Study |
|
ORDER Study |
|
E-ACTION TRAINING Study |
|
Stimo.TE-REHAB Study |
|
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
STUDY | INCLUSION CRITERIA | EXCLUSION CRITERIA |
---|---|---|
PRO-HOME |
|
|
EASYDOM |
|
|
ORDER | A.
| A.
|
E-ACTION TRAINING | Common:
| Common:
|
Stimo.TE-REHAB |
|
|
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STUDY | MAIN OBJECTIVE | METHODS | RESULTS |
---|---|---|---|
PRO-HOME | Testing the efficacy of a transitional care program based on a multicomponent intervention in reducing length of hospital stay (LOS) in older patients. | Randomized clinical trials on 60 hospitalized older patients. The intervention group (IG, n = 30) underwent a multicomponent intervention inside a technologically equipped protected discharge intra-hospital facility. The control group (CG, n = 30) underwent usual care until discharge. Variables: multidimensional frailty (MPI), Health-related Quality of Life (HRQOL), re-hospitalization, institutionalization, death rates. Follow-up: 1, 3, and 6 months. | In the IG, a 2-day reduction in LOS (p < 0.001), and improvement in multidimensional frailty (p = 0.040), i.e., nutritional (p = 0.002) and cognitive status (p = 0.041) were observed vs. CG. No changes in HRQOL, re-hospitalization, institutionalization, and death rates were observed in both groups. Only the CG showed a significant worsening in number of comorbidities (p = 0.014) [17,18,19]. |
EASYDOM | Testing the effectiveness of ICT-supported prescription and monitoring of patients with chronic conditions undergoing optimal treatment. | Randomized clinical trial on 102 hypertensive outpatients with physical pre-frailty (2 positive out of 5 Fried Criteria) treated with Adapted Physical Activity (APA). Two groups involved: Intervention group (IG, n = 50): APA prescription plus ICT support kit; Control group (CG, n = 52): receiving only APA prescription (no ICT support kit). Variables: Reduction in cardiovascular risk, according to the Italian Institute of Health risk maps, number of unplanned hospitalizations, physical activity, and fitness parameters. Follow-up: 6 months. | The ICT-supported Adapted Physical Activity (APA) program led to greater improvements in physical performance in IG compared to the CG. Participants in the IG showed a significant increase in exercise tolerance after the 3-month intervention. After 6 months of follow-up, a decrease in the pre-frailty incidence compared to baseline in all groups was observed: the decrease was greater in the IG vs. CG. |
ORDER |
|
Follow up: not applicable per study design.
Follow-up: 24 h, 48 h, and 1 month after ED admission. |
|
E-ACTION TRAINING | Evaluating the efficacy of a home-based training, combining Action Observation (AO) and physical exercises (E-ACTION TRAINING) to improve balance and gait performances in people at risk of falls. | Comparative study with a pre-post design conducted on 60 patients, divided into three groups (20 participants per group):
Assessment: before and after the training period. | Patients in all three groups showed a significant improvement in several outcome measures assessing balance and gait after the treatment. However, only the healthy older adults group also exhibited an improvement in quality of life. System Usability Score showed excellent performance in all the three groups. |
Stimo.TE-REHAB | Evaluating the effectiveness of Remote Cognitive Stimulation (RCS) in improving cognitive performances and activities of daily living. | Randomized controlled trial on 81 older patients with mild to moderate cognitive impairment, assigned to RCS Stimo.TE-Rehab (intervention group, IG) or traditional Cognitive Stimulation (control group, CG). The total sample included: Parkinson’s Disease patients (PD, n = 45); post-stroke patients (PS, n = 36). Variables: visuospatial abilities (VSA), attention and working memory, language and executive functions, mood (M) as assessed by Beck Depression Inventory, BDI + State Trait Anxiety Inventory (STAI), Short Form 36 Health Outcome (SF-36), caregiver burden (CB). Assessment: before and after the treatment. Follow-up: 6 months after treatment. | Stimo.TE-Rehab IG: patients with PD increased their VSA (p = 0.014), attention and working memory (p = 0.046), and language and executive functions (p = 0.037); patients with PS showed a significant improvement in language (p = 0.001), M (p = 0.03), and showed a reduction in CB (p = 0.04). Stimo.TE-Rehab CG: patients with PD showed an improvement in VSA (p = 0.014), language (p = 0.010), and M (p = 0.048); patients with PS showed a significant improvement in VSA (p = 0.04), attention, and executive functions (p = 0.01) [21,22]. |
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Pilotto, A.; Massone, C.; Iaccarino, G.; Genazzani, A.; Trompetto, C.; Arabia, G.; Morganti, W.; Seminerio, E.; Illario, M.; Castello, L.; et al. A Digital-Health Program Based on Comprehensive Geriatric Assessment for the Management of Older People at Their Home: Final Recommendations from the MULTIPLAT_AGE Network Project. Healthcare 2025, 13, 1105. https://doi.org/10.3390/healthcare13101105
Pilotto A, Massone C, Iaccarino G, Genazzani A, Trompetto C, Arabia G, Morganti W, Seminerio E, Illario M, Castello L, et al. A Digital-Health Program Based on Comprehensive Geriatric Assessment for the Management of Older People at Their Home: Final Recommendations from the MULTIPLAT_AGE Network Project. Healthcare. 2025; 13(10):1105. https://doi.org/10.3390/healthcare13101105
Chicago/Turabian StylePilotto, Alberto, Carolina Massone, Guido Iaccarino, Armando Genazzani, Carlo Trompetto, Gennarina Arabia, Wanda Morganti, Emanuele Seminerio, Maddalena Illario, Luigi Castello, and et al. 2025. "A Digital-Health Program Based on Comprehensive Geriatric Assessment for the Management of Older People at Their Home: Final Recommendations from the MULTIPLAT_AGE Network Project" Healthcare 13, no. 10: 1105. https://doi.org/10.3390/healthcare13101105
APA StylePilotto, A., Massone, C., Iaccarino, G., Genazzani, A., Trompetto, C., Arabia, G., Morganti, W., Seminerio, E., Illario, M., Castello, L., Mori, L., Pignolo, L., & Custureri, R., on behalf of MULTIPLAT_AGE Investigators. (2025). A Digital-Health Program Based on Comprehensive Geriatric Assessment for the Management of Older People at Their Home: Final Recommendations from the MULTIPLAT_AGE Network Project. Healthcare, 13(10), 1105. https://doi.org/10.3390/healthcare13101105