Background: The main objective of the I-COUNT pilot study (Spoke 8, WP3) is to assess the feasibility of a 6-month multidomain intervention performed on older adults in Long Term Care Facilities (LTCFs).

Methods: The intervention involves two LTCFs and includes physical exercise and cognitive training, a nutritional program based on the Mediterranean diet enriched with selected functional foods, and the administration of the vaccinations in accordance with the national vaccination plan. The study protocol includes baseline evaluations, a 6- months multidomain intervention, and follow-up assessments at 3, 6 and 9 months.

Results: We present findings from the baseline evaluations. In February 2025, 90 participants (mean age 88 years, 71% female) were enrolled and randomized into intervention (n=48) and control (n=42) groups. The majority (79%) were classified as pre-frail, according to the Multidimensional Prognostic Index, and exhibited a moderate comorbidity burden (CIRS score 4.2±2.1). Cognitive assessments revealed generally preserved cognitive function, while symptoms of depression and poor sleep quality were frequently observed, as measured by the Geriatric Depression Scale and the Pittsburgh Sleep Quality Index, respectively. Quality of life scores indicated moderate levels of physical and psychological well-being. The interventions started in March, with high adherence rates: over 80% of participants are actively engaged in both cognitive and physical training. Functional foods, particularly artichokes, were well accepted.

Conclusions: The I-COUNT study will provide crucial insights about feasibility and acceptability of multidomain interventions, informing design of future large-scale trials aimed at improving health, well-being, and quality of life in older populations.

Background: REmote stimulation for COgnitive Decline (RECODE) program is a novel computer-based platform designed to deliver cognitive stimulation (CS) to older adults with cognitive decline. Its efficacy and feasibility have been assessed in a pilot study. RECODE is currently being implemented as part of the “Multidomain Interventions to improve the COgnitive and fUNctional well-being of elderly individuals in residential sTructures” (I-COUNT) pilot study (Spoke 8, Workpackage 3), an ongoing six-month multidomain intervention in long-term care facilities.

Methods: A non-randomized pilot study evaluated RECODE; 12 older adults with Mild Cognitive Impairment or mild-to-moderate dementia completed a two-month CS by using RECODE. Their outcomes were compared to those of a matched control group (n=12) who received standard in-person CS. In the I-COUNT pilot study, CS is delivered twice a week and the program includes RECODE-based individual sessions and group-based cognitive activities.

Results: The pilot study assessing RECODE's efficacy found that the RECODE group showed significant improvements in both the Mini-Mental State Examination (MMSE Δ=3.26) and the Brief Neuropsychological Examination-2 global scores (ENB-2 Δ=4.83), with high engagement and usability.

The I-COUNT study enrolled 90 participants (intervention group 48), of whom 58% have normal cognitive functioning (MMSE≥24). After 10 weeks, 83% of the intervention group consistently attended CS sessions. Participants expressed satisfaction with both RECODE and the group sessions that foster social interaction.

Conclusions: RECODE appears to be a promising tool for computerized CS in older adults with cognitive decline. Data from the I-COUNT study will further clarify its feasibility and inform future large-scale interventions.

Short abstract

Bridging the gap between evidence generation and clinical practice requires developing effective interventions and assessing their implementability—i.e., the extent to which evidence-based interventions (EBIs) are likely to be adopted, integrated, and sustained in routine care. Within the Age-It project, three randomized controlled trials (RCTs) were developed under Spoke 8 (WP1–3), each targeting a distinct setting: IN TeMPO (community-dwelling), OPTIMAge-IT (hospitalized), and I COUNT (residential care). Each RCT involves participants aged ≥60 recruited across multiple centers nationwide. This study, conducted within Spoke 8, WP6, assessed the implementability of the three RCT protocols by applying the WHO's guidance on implementation research and Implementation Outcomes framework (Proctor et al., 2011), covering eight domains: acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability. A structured thematic analysis was conducted using an ad hoc coding matrix. Data extraction and analysis were performed with NVivo software, following a mixed-methods approach. Each domain was scored on a 3-point scale (0 = not addressed; 1 = partially addressed; 2 = fully addressed) for a maximum of 16 points. OPTIMAge-IT reported the highest score (13/16; mean = 1.62), with full integration of feasibility, fidelity, adoption, implementation cost, and sustainability. IN TeMPO and I COUNT each scored 11/16 (mean = 1.38), with IN TeMPO showing strengths in appropriateness and acceptability and I COUNT demonstrating innovation in outcome measurement and feasibility. This analysis confirms that implementation planning can be effectively embedded in RCT design, supporting Age-It's goal of developing sustainable EBIs for national implementation.

Background: Hospital-acquired disability (HAD) refers to the new onset of dependence in at least one basic activity of daily living that occurs during hospitalization. HAD affects approximately one in three hospitalized older adults and is associated with higher risks of institutionalization and mortality. Despite its relevance, prevention strategies are still lacking. The OPTIMAge-IT trial (NCT06611228) aims to evaluate the effectiveness and feasibility of a digitally supported, multidomain intervention to prevent HAD in frail older adults.

Methods: OPTIMAge-IT is a multicenter, cluster-randomized controlled trial enrolling patients aged ≥70 years, hospitalized for acute medical conditions, with mild-to-moderate frailty across eight Acute Geriatric Units in Italy. Patients are randomized to receive either usual care or a multidomain intervention starting during hospitalization and continuing for 12 weeks post-discharge via digital tools. The intervention includes physical exercise, cognitive stimulation, nutritional counseling, medication review, health education, and social activities, supported digitally by smartwatches and tablets. The primary outcome is functional status at discharge, measured by the Short Physical Performance Battery (SPPB).

Results: A total of 88 patients have been enrolled to date (mean age: 82.2 ± 5.2 years; 42% female). Recruitment is ongoing and expected to be completed within the next month. We anticipate that the intervention will result in significant improvements in functional outcomes at discharge. Full results will be presented at the congress.

Conclusions: The OPTIMAge-IT study will generate robust evidence on effective strategies to prevent HAD in older adults, paving the way for scalable, proactive care models tailored to the aging population.

BACKGROUND
Over the past few decades, global life expectancy has significantly increased, rising from around 60 years in 1980 to 73.5 years today. This figure is even higher in developed countries, where living conditions are generally better (e.g., Italy around 84 years; France, Spain, and Sweden around 83.5 years). However, one of the biggest challenges associated with this demographic shift is how subjects experience their last years of life. According to Passi d’Argento Survey data, over 50% of people aged 65+ developed at least one chronic condition. Researchers worldwide have tested various preventive interventions and programs aimed at promoting healthy aging, focusing on improving physical and cognitive functioning, as well as enhancing quality of life and overall well-being. These strategies targeted both the general older population and specific subgroups, including those with physical or cognitive impairments, sedentary lifestyles, overweight/obesity, or pre-existing chronic conditions. To date, several systematic reviews have been conducted on this topic, often focusing on the general population, specific types of interventions, or health outcomes. However, no systematic review has stratified findings by risk of (un)healthy aging across different population subgroups, considering the possibility to provide tailored intervention in the framework of personalized prevention. Therefore, the aim of this systematic review was to summarize preventive strategies and interventions implemented in population subgroups with different levels of (un)healthy aging risk.

METHODS
The systematic review was conducted in accordance with PRISMA guidelines and was registered on PROSPERO (CRD420251025399). The literature search was carried out on PubMed. The Inclusion criteria were: participants aged 65+ years old; primary studies (observational or experimental), conducted between 2010 and 2025; no preliminary, feasibility, or pilot studies; concerned population subgroups with stratified risk of (un)healthy aging; focus on a healthy aging outcome; and implementation of a middle or long-term preventive intervention. The risk of bias was assessed using ROB-2 or ROBINS-I-V2, depending on the study design. Results were summarized by stratifying according to the subgroups of participants analyzed.

RESULTS
Out of 2,613 studies, 177 were included after full-text screening. The results were stratified considering 11 different subgroups: subjects with cognitive impairment, mental disorders, previous comorbidities, frailty (or pre-frailty), physical impairments, hearing loss, abnormal weight, a high or low physical activity level, nutritional issues, low socioeconomic position, and no-smoking habits. The same study could contribute to more than one subgroup. Due to space limitations, only the most relevant subgroups will be presented.

Forty-four studies focused on subjects with physical impairments. Most interventions involved physical activity (e.g., training programs focused on flexibility, resistance, aerobic, and balance exercises, activities like walking or doing team sports), nutrition (e.g., amino acid, protein, or vitamins supplementation), physiotherapy (specific tailored physiotherapy treatments), or were of a medical nature (specific care programs). The outcomes analyzed mainly concerned physical performance (such as strength, balance, mobility, and speed), quality of life, falls, and physiological (specific comorbidities or related risk-factors such as blood pressure) or biological (particularly inflammatory and (cardio)metabolic biomarkers) parameters. The results showed that nutritional, physical activity–based, and medical interventions were particularly effective in improving performance, enhancing quality of life, and reducing the number of falls. Thirty-four studies examined the subgroup of individuals characterized by a specific level of physical activity (almost all sedentary or low-active). The interventions involved physical activity or were multicomponent, including physical activity and nutrition or cognitive strategies (such as specific cognitive tasks, involving memory training and finger dexterity). The most frequently assessed outcomes were related to physical performance, body composition (e.g., lean mass, fat mass, waist circumference), and biological/physiological outcomes. Most interventions showed significant benefits in terms of physical performance, body composition, and overall health. Finally, nineteen studies focused on subjects with cognitive impairments. The interventions were mainly cognitive (such as singing-based therapy, or cognitive activities involving memory, language and attention), and nutritional in nature, or multicomponent, combining physical, nutritional, and/or cognitive strategies. The most frequently investigated outcomes concerned physical performance (e.g., strength, mobility, flexibility, and balance), cognitive functioning, and mental health. The findings showed that interventions targeting cognitive domains, nutrition, and physical activity were particularly effective in improving performance or mental health and promoting healthy aging in this subgroup of subjects.

MAIN IMPLICATIONS

This research is particularly relevant for prevention. In fact, it allows to identify tailored interventions that could be provided to general population on the basis on the individual risk of (un)healthy ageing.