Intrinsic Capacitiy monitoring by digital biomarkers in Integrated Care for Older People (ICOPE)

Abstract

The WHO action plan on aging expects to change current clinical practices by promoting a more personalized model of medicine. To widely promote this initiative and achieve this goal, healthcare professionals need innovative monitoring tools. Use of conventional biomarkers (clinical, biological or imaging) provides a health status assessment at a given time once a capacity has declined. As a complement, continuous monitoring thanks to digital biomarkers makes it possible to remotely collect and analyze real life, ecologically valid, and continuous health related data. A seamless assessment of the patient’s health status potentially enables early diagnosis of IC decline (e.g. sub-clinical or transient events not detectable by episodic evaluations) and investigation of its probable causes. This narrative review aims to develop the concept of digital biomarkers and its implementation in IC monitoring.

Blood Biomarkers from Research Use to Clinical Practice: What Must Be Done? A Report from the EU/US CTAD Task Force

“…The World Health Organization (WHO) ICOPE step 1 is a simple tool, which can be used to detect an impairment in one or more domain(s) of the intrinsic capacity (i.e., cognition, mood, nutrition, mobility, sensory). In France, a mobile app and a conversational robot, that enable self-assessment, have been developed to promote ICOPE step 1 use ( 44 ). These tools are now extended internationally.…”

Implementation of the WHO integrated care for older people (ICOPE) programme in clinical practice: a prospective study

“…The creation of both digital tools for data collection and a database that automatically receives these data and produces alerts when positive screenings for intrinsic capacity are detected facilitate a timely follow-up of patients and are essential to increase the involvement of stakeholders. 26 To shorten the time required for the implementation of organisational changes, and the time for these changes to produce results, several communication, information, and training campaigns have been launched with professionals and older people. Finally, the creation of the INSPIRE ICOPE-CARE monitoring platform, made up of experienced nurses who support health-care professionals to monitor their patients, is a crucial step in the deployment of this programme.…”

Digital health in older adults for the prevention and management of cardiovascular diseases and frailty. A clinical consensus statement from the ESC Council for Cardiology Practice/Taskforce on Geriatric Cardiology, the ESC Digital Health Committee and the ESC Working Group on e‐Cardiology

“… 11 , 117 Digital biomarkers when applied to the identification of the frailty phenotype are objective, quantifiable, physiological and behavioural data that are collected and measured by means of digital devices such as sensors or wearables, enabling remote data collection and processing of large amounts of real‐life, continuous and long‐term health‐related data. 118 Examples of such digital biomarkers include waist‐worn accelerometer sensors that allow digital monitoring of walking speed—they have been shown to be able to accurately measure continuous gait speed in frail, older patients. 119 Wrist‐worn sensor‐derived frailty indices have also been validated in comparison with other established measures of frailty such as gait, timed ‘up and go’ and ‘sit‐to‐stand’ assessments.…”