Healthy Aging Through Internet Counselling in the Elderly

Diabetes mellitus, hypertension, obesity, hypercholesterolemia, smoking and physical inactivity are common in elderly persons and are all associated with an increased risk of myocardial infarction, stroke and dementia. Efficacious treatments of these cardiovascular diseases are available, but in elderly patients with multiple cardiovascular diseases and risk factors however, treatment is currently insufficient. Optimisation of management of these diseases in order to decrease the burden of cardiovascular disease and its long-term complications is urgently needed. In this project we will develop and evaluate an innovative intervention strategy to improve pharmacological and non-pharmacological treatment for cardiovascular disease in elderly patients. First, data from three large ongoing clinical trials on multi-component vascular interventions in the elderly will be used to explore efficacy and feasibility of various treatment regimens. Second, an innovative and interactive internet platform for self-management of vascular diseases in the elderly will be developed. Interactive support by practice nurses and patient’s own physician and monitoring of adverse events will be integrated. Third, the efficacy of access to this new internet platform will be evaluated in a randomised controlled trial in 2600 elderly with multiple cardiovascular diseases. Patients randomised to the control condition will receive regular care. Primary outcome is a composite score including three vascular risk factors: systolic blood pressure, LDL cholesterol and BMI. Secondary outcomes are new cardiovascular events, handicap, cognition and survival. This flexible internet-based intervention strategy can be easily translated and adapted for use in different health-care systems in the EU. It will allow for tailor-made interventions specifically suited to the needs of older people and meticulous monitoring of side effects. The expected decrease in new cardiovascular events and dementia will result in lowering of healthcare costs substantially.