The DORIAN GRAY project, an ambitious new initiative funded by the European Union (EU), aims to identify the connection between cardiovascular disease (CVD) and mild cognitive impairment (MCI) to improve healthy aging and survival.1 Spearheaded by the University of Brescia, Brescia, Italy and supported by 24 partners, including the European Society of Cardiology (ESC), the project uses cutting-edge artificial intelligence (AI) and avatar technology to explore the relationship between CVD and cognitive decline.
The connection between CVD and MCI
Around one-third of individuals with CVD also experience MCI; however, MCI remains undiagnosed in an estimated 50–80% of these cases. MCI is characterized by cognitive decline that is more pronounced than expected for a person’s age but not severe enough to interfere with daily activities. Furthermore, recent research suggests that CVD may not only share risk factors with MCI, but could also actively contribute to cognitive impairment through mechanisms like reduced blood flow to the brain, arterial stiffness and small brain infarcts.
The DORIAN GRAY project seeks to explore this connection further and identify the biological processes that link CVD to cognitive decline. Dr Riccardo Proietti, the scientific coordinator of the project, explained, “The goal of DORIAN GRAY is to develop a neurobiology-based hypothesis linking MCI to CVD, using biomarkers for clinical assessment to inform joint health policies for prevention, while also developing an innovative digital tool that can be used for cognitive enhancement.”
AI and avatar technology to drive innovation
A key feature of the DORIAN GRAY project is the integration of real-world data and AI to improve risk prediction and personalize treatment. The project will draw from data collected from over 300,000 individuals across six countries, utilizing smartphones, smartwatches and tablets to track health metrics. This data, combined with clinical variables, will enable researchers to predict the progression of MCI and to design personalized interventions for those at risk.
One of the most innovative aspects of the project is the development of avatar-based coaching exergaming (ABCE): this technology combines a cognitive enhancement tool with a lifestyle intervention. The avatar serves as a coach, guiding users through a holistic program designed to improve both physical and mental well-being. This system aims to empower individuals to take charge of their health, promoting lifestyle changes and cognitive improvement in an engaging way.
Practical applications and expected impact
The DORIAN GRAY project will include a pilot randomized controlled trial to test the effectiveness of the ABCE intervention in patients with heart failure and MCI. This study will evaluate the feasibility of the technology and its potential to slow the progression of cognitive decline. Additionally, the project will produce a Health Technology Assessment report to evaluate effectiveness.
The project is expected to have a significant impact on dementia prevention by addressing key risk factors like hypertension, diabetes and obesity. If the intervention leads to even a 5–10% reduction in dementia risk factors, it could prevent 1–2 million cases of dementia in EU countries by 2050.
A holistic approach to prevention
DORIAN GRAY is focused not only on understanding the science behind CVD and MCI, but also on developing practical solutions for the prevention of cognitive decline. The project aims to identify at-risk individuals early, promote healthy lifestyle changes and create digital tools to enhance cognitive function. By addressing both the physical and mental aspects of aging, DORIAN GRAY offers a comprehensive approach to promoting healthier, more resilient aging populations in Europe.
References
- European Society of Cardiology. EU Flagship project DORIAN GRAY to use pioneering AI and avatar technology to uncover links between cardiovascular disease and mild cognitive impairment to improve healthy ageing and survival. 2025. Available at: www.escardio.org/The-ESC/Press-Office/Press-releases/eu-flagship-project-dorian-gray-to-use-pioneering-ai-and-avatar-technology-to-un (accessed 28 March 2025)
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Editor: Victoria Jones, Senior Content Editor
Support: No funding was received in the publication of this short article.
Citation: DORIAN GRAY Project: Uniting AI and Avatar Technology to Address Cardiovascular Disease and Mild Cognitive Impairment. touchCARDIO. 24 April 2025.
Disclosures: This article was created by the touchCARDIO team utilizing AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat.) The content was developed and edited by human editors. No funding was received in the publication of this article.
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