OBJECTIVES: The “Virtual coach for a continuity of care” developed under the EU Project HOSMARTAI (H2020,GA:101016834) utilizes a modular system to enhance continuity of care, aiming to prevent cognitive decline and frailty in older adults by promoting healthy lifestyles and health monitoring. The study evaluated the economic and clinical performance of the new AI technology on cognitive performance, mood, and quality of life among older adults.

METHODS: A micro-costing analysis, based on costs of the Spanish healthcare system, was performed to identify the costs of development of the new AI technology and an array of the most important indicators to enable performance identification. The study was performed in clinical (with individual or group intervention) and dwelling settings, involving 132 patients and 15 caregivers (informal and formal). Usability was assessed using the System Usability Scale (SUS), User Experience Questionnaire (UEQ-S), and Post-Study System Usability Questionnaire (PSSUQ). Cognitive changes were monitored using the Mini-Mental State Examination (MMSE), and quality of life with EuroQol (EQ-5D-3L). The interface varied with a humanoid robot in the clinic setting and tablet in the dwellings with more user autonomy and longer intervention duration (1.5 and 2.5 months respectively).

RESULTS: The system was highly rated in the dwelling setting (SUS score: 79.66%) compared to the clinical settings (SUS scores: 36% and 45%). Results from PSSUQ were consistent but with the clinical settings scoring lower but still positive. Cognitive performance significantly improved in the dwelling group (p-value: 0.042). Changes in mood and quality of life were not significant. Cost-consequence analysis showed a cost reduction of €79.34 per patient in the dwelling setting, contrasting with a higher cost in the clinical setting by €592.54.

CONCLUSIONS: The virtual coach proved more effective and cost-efficient in the dwelling setting, underscoring the viability of home-based interventions.