COMFORTage’s third Community Forum webinar was held on 26 September 2025, supported by EHTEL.

Today, COMFORTage has reached a point where its members believe that technology can impact and change policies. It looks at conditions like dementia and frailty as a societal priority. During the webinar, speakers, panellists, and attendees examined various policy choices and innovative public initiatives that can support either people living with dementia or frailty and/or their care-givers.

Take-aways:

Throughout the workshop, the chief learnings – which emerged from the main observations made on policies – were as follows.

• Policy: From policies to pilots to practice. There is a fundamental challenge implicit in moving from well-written policies (or ‘strategies’), to promising pilots, and – ultimately  – to scalable, sustainable, and equitable real-world practice. Today, many potential ways of facing dementia and frailty are still not known well enough.

National strategies: Country-based policies (‘strategies’) exist almost everywhere in Europe, but they are often not matched by either sustainable funding or consistent implementation.

Regional inequalities: Differences in application occur either at national levels or at regional levels. Inequalities undermine equity of care whether e.g., this takes place, in France, between urban and rural environments; in Italy, between the north and the south of the country; or, in Spain, among local pilot initiatives.

• Financing: A lack of appropriate business models and sustainability: Financing hinges on ‘smart governance’. Examples of useful methods for sustaining outcomes include registries, results-based reimbursement, and the integration of health and social care. All need suitable financing.
• Diagnosis and screening: The early diagnosis of dementia/frailty is essential. In most countries, however, appropriate diagnosis is delayed and systematic screening strategies are underdeveloped.
• Technology and Artificial intelligence (AI): Technologies, including AI, can offer major potential for improvement in diagnosis and treatment, such as through more screening, personalised therapy, and caregiver support.

Technology adoption: The adoption of technologies, however, is slowed down by a lack of reimbursement frameworks, the obsolescence of digital tools and slow policy cycles, clinician mistrust of technologies and failure to integrate technologies into clinical pathways.

• The ‘caregiver burden’: Caregiving responsibilities remain considerable. Policies on dementia and frailty should strengthen support not simply for people who are living with dementia or frailty but for the families, friends, care-givers, and communities.
• Design and creativity: Good design can help to complement medical and digital innovations by reducing stigma, fostering people’s empowerment, and enabling community-based care.

Overview

This COMFORTage workshop, co-organised by EHTEL, was one of several online community forum meetings that form part of the agenda of the COMFORTage community forum (CCF). This was the third in a series of webinars called Thematic Action 1 (TA1) on Dementia and Frailty Service Delivery Models for affected patients and their care-givers. Three webinars have now been held in 2025. In 2026, a further three will be held.

EHTEL digital health and workshop facilitator, Luc Nicolas (EHTEL), offered a wide-angle introduction to the webinar with its focus on neuro-generative conditions.

General background

The speakers came from three different European country contexts (Italy, Slovenia, and the United Kingdom).

The speakers outlined a range of policy challenges and policy choices facing individual countries and regions. The challenges (which are further explored in the learnings – below) which they highlighted included:

• Overall policies and their national or regional implementation.
• Financing, business models, and sustainability.
• The role of technologies and the policies related to them – especially artificial intelligence (AI).
• Approaches to caregiving.
• The roles to be played by design and co-design.

Speakers

Three speakers introduced the different approaches taken towards dementia and frailty in their own countries or regions, including descriptions of national plans or strategies.

💠 Mercedes Lovrocic – JADE Health Joint Action & National Institute of Public Health, Slovenia. “Overview of evolution of EU policies, and insights into the Slovenia case report.

In making her presentation of the Slovenian dementia management strategy, active since 2023, Mercedes Lovrocic placed the country’s work in the international context of Alzheimer’s Disease International (ADI) and the European JADE Health Action Plan. Slovenia has made substantial recent progress on dementia, although gaps in approach remain to be filled. In the future, digital technologies, including artificial intelligence (AI) may prove helpful, as too will a focus on prevention.

Mercedes introduced a Slovenian dementia management strategy, launched in 2023 and which will now run until 2030. It has been built on an earlier approach which ended in 2020. Overall, she commented that:

• A strategy is only the beginning.
• Strategies need to be implemented.
• Evaluation is needed.

Queried about dementia and frailty, in addition to being perceived as a health challenge, but – rather – as a social challenge and an economic challenge, Mercedes emphasised the importance of three levels of prevention.

• Primary prevention: Prevention of the onset of dementia.
• Secondary prevention: Early detection.
• Tertiary prevention: Improving people’s quality of life.

💠Camillo Marra – Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy. “A paradigm shift in the early diagnosis and therapy of dementia. The Italian approach to the new scenario”

Camillo Marra observed that the approaches adopted in countries such as France, Germany, the UK and the United States of America have been very different. Italy has become aware both of the growth in dementia in the country and its socio-economic impact there. The country has a national dementia plan. The country now places an emphasis on a new therapeutics revolution, and has also generated a network for Centres for Cognitive Disorders and Dementia. Several challenges remain to Italy’s approach: they range across interoperability, prescribing, reimbursement, support and training, and future data-gathering.

There continue to be discrepancies, however, between the approach to the conditions in the north and the south of the country. Indeed, “inequities between the Italian regions are likely to increase,” Camillo posited.

Among the country’s technical and societal challenges, Camillo observed the needs for the following:

• An interoperability registry.
• Accredited prescribing centres.
• Accompanying reimbursement models.
• Appropriate support and training for care-givers in their role as an essential pillar of the care system.

💠Kristina Niedderer – Manchester Metropolitan University, Manchester, UK. “Design approaches to empower people living with mild to moderate stages of dementia in the UK”

Researcher, Kristina Niedderer acknowledged that many policies are moving in the direction of prevention, yet she explored in more detail what prevention actually means. Starting from an overview of how the UK is approaching interacting with people with dementia and the volunteers who work with them, Kristina introduced the results of research and studies undertaken at the Manchester Metropolitan University. The approach towards use of digital technologies that she introduced was very much oriented towards co-design approaches.

Kristina described the work of her University’s DoWell (Design for Health and Wellbeing) research group and the various projects in which it has been or is still involved e.g., on the use of digital technologies for volunteers who work with people with dementia. Her emphasis was on activities that can build a sense of agency.

Kristina’s approach involves the importance, for people, of being involved in design, co-design, person-centred and de-stigmatising approaches, and mindful story-telling. She highlighted work that emerged on a board game called ‘This is me’, which was trialled using a focus group methodology with 50 people with mild or moderate dementia and 19 carers across four countries. The approach emerged from a European project, called MiND. Other interesting work was conducted in the ‘I do service’ project.

Kristina summarised her, and her team’s, approach to design with the following two insights:

• Careful consideration is needed to a balance between the roles to be played by digital technologies and AI and the focus on accessibility.
• There is a need to introduce careful design approaches to policy-makers.

Panellists

The three panellists each offered their views on the subject of policy choices, and some posed questions to the three speakers. They reflected on the gaps between policies/strategies and actual implementation; the need for appropriate business models and reimbursement mechanisms; and the limitations of pilots that do not materialise in deployment or in scaling-up.

Chirine Katrib (WPC 2026 Science Ambassador, France) works on Parkinson’s disease, a long-term neurodegenerative disorder. She commented that dementia is not only a biomedical challenge, but also a societal challenge and a community challenge. She had two concerns: How does any work on dementia actually reach patients and carers? How do studies and research scale up and not simply stay as pilot projects? In response, Kristina Niedderer made two additional comments. Policy changes are needed in relation to the relationships built with people who experience dementia and their families, as well as more personalisation. A range of simple solutions are needed to help e.g., entrepreneurs to set up companies that can work on actual implementation/scaling up of approaches to dementia. Among Kristina’s list of implementation solutions were: licensing; spinoffs; service development; and a greater focus on volunteering.

Sofoklis Kyriazakos (Healthentia, Belgium), a device produced by Belgian medtech manufacturer, Innovation Sprint, placed his focus on improving business models. Having useful technologies available can help people adhere to the relevant treatments for their conditions. Some countries – Sofoklis named Belgium and Germany – have fast-tracked approaches to the use of technologies. He observed, in financial terms, that if payers are unwilling to pay it will continue to be difficult to bring on board technological solutions.

Juan Guanyabens (TicSalut Social, Catalunya, Spain), a Catalunyan public body facilitating digital transformation in health and care, reinforced the message that the big problem is with the adoption of solutions. For Juan, the challenges lie around making decisions about: Who will pay for digital solutions? How will they pay for these digital solutions? Any solutions need to be integrated with careways, pathways, and protocols. He reflected that Spain, as a country, has not yet reached a specific successful remedy. On Catalunya, while some attractive local solutions have been developed/applied in the autonomous region, there is not yet a universal solution. Luc Nicolas, workshop facilitator, enquired how Catalunya would handle the further development of a solution if the region did have/evolve one, and how the region is preparing. Juan responded that it is validation that is important. Catalunyan health professionals would be ready to prescribe digital solutions; however, the solutions themselves still need to be validated. Hence, Catalunya is working on refining the whole process of development/prescription before solutions are extended to the region’s citizens. Overall, he summarised, “We have a problem with the business model.”

Conclusions and next steps

To conclude, several policy messages may help influence the directions that European countries/nations, and their regions, take on conditions like dementia and frailty. They include:

• Making modifications in perceptions and approaches to conditions like dementia and frailty, by policy-makers’ taking on board approaches like the 14 modifiable risks.
• Using digital technologies, including artificial intelligence (AI).
• Using appropriate design and co-design in both technology design and in the design of other policies.
• Building on large-scale project and pilot initiatives, like COMFORTage, which are vitally important in positioning the usefulness of digital technologies in fields of care like dementia and frailty.
• Formulating and applying appropriate recommendations, so as to handle the widespread effects that dementia and frailty are currently having on communities and societies.

When these recommendations are written up in working papers and briefing papers, European projects and initiatives, like COMFORTage, will start to lead the way in fields related to dementia and frailty in:

• Identifying appropriate recommendations.
• Outlining how to implement these recommendations.
• Suggesting how to apply these recommendations quickly.

Learn more about the COMFORTage Community Forum.