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Sustainable care for multimorbid elderly patients with mild cognitive impairment
Published on 22 October 2021

Multimorbidity, defined as the simultaneous occurrence of at least two chronic diseases, is a characteristic of the health situation of older people and is common among those in high-income countries [1]. Managing multimorbidity is complex and patients face several challenges in terms of understanding and self-managing the conditions and medication, regularly monitoring several clinically relevant vital parameters, and coordinating multiple medical services [2]. The appearance of dementia symptoms makes it more difficult for patients to cope with their everyday routine and their diseases. Home-based telemonitoring may support older patients with multimorbidity and mild cognitive impairment (MCI) in their regular monitoring and self-management [3]. Early recognition and assessment of dementia and supports the development of a care plan are necessary [4]. People with MCI need extra care plan in many aspects, some of the general and important cares include:

Medication Management

Medication monitoring is very important for MCI to improve safety and compliance of patient

Caregiver Support

Discuss needs, coping strategies, support system and stress management with caregiver

Memory

Involving patients to some memory activities to help them remembering some tasks and landing spots

Behavioural

In case the patient is considered at risk to others or themselves through reactive, repetitive, and wandering behaviours.

Mental Health

Dementia may co-exist with other complex mental health conditions. Involve mental health care can help in distinguishing depression from dementia and assessing and treating significant behavioural problems.

Socialization

Patients with dementia may become socially withdrawn. Encouraging them for some social activities is highly required

Household Safety

This can help in monitoring home appliances to assess home for safety hazards

Nutrition

Weigh regularly to monitor for weight change and have the caregiver monitor the refrigerator for food safety, and meal support services Toward this end, the emerge of new potential technologies such as the fifth generation mobile network 5G system, artificial intelligence AI, machine learning and many other promising technologies, the above mentioned cares and others can be leveraged and optimized in a robust and efficient way by proposing an ICT based solution for the optimization of clinical practice in the treatment and management of multimorbid patients with Mild Cognitive Impairment or mild dementia (MD) as well as for caregivers.

Reference:
  1. The Lancet. Making more of multimorbidity: an emerging priority. Lancet 2018 Apr 28;391(10131):1637.
  2. Wallace E, Salisbury C, Guthrie B, Lewis C, Fahey T, Smith SM. Managing patients with multimorbidity in primary care. BMJ 2015 Jan 20;350:h176.
  3. Zulman DM, Jenchura EC, Cohen DM, Lewis ET, Houston TK, Asch SM. How can eHealth technology address challenges related to multimorbidity? Perspectives from patients with multiple chronic conditions. J Gen Intern Med 2015 Aug;30(8):1063-1070
  4. Cognitive Impairment - Recognition, Diagnosis and Management in Primary Care. https://www2.gov.bc.ca/assets/gov/health/practitioner-pro/bc-guidelines/cogimp-full-guideline.pdf