AI Solutions for Aging in Place: Systematic Review Identifies Six Key Domains of Unmet Needs

Can AI Empower a New Era for Aging in Place?

Artificial intelligence and large language models may offer novel solutions to address the unmet needs of older adults aging in place, according to a recent systematic review published in Innovation in Aging. The comprehensive analysis identified six key domains of unmet needs, highlighting opportunities for technological interventions that could significantly improve quality of life for community-dwelling seniors.

The global demographic shift toward an aging population presents significant challenges for healthcare systems worldwide. With the number of adults aged 60 years and above projected to reach 2.1 billion by 2050, understanding and addressing the unmet needs of older adults who wish to age in place—remaining in their homes rather than moving to institutional settings—has become increasingly important. This preference for independent living is well-documented, providing greater autonomy for seniors while reducing healthcare costs compared to long-term care facilities. The systematic review aimed to identify the comprehensive range of unmet needs experienced by this population, moving beyond the narrower focus of previous studies that typically examined specific sub-populations or pre-defined need categories.

How Was the Systematic Review Conducted?

The research team conducted a thorough analysis of literature published since 2013, querying three major databases—PubMed, CINAHL, and ProQuest. Following a rigorous screening process that included deduplication and consensus-based decision-making, 64 articles met the inclusion criteria: 40 containing original needs assessments and 24 based on prior research. The analysis revealed unmet needs clustering around six major domains: health management, social needs, homecare and practical needs, information needs, technology needs, and healthcare system needs. These domains were further divided into subthemes, providing a nuanced understanding of the challenges faced by older adults living independently.

What Unmet Needs Challenge Community-Dwelling Seniors?

Health management needs encompassed physical health concerns (mobility support, oral health, eyesight and hearing assistance), cognitive and mental health support (memory problems, psychological counseling), and chronic condition management (symptom burden, pain control). Social needs revealed significant issues with isolation and loneliness, with many older adults reporting dissatisfaction with their social networks and limited opportunities for meaningful interaction. Particularly concerning was the finding that many seniors lacked confidants with whom they could discuss emotional distress, highlighting a critical gap in emotional support systems.

Homecare and practical needs emerged as particularly prevalent, appearing in 25 of the reviewed articles. These included difficulties with activities of daily living (ADLs) such as bathing, dressing, and eating, as well as instrumental activities of daily living (IADLs) like grocery shopping, meal preparation, and medication management. Practical challenges extended to transportation limitations, food insecurity, housing stability concerns, and financial insecurity—particularly anxiety about healthcare costs and retirement funds. Information needs centered around health literacy gaps and difficulties navigating available support services, while technology needs highlighted barriers to digital adoption including limited skills, high costs, and poorly designed interfaces that fail to accommodate age-related changes.

Healthcare system needs revealed access barriers to services including dental, hearing, vision, and mental health care, as well as quality concerns such as insufficient time with primary care providers and lack of culturally informed care for ethnic and sexual minorities. The review noted that individuals with intersectional identities often experienced compounded challenges, underscoring the need for personalized, context-aware solutions rather than one-size-fits-all approaches. Notably, when examining only original needs assessments, social needs appeared most frequently (15 articles), suggesting this may be a particularly critical area from the perspective of older adults themselves.

How Robust Is the Study’s Methodology and Findings?

The authors propose that recent advances in artificial intelligence, particularly large language models (LLMs) and natural language processing, offer promising avenues for addressing these multifaceted needs. AI-enabled tools could support health management through real-time monitoring and personalized guidance, while conversational agents might alleviate social isolation through responsive dialogue that encourages social engagement. Smart home technologies could assist with ADLs and IADLs, creating safer living environments, while LLM-powered interfaces might improve access to health information and community resources. The natural conversation capabilities of these technologies could significantly reduce usability barriers for those with limited digital literacy.

The research methodology employed in this systematic review was particularly robust. The team screened titles and abstracts based on specific inclusion criteria: focus on older adults aged 65+, inclusion of a needs assessment, community-dwelling population (not in long-term care), English language publication since 2013, and exclusion of studies solely about caregiver needs. Data extraction utilized Airtable, a cloud-based relational database that facilitated structured data entry and efficient organization of themes. Thematic analysis was employed to categorize the identified needs into distinct groups that emerged through iterative review during the coding process.

The results were visualized through a PRISMA 2020 flow diagram detailing the study selection process and a bar chart showing article counts by domain and assessment type. From an initial 1,963 records identified, 263 duplicates were removed, and after thorough screening, the final analysis included 64 articles. Table 1 in the original publication provided a comprehensive summary of identified unmet needs by thematic domain and subtheme, offering concrete examples that could guide intervention development.

What Future Role Could AI Play in Transforming Elder Care?

The review's strengths include its comprehensive approach across multiple databases and inclusion of both original assessments and secondary analyses. However, limitations include the exclusion of literature published before 2013 and potential gaps from databases not included in the search. The authors suggest future work should focus on developing novel AI solutions for emerging challenges such as digital literacy support and fraud protection in online environments. Could the integration of AI-powered conversational agents into clinical care pathways create more accessible, personalized support systems for older adults with multiple chronic conditions? How might healthcare providers balance the potential of these technologies against concerns about privacy, data security, and the preservation of human connection in care delivery?

As the population continues to age, addressing these unmet needs becomes increasingly urgent for healthcare systems worldwide. This systematic review provides a valuable framework for understanding the multidimensional challenges faced by older adults aging in place and highlights the potential for technological innovation to support healthy, independent aging. The findings suggest that while technology alone cannot solve all problems, thoughtfully designed AI-enabled solutions could play a significant role in helping older adults maintain autonomy, manage health conditions, and remain socially connected while aging in their homes and communities.

Summary

A systematic review published in Innovation in Aging examines how artificial intelligence and large language models could address unmet needs of older adults aging in place. Researchers analyzed 64 articles and identified six key domains of unmet needs: health management, social needs, homecare and practical needs, information needs, technology needs, and healthcare system needs. The study, which reviewed literature from 2013 onward across PubMed, CINAHL, and ProQuest databases, found that social needs appeared most frequently in original assessments, with many seniors experiencing isolation and lacking confidants for emotional support. Health management challenges included mobility support, cognitive assistance, and chronic condition management, while homecare needs encompassed difficulties with daily activities, transportation, food security, and financial concerns. The authors propose that AI-enabled tools, particularly conversational agents and smart home technologies, could provide real-time health monitoring, reduce social isolation, assist with daily living activities, and improve access to health information. With the global population aged 60 and above projected to reach 2.1 billion by 2050, these findings highlight the urgent need for technological innovations that support independent living while maintaining autonomy and reducing healthcare costs compared to institutional care settings.