Intrinsic Capacitiy Monitoring by Digital Biomarkers in Integrated Care For Older People (ICOPE)
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SPECIAL ARTICLE
INTRINSIC CAPACITIY MONITORING BY DIGITAL BIOMARKERS IN INTEGRATED CARE FOR OLDER PEOPLE (ICOPE) A. PIAU1,2, Z. STEINMEYER1, M. CESARI3, J. KORNFELD4, Z. BEATTIE4, J. KAYE4, B. VELLAS1,2, F. NOURHASHEMI1,2 1. Gerontopole, Toulouse University Hospital, 31059 Toulouse, France; 2. UPS/INSERM, UMR1027, F-31073 Toulouse, France; 3. Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy; 4. Oregon Center for Aging & Technology (ORCATECH), Oregon Health & Science University, Portland, USA. Corresponding author: Antoine Piau, La Cité de la Santé, Bâtiment Ex-Biochimie, Hôpital La Grave, Place Lange, TSA 60033, 31059 Toulouse Cedex 9, France, E-mail address: [email protected], Phone number: +335 61 32 30 10, Fax number: +335 61 77 64 75
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. Key words: ICOPE program, digital biomarkers, technology, remote monitoring, intrinsic capacity. J Frailty Aging 2020;in press Published online October 5, 2020, http://dx.doi.org/10.14283/jfa.2020.51
The ICOPE program and the necessary but difficult monitoring of intrinsic capacity over time
persists as among the most critical issues faced by modern medicine (4, 5) for a number of reasons: (i) Increasing numbers of patients with limited health resources, constrains the possibility of in-person assessment (self-management is increasingly necessary); (ii) For implementation of proactive or preventive personalized interventions, early negative trends in IC must be detected in order to investigate underlying causes; (iii) Continuous monitoring of IC dimensions is needed to measure an individual’s longitudinal trajectories over time after an intervention; (iv) Functional abilities assessment – explained by the interaction of a person’s IC with its environment – must be unobtrusively measured in one’s own environment (achieving ecological validity).
The WHO defines Intrinsic Capacity (IC) as a “composite of all physical and mental capacities that an individual can draw on”, and functional ability as “health-related attributes that enable people to be and to do what they have reason
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