CC.AGE
The Trond Mohn Research Foundation and the University of Bergen generously provided financial support to SEFAS to establish the Centre for Complex Conditions and Ageing (CC.AGE). Here, we investigate the use of novel technology and high-quality care to improve the lives of older persons with complex conditions living at home.

Main content
Providing care and support for the steadily growing population of older adults with chronic complex conditions (CCC) is one of the key challenges of our society. Most older adults do not want to be institutionalized – research has consistently shown that they wish to live independently at home for as long as possible. At the same time, in the coming years, the healthcare system will register a lack of professional health care workers to match future demands, which calls for a paradigm change.
The primary aim of CC.AGE is to improve the living situation for older adults with chronic complex conditions to live safely and independently at home with a good quality of life. At the same time, CC.AGE aims to support their relatives and municipal healthcare professionals. To achieve this, we aim to:
- design, implement, and test the efficacy of a research-based digital plug-and-play platform with a range of technologies integrated into a mobile tool for use at home.
- identify traditional care areas which can be safely replaced by digital support.
- determine specifications for integrating existing technologies and for developing new products that will be able to sustain ‘plug-and-play’ integration.
- perform cost-benefit analyses.
- contribute to the design and testing of a social living environment.
Transdisciplinary team
The Centre for Complex Conditions and Ageing (CC.AGE) employs major transdisciplinary collaboration between medicine, nutrition, systems science, artificial intelligence, software engineering, economy, and ethics that builds on existing evidence, user-involvement, and methodological expertise. Our industry partner, Youwell, is a developer of e-health platforms, while our public sector partner is the Bergen Municipality. Our local scientific partners are the Center for Nutrition (UiB) and the Bergen Center for Ethics and Priority Setting in health (BCEPS, UiB).
Our collaborators include colleagues from Tohoku University (Japan), Yale University (USA), Harvard McLean Hospital (USA), Massachusetts Institute of Technology (MIT, USA), and Leiden University (The Netherlands). Our national collaborators include the EITRI medical incubator and the Alrek Health Cluster.
Work package organization
The approach of CC.AGE is highly multidisciplinary, encompassing various work packages (WPs). The central activity will be a 12-month randomized controlled trial (RCT) to explore the effect and cost-effectiveness of a multicomponent intervention in home-dwelling people with complex conditions. WPs 1, 3, and 4 inform the development in WPs 5 and 6. WP2 for ethics informs all aspects of our work. The management falls under WP7.

WP1: e-Delphi
The e-Delphi process is a combined effort informed by all other work packages, with the entire team contributing under the coordination of postdoc Zoya Sabir. e-Delphi is intended to address several questions related to the overarching theme of technology use in elderly care and will be conducted via electronic survey (the Delphi Method Software (https://www.edelphi.org/), consisting of 2–3 rounds. We intend to gather experts within technology, innovation, AI and social living environments. The panel of experts will be recruited from various environments, including Bergen Municipality and the NET4Age-Friendly, a COST Action (CA19136) aimed at establishing an international and interdisciplinary researcher network to promote the creation and implementation of age-friendly environments. Additionally, experts will be recruited from several of our collaborating universities, including Harvard (USA), Yale (USA), Tohoku (Japan) and Leiden (The Netherlands).
WP2: Ethics
This WP deals with ethical decision-making and consists of practical and theoretical tasks, through which we will ensure ethical assessment throughout all WPs and identify new challenges along the way. Led by Professor Bettina S. Husebø and in collaboration with the Bergen Center for Ethics and Priorities (BCEPS), we employed Justin Haugeland-Pruitt in October 2024 as a PhD candidate for this WP with the PhD project “Ethical assessment of technology and artificial intelligence for the care of older adults”. He will work on exploring and evaluating ethical and regulatory challenges related to all other work packages as the project evolves in both practical and theoretical proceedings. Ethical considerations work has begun in the form of a contribution to a book on “Neuropsychology in the Age of Digital Health: Explorations, Applications, and Practical Implementations” edited by Sara Weisenbach and Shifali Singh, Harvard McLean Hospital. We are collaborating on “Chapter 12: Ethical Challenges.”
WP3: Nutrition
Clinical nutritionist and postdoc Zoya Sabir started in May 2024 and will in collaboration with Professor Jutta Dierkes (Center for Nutrition), investigate food supply for home-dwelling older adults and how this affects nutritional status, activities, quality of life, and general health. This will involve a comprehensive mapping of food and meal services with an emphasis on cost, availability, and user-friendliness for the project’s target group. They will emphasize assessment of hydration status, which is often critically important and not easy to measure. In this regard, they will test sensor technologies and assess whether these can be useful in protecting older adults against dehydration. In addition, a PhD candidate with a background in nutrition will be hired to work with both quantitative and qualitative dietary data. A pilot study among healthy adults is currently in progress to assess the performance of a newly developed hydration sensor. The findings of the pilot study will be used to guide the choice of methods for hydration assessment in older adults with CCC.
WP4: Proof of concept (pilot studies)
This WP is led by Line Iden Berge and will develop digital psychological and social interventions for older adults living at home and will determine the feasibility of selected devices. The WP covers: general functionality and health status; physical, mental, social activities; mental health / psychological intervention; sleep; and bottom-up development of “Pårørendebanken” (see separate chapter). PhD candidate Lisa Aaslestad started in September 2024 in this WP with her PhD project “Relationships between psychosocial activities, physical activities and sleep in healthy older adults. Alongside her main supervisor, Assoc. Professor Line Iden Berge and her co-supervisors, she will focus on assessing the feasibility of digital psychological and physical interventions to enhance sleep quantity and quality. She will perform a feasibility study of digital sensors to supplement self-reported data for quantifying the activity levels and sleep metrics in older adults.
WP5: ALIVE platform
This WP is being led by postdoc and systems engineer Monica Patrascu. In collaboration with Youwell, we will design a modular, digital plug-and-play mobile platform (ALIVE), with five components: core application, sensing devices, intervention modules, human-machine interface, and user application. CC.AGE will implement knowledge-based AI (e.g., fuzzy, Bayesian), which utilizes the outcomes of evidence-based healthcare structured into inference engines comprised of rules. Restriction mechanisms will be put in place to ensure adherence to ethical, moral, and legal perspectives. The ALIVE platform will interact with the physical world through sensors and actuators. The design, testing, validation, and evaluation of all automation in the project will be performed using established methods from control engineering and systems theory, with special attention to stability, robustness and reliability. Sensors (Garmin Venu 3S, Somnofy installation) will provide information on the status of the user and one fully closed cascaded feedback control system will be implemented, which involves interaction with the user through a smartwatch, mobile phone, or tablet. Interventions will be delivered based on individualized assessment of the complex chronic conditions and preferences of the user. A postdoc and a PhD candidate with background in software engineering have been hired and will begin work in early 2025.

WP6: A mixed method randomized controlled trial (RCT)
All activities are directed toward the establishment of the RCT, estimated to begin in 2026. Led by Bettina S. Husebø, this will be a 12-month RCT to explore the effect and cost-effectiveness of a multicomponent intervention in home-dwelling people with complex conditions.
WP7: Project management and coordination
This consists of the employment processes and the regular management of the project, and dissemination efforts with scientific presentations, public engagement, and popular science dissemination. The project management and coordination are led by Bettina S. Husebø.
Societal impact
The centre will increase access to research-based mental and physical value-based healthcare with positive impact on safety, quality of life, caregiver burden, ethics, cost-benefit, e-health, and society. This might lead to game-changing support to older adults with complex diseases, enabling them to live safely and independently at home with a good quality of life, at the same time benefitting their relatives and municipal health professionals.
Highlights so far
The centre began its work on February 1st 2024, and held its opening ceremony in the University Aula on October 1st, 2024. The project’s vast reach and multidisciplinarity were showcased through several insightful contributions from our national and international colleagues and collaborators. The highlights of the programme included an excellent collaborative talk by Dr. Ipsit Vahia and Catharyn Gildesgame from Harvard University titled “Medical Center’s Partnership to Support Older Adults’ Needs”, followed by an energizing and inspiring talk centred around “Successes in Aging” by Professor Heather Allore from Yale School of Medicine. Additionally, our CC.AGE collaborators took the stage to provide insights on the specific work packages encompassed by the project. Overall, it was a successful inauguration that demonstrated the importance of personal engagement and collaboration across disciplines.
Additional and prospective funding: To expand our list of living environments and to have a good testing ground for the ALIVE platform, we have collaborated with about 35 industry and public sector partners, including the CG Rieber Eiendom and the Municipalities of Bergen, Sauda and Tysvær, which resulted in an application for a Center for Research Driven Innovation funded by the Research Council of Norway, currently selected to submit a proposal for round 2.
Our collaboration with Vitalthings (NO), Mentech (NL), and Sara Robotics (NL) resulted in funding for the project Emotion-Intelligent Robot System for people with impaired cognition (EI ROBOT) from the European Union program Eureka Eurostars.