Evaluation of the effectiveness of a personalized multimodal intervention in community-dwelling frail and pre-frail older people using innovative ICT solutions - the MIRATAR study

Background: Frailty is a condition characterized by an age-related decrease of physiological reserve, which increases vulnerability to stressors, leading to higher risk of negative health events. Evidence has demonstrated that frailty can be reversed through a multidisciplinary approach that encompasses multicomponent exercise, nutritional advice and medication management. However, the role of Information and Communication Technologies (ICTs) in the implementation of such programs has been scarcely explored in the scientific literature. We describe the rationale and methods of a multimodal intervention in frailty using innovative ICTs, the MIRATAR study.

Methods/design: The MIRATAR study is a quasi-experimental, longitudinal, multicentre, clustered, superiority, and prospective study. A sample of 50 community-dwelling older adults (aged > 65 years), identified as pre-frail or frail according to the Fried Frailty Phenotype (FFP), will be recruited in two Spanish sites (Getafe and Albacete). Our primary objective is to evaluate if a personalized multi-modal intervention supported by the MIRATAR technological ecosystem can improve frailty status after 6 months, either based on a reduction in more than 2.5 points in the 5-item Frailty Trait Scale (FTS-5) and/or a reduction in more than 1 points in the FFP score. Secondary outcomes include participant’s autonomy, nutritional status, quality of life and cost-effectiveness. The core of the MIRATAR ecosystem is an AI-powered virtual assistant/carer that will interact with participants via an intelligent mirror, enabling natural interaction. It will provide guidance on physical exercise and nutrition, tailored to each participant's functional status and characteristics. Additionally, MIRATAR will use multiple sensing technologies to gather supplementary information like physiological data (e.g., weight, blood pressure), environmental data (e.g., temperature, presence), and activity tracking through wearable sensors.

Conclusions: The MIRATAR study will provide evidence on the usability, acceptance, and clinical and functional effectiveness of a personalized multi-modal intervention for frail and pre-frail older people provided through innovative ICTs.