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The Aristotle University of Thessaloniki (AUTH) is one of the largest Universities in South East Europe and the largest one in Greece covering all disciplines. It has been actively participating in the Erasmus Program since 1987, accounting approximately one fourth of the total Erasmus mobility in Greece in the frame of Student for Studies Mobilities as well as Staff for Teaching Mobilities.
Aristotle University is hosting the most prominent School of Medicine. We are home to world-leading educators, physicians, surgeons, and medical scientists. The School of Medicine was founded in 1942 and bears ever since as its oïŹcial emblem a bust of Hippocrates (commonly referred to as the âFather of Medicineâ). It is one of the four Schools of AUTHâs Faculty of Health Sciences and the largest School of AUTH. It accounts for more than 30.000 graduates, some of them with a great impact on science and humanity. It has recently been ranked top in an international evaluation among the countryâs seven University Medical Schools.
Dementia and frailty in Greece
In Greece, one-quarter of the population is over 60 years old, and more than 450,000 already suffer from dementia-related diseases. According to Alzheimer Europe, the incidence rate of dementia in Greece (in % of the population) was 1.99% in 2018 and will reach 3.95% in 2050. This is the second highest rate in the EU, just after Italy.
Frailty incidence rate varies depending on the scale used, but one can estimate this rate to be between 14 and 16% for the population aged 50+[1]. According to the SHARE study, the prevalence of frailty among individuals aged 65 years and older was found to be 14.7%, with an additional 44.9% identified as pre-frail[2].
A first Greek National Action Plan for Dementia was approved in March 2016 but it was only in 2023 that a bill was introduced to support an updated and more comprehensive plan. It aims to enable an effective treatment of dementia syndromes and improve the quality of life for people with dementia and their caregivers, support the prevention of dementia and the promotion of the populationâs health and focus on the implementation of cost-effective management measures for the dramatically increased number of people with dementia. The registration and classification of people with dementia in Greece and research on dementia are two important axes of this action plan.
From vision to reality: 15 years of continuous innovation in ageing care and holistic health through research, education and lifelong learning anchored in technology and community.
The Laboratory of Medical Physics and Digital Innovation (iMedPhys) is a dynamic and interactive scientific community. It is the largest laboratory of the Aristotle University of Thessaloniki in terms of number of researchers, research projects, funding, and overall academic output.
The mission of the Laboratory is to excel in education and interdisciplinary research, within an environment that fosters creativity and collaboration. iMedPhys leads research in cutting-edge areas such as assistive technologies for health and well-being, digital health, living labs, applied neuroscience, smart hospitals, medical education technology and innovation, medical imaging and emerging fields like brain-computer interfaces and medical and social robotics.
iMedPhys consists of several research teams, each being a leader in its respective field, pursuing innovative and interdisciplinary research. Its members are internationally recognized for research excellence and have received funding from a broad range of sources.
The Laboratory offers state-of-the-art working spaces and specialized research infrastructures, including:
- A Digital Living Lab Simulation Space
- A Hospital-Based Transitions Living Lab
- A Rehabilitation Laboratory equipped with a human centrifuge short-arm
- A Fully Equipped Neuroscience Lab featuring high-density EEG, neurofeedback, and an OPM-MEG unit (BioMEGa) for human brain dynamics, biomedical technology and digital health applications.
- An advanced Virtual Reality Lab
The Laboratory is also preparing to launch the first “Immersive Cube” in the regionâan innovative large-scale infrastructure that will transform a classroom into a 360° interactive environment with 3D projections surrounding students and instructors. This CAVE-type (Cave Automatic Virtual Environment) Immersive Cube offers a fully immersive virtual reality experience, enhancing medical education through realistic simulations of environments and procedures that are otherwise difficult or unsafe to explore in real life.
iMedPhys has significantly contributed, during the last 15 years, in a number of flagship, EU-wide projects and initiatives.
At the heart of the digital transformation of health and quality life of older adults  is the belief that older individuals are not merely recipients of care, but equal contributors and research partners to a patient-centered, digitally connected healthcare ecosystem . Through knowledge exchange and lifelong learning, we are witnessing a redefinition of ageing, one that celebrates autonomy, embraces digital skills, and strengthens cognitive and physical well-being.
A short history of iMedPhys
This vision took concrete shape for the first time in 2008 with the Long Lasting Memories (LLM) project, coordinated by iMedPhys. The LLM project marked a turning point: not only did it highlight the unmet needs of older adults, but it also introduced innovative, technology-driven tools to support cognitive and physical well-being (Bamidis et.al. (2015), Konstantinidis, E. I. et. al. (2014), Styliadis et.al., (2015)). For many older participants, this was their first encounter with technology, and it became the beginning of a shared journey towards empowerment and digital inclusion.
Building on LLMâs success, the LLM Care ecosystem emerged as a comprehensive, technology-based service platform that combines physical and cognitive training based on neuroplasticity principles. LLM Care became more than a product; it evolved into a social care innovation model. Through strong partnerships with municipalities, regional authorities, healthcare experts, and non-governmental organizations that support vulnerable groups, it has impacted the quality of life of thousands of older individuals across Greece, Cyprus and Europe. Today, it stands as a member of the European Innovation Partnership on Active and Healthy Ageing (with a three star reference site on EIP on AHA) and the European Network of Living Labs (ENoLL) showcasing whatâs possible when academic research rigor is driven by real-world challenges and meets community-based action.
iMedPhys was the coordinator of the CAPTAINÂ H2020 project, which envisioned a future where virtual assistants could support older adults navigate complex daily routines, offering gentle guidance based on real-time needs. Within CAPTAIN, AUTH iMedPhys established a strong community of older adults committed to drive research for independent living, through digital technologies. Â In that respect, older adults were involved from the outset of the project, ensuring that the final product reflected their real-life experiences and needs. Following the successful completion of the project, a spin-off start-up was established (CAPTAIN Coach) , with the aim to exploit research outcomes and bring real-world impact to the lives of older adults. CAPTAIN Coach was one of the the first 12 spin-offs at AUTH.
More recently, AUTH iMedphys participated in large-scale pilots of innovative technologies and its LLM Care system through the SHAPES (Smart and Healthy Ageing through People Engaging in Supportive Systems) project. With 36 partners across 14 countries, AUTH iMedPhys implemented a real-world pilot study, involving number of older adults across many social care structures etc. to understand how data-driven personalization and ethical digital design can improve care delivery and quality of life and support older individuals live independently.
Some other significant research initiatives that contributed to the collection of a wealth of data relevant to active and healthy aging included the USEFIL and UNCAP projects. Within the USEFIL and UNCAP projects a longitudinal BigData collection took place, through ecologically valid experimentation settings and protocols, as well as in-the-wild use of remote patient technologies. In total, 250 older adults have contributed with 500 records of self-reported data and involved 13 different stakeholders.
In parallel, iMedPhys has a long experience in empowering older adults through digital educational programs promoting the uptake of assistive technologies. Key past projects include the DISCOVER project, the AD-Autonomy, ERMAT and mHealth-AD Erasmus+ projects. Â A major objective of the aforementioned projects is the development of a wealth of digital educational resources equipping informal carers and healthcare professionals with digital skills and competences, which can be transferred to the real world and transform the lives of humans. Such skills and competencies are crucial to allow the adoption of digital health tools (assistive technologies, mobile health apps and portable devices such as wearables) in the support of older adults and the promotion of their independence in the community. In this context, a number of innovative training programs have been developed and piloted with older adults suffering from cognitive and physical impairments and their supports. AUTH iMedPhys has transformed this knowledge base into courses available to future healthcare professionals, that participate in Undergraduate and Post Graduate programs such as the ManagiDiTH Masterâs Program, as open MOOCs delivered through the Biomedical Research and Education Special Unit (BRESU) and seminars delivered through the Center for Education and Lifelong Learning of Aristotle University of Thessaloniki.
Pilot 6 Study starts a journey to Support Frail Older Adults with Brain Training, Exercise, and Nutrition via Digital Tools
Pilot 6 is part of a larger journey that started years ago at the Lab of Medical Physics and Digital Innovation (iMedPhys), where researchers have been using technology to help older people stay healthy and independent. This new study explores how a mix of cognitive games, physical exercises, and nutritional recommendations, delivered through a friendly app, a cognitive training platform, and supported by wearable devices like smartwatches, can improve cognition and physical strength in older adults who are becoming frail. These tools and interventions were designed based on years of experience from earlier projects and have been tested and improved together with older adults. The study will run for 18 months, assessing the efficacy of a remote multimodal intervention and identifying key risk factors for cognitive decline and frailty with ultimate scope to make a real difference in peopleâs daily lives.
What Are the Goals of the Study?
The main objectives are to:
- Evaluate the efficacy of the remote multimodal intervention in reducing cognitive decline among pre-frail and frail older adults
- Identify Risk Factors: Investigate early risk factors contributing to both frailty and cognitive decline.
Whatâs the Study About?
The study is exploring whether a six-month remote intervention that includes cognitive training, physical exercise, and nutrition guidanceâdelivered through a cognitive training platform, an app, and wearable devicesâcan improve the health of pre-frail older adults. Researchers will assess participants at four time points: the beginning (baseline), after six months, and then again at 12 and 18 months to track both short- and long-term outcomes.
Whoâs Involved?
 Pilot 6 will include 150 participants aged ℠55 years, divided into groups of 50 individuals each. Eligible participants will be those who are pre-frail older adults and do not have dementia or severe cognitive decline and severe physical impairment.
Participantsâ recruitment will be actualised within the network of the Thessaloniki Action for Health & Wellbeing Living Lab – Thessahall, under the auspices of the Lab of Medical Physics and Digital Innovation, Aristotle University of Thessaloniki (AUTH), as well as the Ippokrateio General Hospital of Thessaloniki in the 3rd Cardiology Department.Â
The measurements occur at the Medical Physics & Digital Innovation Laboratory, Aristotle University of Thessaloniki (AUTH), and the Ippokrateio General Hospital of Thessaloniki.Â
Participants will follow a standardized protocol, collecting demographical, medical, neuropsychological, motor, nutritional, and quality of life data. Obtaining these data will allow us to have a concrete profile of the participants’ cognitive and physical profile and the changes that will happen over time.
The study design consists of the following groups:
- Intervention Group: Receives a remote multimodal intervention with interactive cognitive training (using the fully validated tool BrainHQ), physical training , and nutrition guidance and educational training and all supported by wearable technology (Fitbit and smart scales).
- Active Control Group: Uses a simpler version of the app with general health tips, basic exercises, and leisure games like Sudoku, but without targeted the main elements of the intervention.
- Passive Control Group: Continues with their usual lifestyle and medical care, without any added intervention.
Healthy older adults (with no signs of frailty) are also participating as a comparison group and will be assessed throughout the study.
How Does It Work?
Participants in the intervention group receive tablets and smartphones (if needed), along with full training to use the tools. They’re encouraged to complete cognitive training three times a week, use a mobile app for daily physical activity and nutrition guidance, and track their progress with a smartwatch and smart scale.
The app includes features like physical training activities, nutritional training and guidance, and educational content on general health topics on frailty and prevention, physical activity and on nutrition, mindful eating strategies, and a badge system to motivate users and enhance engagement.
Pilot 6 will leverage different opt-in tools to support data collection. The mHealth mobile application provides physical and nutritional training and the educational content and monitoring their progress. The BrainHQ, which provides interactive games for cognitive training, allows personalization to the needs of each person. Finally, the Training and Education Toolkit (TET) provides the opportunity to participants to have a more in-depth educational training in frailty, self-management, and digital tools. Â
Plans to leverage COMFORTage platform
Pilot 6 will leverage the COMFORTage platform to support a more precise, personalized approach to the early detection and management of cognitive decline. By contributing rich, multidimensional datasets, including cognitive, physical, nutritional, and lifestyle indicators. The pilot will enhance the COMFORTage platform’s algorithms and contribute valuable inputs to the development of AI-driven models. These data will be integrated into the platformâs predictive analytics to support early identification of individuals at high risk for dementia, enabling timely and targeted interventions. A central innovation is the use of Digital Twins, which will facilitate predictive simulations and allow clinicians to forecast disease trajectories and tailor care pathways accordingly.
References*
Bamidis, P. D., Fissler, P., Papageorgiou, S. G., Zilidou, V., Konstantinidis, E. I., Billis, A. S., … & Kolassa, I. T. (2015). Gains in cognition through combined cognitive and physical training: the role of training dosage and severity of neurocognitive disorder. Frontiers in aging neuroscience, 7, 152.
Konstantinidis, E. I., Billis, A. S., Mouzakidis, C. A., Zilidou, V. I., Antoniou, P. E., & Bamidis, P. D. (2014). Design, implementation, and wide pilot deployment of FitForAll: an easy to use exergaming platform improving physical fitness and life quality of senior citizens. IEEE journal of biomedical and health informatics, 20(1), 189-200.
Styliadis, C., Kartsidis, P., Paraskevopoulos, E., Ioannides, A. A., & Bamidis, P. D. (2015). Neuroplastic effects of combined computerized physical and cognitive training in elderly individuals at risk for dementia: an eLORETA controlled study on resting states. Neural plasticity, 2015(1), 172192.
