As the world's population increases in age, the number of people living with dementia grows. Dementia has long been considered to be neither preventable nor treatable, but while the underlying illnesses are not curable, today we know that the disease course might be modifiable with good preventive interventions at an early time point. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) showed a positive effect after a 2-year intervention targeting several lifestyles and vascular risk factors simultaneously. LETHE will go beyond and provide a data-driven risk factor prediction model for older individuals at risk of cognitive decline building upon big data analysis of cross-sectional observational and longitudinal intervention datasets from 4 clinical centers in Europe including the 11- years analysis of FINGER. LETHE will establish novel digital biomarkers, for early detection of risk factors, based on unobtrusive ICT-based passive and active monitoring. The aim is to establish a digital-enabled intervention for cognitive decline prevention based on the evolution of a successful protocol (FINGER) evolving into an ICT based preventive lifestyle intervention through individualized profiling, personalized recommendations, feedback and support (FINGER 2.0), well targeted on a population stratified by cost-effective biological biomarkers. The LETHE solution will be tested in a feasibility study validating the achieved improvements. A successful LETHE project could lead to a more personalized risk factor prevention for persons with beginning cognitive decline, thereby empowering people to an active and healthy lifestyle. Expansions of prevention trials on large scale by an automatized roll out of a multimodal intervention approach, reaching out to large populations, could save future costs on expensive traditional interventions and confer benefits for the wider society.
The three majorachievements expected in LETHE are: 1) A data-driven risk factor prediction model for older individuals at risk of cognitive decline building up on big data analysis of cross-sectional observational and longitudinal intervention datasets 2) Novel digital biomarkers, for early detection of risk factors, based on unobtrusive ICT-based passive and active monitoring 3) A digital enabled intervention for cognitive decline prevention based on the evolution of a successful protocol (FINGER) evolving into an ICT based preventive lifestyle intervention through individualized profiling, personalized recommendations, feedback and support (FINGER 2.0), well targeted on a population stratified by cost-effective biological biomarkers. A broader approach to prevention of dementia, including promoting resilience, makes sense in our ageing societies. Strategies for promoting resilience to prevent or delay the onset of dementia are extrapolated from studies on declining dementia incidence, which report that healthier lifestyles are associated with declining prevalence of cognitive impairment and dementia. Any future disease- modifying treatment for dementia will not remove the need for its effective prevention. Modifying risk factors could translate into a large effect on the global burden of dementia, which would then have huge implications for social and health- care costs. While public health interventions will not delay, prevent, or cure all potentially modifiable dementia, the management of metabolic, mental health, hearing, and cerebrovascular risk factors might push back the onset of many cases for some years. Dementia prevalence would be halved if its onset were delayed by 5 years. Estimates suggest that a 10% reduction in the prevalence of the seven principal health and lifestyle factors would reduce worldwide dementia prevalence by more than a million cases, or an intervention that delayed dementia by a year could decrease the number of people living with dementia globally by 9 million in 2050. While we might not expect risk factor modification to have this magnitude of effect in reality, any reduction in dementia risk would be a great achievement. Although no disease-modifying treatment for any common dementia is available, a delay in the onset of dementia would benefit even the oldest adults. The LETHE project capitalizes the clinical research and experience of different Pilot partners involved in projects dealing with people with dementia. In the last decade, several scientific research and deployment Proof of Concept projects addressing technologies for smart and healthy living have been developed by partners of the LETHE consortium, significantly contributing to development in the field of ICT solutions and services for older people.
