Integrating Empathy into Assistive Technology: Practical Recommendations for Aging Populations

The integration of artificial intelligence (AI) into assistive technologies is an emerging field with transformative potential, aimed at enhancing autonomy and quality of life for individuals with disabilities and aging populations. This overview of reviews, utilizing a standardized checklist and quality control procedures, examines recent advancements and future implications in this domain. The search for articles for the review was finalized by 15 December 2024. Nineteen review studies were selected through a systematic process identifying prevailing themes, opportunities, challenges, and recommendations regarding the integration of AI in assistive technologies. First, AI is increasingly central to improving mobility, healthcare diagnostics, and cognitive support, enabling personalized and adaptive solutions for users. The integration of AI into traditional assistive technologies, such as smart wheelchairs and exoskeletons, enhances their performance, creating more intuitive and responsive devices. Additionally, AI is improving the inclusion of children with autism spectrum disorders, promoting social interaction and cognitive development through innovative devices. The review also identifies significant opportunities and challenges. AI-powered assistive technologies offer enormous potential to increase independence, reduce reliance on external support, and improve communication for individuals with cognitive disorders. However, challenges such as personalization, digital literacy among the elderly, and privacy concerns in healthcare contexts need to be addressed. Notably, AI itself is expanding the concept of assistive technology, shifting from traditional tools to intelligent systems capable of learning and adapting to individual needs. This evolution represents a fundamental change in assistive technology, emphasizing dynamic, adaptive systems over static solutions. Finally, the study emphasizes the growing economic investment in this sector, forecasting significant market growth, with AI-driven assistive devices poised to transform the landscape. Despite challenges such as high development costs and regulatory hurdles, opportunities for innovation and affordability remain. This review underscores the importance of addressing challenges related to standardization, accessibility, and ethical considerations to ensure the successful integration of AI into assistive technologies, fostering greater inclusivity and improved quality of life for users globally.

Frailty is an age-associated syndrome heightening vulnerability to stressors. Mobility limitations common among individuals with frailty can impede access to physical resources and can lead to social isolation, detrimentally affecting mental and physical health. Digital literacy offers access to health information access, assistive and remote monitoring technologies and social engagement. Each are vital for people with frailty because they can enhance independence, cognition and quality of life. Despite the potential of digital literacy, internet access and digital health resources remain underutilized with older adults, especially among older adults with lower incomes and education levels. We designed a theory and values-based person-directed intervention to address digital literacy for older adults, aiming to recognize and leverage the motivational factors driving their desire to learn new skills. This is a 20 person one-arm feasibility and acceptability pilot trial enrolling participants with varying levels of frailty and digital literacy. The study is comprised of 4-6 in-home biweekly visits over the course of 8-12 weeks that use the older adults’ own values and goals to co-develop action plans that matter to the participant with the primary outcome of improvements in digital literacy. We hypothesize creating a digital literacy intervention that is person-directed will be feasible and acceptable to older adults and will lead to improvements in digital literacy, self-efficacy and quality of life.

Assistive technologies: time for a shift in thinking

In 2020, an estimated 596 million people worldwide had distance vision impairment and a further 510 million had uncorrected near vision impairment.1 Most of these people live in low-income and middle-income countries (LMIC). Eye health is also affected by conditions that do not, at least initially, impair vision. Although these conditions are not currently included in global prevalence estimates, they contribute substantially to the unmet need for eye health services. Vision is important for many aspects of life, and vision impairment can profoundly affect individuals, families, and society. Eye health touches all lives, either directly or indirectly, through its impact on those close to us. The year 2020 marks the culmination of the global initiative to eliminate avoidable blindness, VISION 2020: The Right to Sight (appendix 1 p 7). This initiative provided the framework for national programmes to address eye health over the past 20 years. In 2019, WHO published the World report on vision,2 which was endorsed by the 73rd World Health Assembly in 2020. The report and resolution call for the advancing of eye health as an integral part of universal health coverage, by implementation of integrated people-centred eye care, following the approach outlined in a broader health services framework.3 The Lancet Global Health Commission on Global Eye Health contends that eye health should be part of the mainstream agenda to achieve universal health coverage and sustainable development. We define eye health as the state in which vision, ocular health, and functional ability are maximised, thereby contributing to overall health and wellbeing, social inclusion, and quality of life. Eye health can be considered both a process and an outcome. We define eye care services as those that contribute to any of vision, ocular health, or functional ability being maximised. This report broadly divides into two halves. First, we present evidence for the importance of eye health, supporting the case for urgent action. Second, looking beyond 2020, we examine approaches to enable delivery of eye health services within universal health coverage. In section 1 we summarise the visual system, vision impairment, and common conditions. In section 2, we synthesise several reviews done by the Commission on the relevance of eye health to the Sustainable Development Goals (SDGs), as well as its impact on quality of life, general health, and mortality. In section 3, we describe the magnitude and causes of vision impairment in 2020 and projected global and regional trends. We explore service needs of people with non-vision impairing eye conditions. We propose a more standardised approach to reporting population-based eye health surveys and examine the disability weights applied to vision impairment. In section 4, we summarise findings from a systematic review of eye health economics, identifying important areas for future work. We present a new estimate of global lost productivity associated with vision impairment for 2020, and an analysis of the cost-effectiveness ratios for cataract surgery and refractive error services. In section 5, we outline a bibliometric analysis of eye health research since 2000, and report a global Grand Challenges project, highlighting crucial issues for concerted research and action. Lastly, we address the question of how health systems can practically advance towards delivering high quality integrated people-centred eye care within universal health coverage.2 We argue that business as usual will be insufficient, as evidenced by new analysis of effective cataract surgical coverage data. We examine service delivery components: primary eye care and integration with general health services, workforce strengthening, financing, health information systems, indicators, advocacy, and approaches to increase quality and equity. The development of global eye health This Commission views global eye health through the global health framework articulated by Koplan and colleagues.4 Eye health started with an understanding of the anatomy, physiology, diseases of the eye, and the development of clinical ophthalmology, the medical and surgical discipline for diagnosis and treatment of eye diseases. From the mid-20th century onwards (figure 1), there have been major technological advances in microsurgical techniques for cataract and other conditions, and equipment for diagnosis and treatment of major non-communicable eye diseases, resulting in more effective interventions. There has been an enormous demographic transition, with ageing populations and epidemiological changes from infectious diseases and towards non-communicable diseases, requiring accessible and affordable eye services with long-term follow-up. The increase in demand, emphasis on better quality, and higher cost of more sophisticated diagnostic and treatment services is requiring an increase in resources, which presents enormous public health challenges. Open in a separate window Figure 1 The development of global eye health Blue circles indicate major global developments. Red circles indicate major treatments and programmatic developments. WHA=World Health Assembly. IAPB=International Agency for the Prevention of Blindness. RAAB=Rapid Assessment of Avoidable Blindness. RACSS=Rapid Assessment of Cataract Surgical Services.

The integration of Artificial Intelligence (AI) and Assistive Technology (AT) in special education has emerged as a pivotal solution in bridging learning gaps for students with disabilities. Despite advancements in inclusive education, students with disabilities continue to face substantial barriers in accessing educational content. AI and AT offer transformative potential in addressing these barriers by personalizing learning experiences and enhancing educational outcomes for these students. This review explores the impact of AI and AT in transforming learning access for students with disabilities, focusing on the integration of AI-powered tools and AT to provide personalized, adaptive learning experiences. In carrying out this review, Google Scholar was the primary literature source. Findings from the included literature were analyzed and synthesized thematically, focusing on studies related to AI and AT applications in special education, and their effectiveness in enhancing accessibility and academic performance. The review identifies significant improvements in academic engagement, independence, and social inclusion among students using AI-powered assistive tools. Case studies highlight the effectiveness of AI in fostering personalized learning environments for students with learning disabilities, autism, and motor impairments. AI and AT have substantial potential to enhance learning outcomes for students with disabilities. However, challenges such as economic barriers, technological inequalities, and resistance to adoption must be addressed to ensure broader accessibility and equity in educational settings.

Artificial Intelligence (AI) technology is advancing at a rapid pace. In addition, our older adult cohort is growing at an unprecedented rate. The purpose of my research is to address the ethical concerns when AI intersects with this population, offering policy recommendations to bridge this ethical digital divide. To address this AI ethical dilemma, my research did not reach back prior to 2019 in order to provide a concise policy analysis that includes existing AI ethical policies/recommendations from the European Union, United States, and U.S. States, key differences, and how ethical AI policies are central to Area Agencies on Aging’s development of aging services. My findings indicated gaps in ethical AI design with developed policy recommendations. These gaps include inclusive data collection, user-centric design, algorithmic biases and understanding, digital literacy, New Jersey AI Task Force membership, and a need for a New Jersey AI Ethical Framework. With my five policy recommendations, New Jersey will be better positioned in assuring AI systems will be equitable, ethical, and effective in addressing the present and future needs of older adults. With this ethical AI framework, New Jersey will help to better older adults’ quality of life, as well as save valuable time and resources through the new industrial revolution that is Artificial Intelligence. Keywords: Artificial Intelligence, ethics, older adults, algorithmic bias, AI ageism

With the continuous development of interactive technology, informatization has begun to integrate into people's life[1].Having been neglected in history, postpartum depression reminds us that we need to pay attention to maternal emotional needs and prenatal care[2]. In the current situation, it is worth researching the interactive products for prenatal emotional care. According to the survey, it is not difficult to find that some speech emotion and facial expression recognition technologies in artificial intelligence are developing Which have large potential for extensive use.[3,4]. Therefore, it is necessary and feasible to design prenatal emotional diagnosis tools for pregnant women. This study has designed a product to care for pregnant women by identifying their emotional needs through AI recognition technologies. Appropriate prenatal intervention is conducive to the prevention of postpartum depression[5,6] . The use of artificial intelligence recognition technology can provide an appropriate emotional care plan. This can reduce the difficulty of training medical personnel and the difficulty of relatives caring for pregnant women. Therefore, the risk of postpartum depression can be reduced. QUESTIONCollecting opinions and information from previous studies is an important reference for this study. Therefore, this study needs to solve the following problems.1) How to design an artificial intelligence product that can accurately diagnose the emotion of pregnant women?2) How to integrate AI facial emotion recognition technology?3) How to help nurses and their families take care of users more professionally and easily through the information database?4) How to adapt the emotional care program provided by interactive products to different pregnant women? Methods:the research methods of this study are as follows:1) Observing the working process of artificial midwives and psychologists to find Which part can be assisted by machines[7].2) To understand the emotional needs of pregnant women through interview.3) To brainstorm according to the real data collected before and research findings, and then design interactive products that can practically solve the emotional care problems of pregnant women.4) Through the experiment of AI emotion recognition technologies, the feasibility of emotion recognition is verified. CONCLUSIONS:With the continuous development of artificial intelligence, more and more artificial intelligence products have entered our life [1]. This study is aimed to help pregnant women prevent prenatal and postpartum depression and maintain their health through artificial intelligence interaction technologies. This study is exploring the solution under the help of artificial intelligence after studying the problem that prenatal and postpartum emotion are neglected. This design is still in the conceptual design stage, but it seems only a matter of time before this design is applied in the future[8]. REFERENCES:[1]. Lee H S , Lee J . Applying Artificial Intelligence in Physical Education and Future Perspectives. 2021.[2]. Beck C T . Postpartum depression: it isn't just the blues.[J]. American Journal of Nursing, 2006, 106(5):40-50.[3].Ramakrishnan S , Emary I M M E . Speech emotion recognition approaches in human computer interaction[J]. Telecommunication Systems, 2013, 52(3):OnLine-First.[4]. Samara A , Galway L , Bond R , et al. Affective state detection via facial expression analysis within a human–computer interaction context[J]. Journal of Ambient Intelligence & Humanized Computing, 2017.[5]. Clatworthy J . The effectiveness of antenatal interventions to prevent postnatal depression in high-risk women[J]. Journal of Affective Disorders, 2012, 137(1-3):25-34.[6]. Ju C H , Hye K J , Jae L J . Antenatal Cognitive-behavioral Therapy for Prevention of Postpartum Depression: A Pilot Study[J]. Yonsei Medical Journal, 2008, 49(4):553-.[7]. Fletcher A , Murphy M , Leahy-Warren P . Midwives' experiences of caring for women's emotional and mental well-being during pregnancy[J]. Journal of Clinical Nursing, 2021.[8]. Jin X , Liu C , Xu T , et al. Artificial intelligence biosensors: Challenges and prospects[J]. Biosensors & Bioelectronics, 2020, 165:112412.

The importance of Assistive technology (AT) is gaining serious attention worldwide due to recent technological advancements, an aging population, and the rising prevalence of non-communicable diseases (NCDs) and functional impairments. Global reports on AT reveal that one in every three globally requires at least one AT and this need is further exacerbated by age, region and socioeconomic status, making individuals belonging to LMICs the most vulnerable. The preliminary findings of the ICMR-initiated rATA survey, currently underway across India, reveal a significant gap between AT needs and AT access, with females, older age groups, and individuals from rural and tribal areas being the most vulnerable. Although there have been significant innovations in the field of AT with the advent of Artificial Intelligence (AI) and machine learning (ML), affordability, accessibility and limited customisations as per user needs hinder the wider adoption of AT, especially in India, with a vast population, diverse cultural and geographical landscapes and limited awareness about AT services and products. Indian government initiatives such as the RPwD Act, ADIP and RVY schemes, intended at provisioning AT services for eligible individuals which includes persons with disabilities (PwDs) and individuals above 60 years, have substantially failed to deliver as promised mainly due to inadequate financial allocations, poor distribution and supply chain networks, weak regulatory enforcements and limited awareness of schemes among the targeted beneficiaries. In this regard, this article attempts to provide a comprehensive overview of the current situation of AT in India, focusing on government initiatives and schemes, current demand and scope for AT, barriers in AT adoption and finally recommendations and best practices for a successful AT adoption in India.

 \nThe use of Assistive Technology (AT) brings relevant meanings in the process of teaching and learning mathematics for students with and without disabilities. The AT encompasses resources, methodologies, strategies and pedagogical practices capable of helping in the effectiveness of the educational process aimed at guaranteeing autonomy, independence, quality of life and social inclusion of students with disabilities. Given the importance of AT arises the need to ascertain the facilities and difficulties of teachers when using them in school routine. This article aims to investigate and evaluate the use of AT in the process of teaching and learning mathematics of blind elementary students in regular classes. The methodology, of qualitative nature, used the interview with the pedagogical coordination of a Class School located in Plano Piloto in Brasília-DF about the use of AT in mathematics classes, for the production of data. The results of this research show how the use of AT can contribute to pedagogical practices in the process of teaching and learning mathematics as facilitators of understanding and development of content and promoting school inclusion.

In the evolving landscape of computer technology, the interaction between humans and machines has undergone significant transformation, particularly emphasizing inclusivity and accessibility for individuals with disabilities. This project introduces a hand gesture recognition system designed to enable disabled individuals to interact with computers effortlessly, replacing traditional hardware like keyboards . Leveraging advanced technologies such as OpenCV, MediaPipe, and Python, the system allows users to control a virtual keyboard through intuitive hand gestures. By using a camera to track and interpret gestures, the system eliminates the need for physical input devices, offering a natural and efficient human-computer interface. The camera feed is displayed on the system screen for calibration, ensuring accurate gesture detection and personalization to the user’s needs. MediaPipe's robust AI capabilities enhance the system’s accuracy and responsiveness, making it a practical and empowering tool for individuals with mobility or dexterity impairments. This innovation aims to bridge the accessibility gap, fostering independence and improving quality of life for users with disabilities. KEYWORD: Hand Gesture Recognition – Accessibility – Inclusivity - Disabled Individuals - Human-Computer Interaction – OpenCV – MediaPipe – Python - Virtual Keyboard - Gesture Detection -Camera Feed – Calibration - AI Capabilities - Mobility Impairments - Dexterity Impairments - Physical Input Devices - Natural Interface - Independent Living - Quality of Life - Assistive Technology

The aim of this systematic review was to interrogate the existing literature that articulates indirect or direct links between quality of life (QoL) and creativity in later life musical learning and participation. Search terms were related to the concept (creativity), the context (music), the population (aging), and the outcome (QoL). Twenty-three articles were retained. The link between creativity and QoL focused primarily on the role of creativity in life enrichment and subjective well-being. Creativity in participatory music-making was found to be underpinned by social engagement, collaboration, and inclusivity. Opportunities for creative expression through participatory music-making offered a range of benefits relating to QoL that included positive emotions, engagement, relationships, a sense of meaning, and accomplishment. Our systematic review highlights limitations with regard to theoretical explanations for the characteristics of a creative musical process or product within later life contexts, the specific contributions of these creative processes and products in relation to quality of later life, and the specific ways in which creative musical expression can be facilitated within diverse and multicultural later life contexts so as to maximize the potential QoL benefits for our aging population.

Despite scientific and technological advances in the field of assistive technology (AT) for people with visual impairment (VI), technological designs are frequently based on a poor understanding of the physical and social context of use, resulting in devices that are less than optimal for their intended beneficiaries. To resolve this situation, user-centred approaches in the development process of AT have been widely adopted in recent years. However, there is a lack of systematization on the application of this approach. This systematic review registered in PROSPERO (CRD42022307466), assesses the application of the ISO 9241-210 human-centred design principles in allegedly “user-centred designed” AT developments for persons with VI (see Supplementary PROSPERO Protocol). The results point to a wide variation of the depth of understanding of user needs, a poor characterization of the application of the User Centred Design (UCD) approach in the initial design phases or in the early prototyping, and a vague description of user feedback and device iteration. Among the principles set out in ISO 9241-210, the application of 5.6: “the design team includes multidisciplinary skills and perspectives” is the one for which the least evidence is found. The results show there is not enough evidence to fully assess the impact of UCD in (1) promoting innovation regarding AT products and practices, and (2) Judging if AT produced following such standards is leading to better user access, wellbeing outcomes and satisfaction. To address this gap it is necessary to, first, generate better implementation of UCD in AT development and second, to strengthen evidence regarding the implementation and outcomes of using UCD for AT. To better engage with the realities of persons with VI, we propose capacity building across development teams regarding UCD, its principles and components; better planning for UCD implementation; and cross-fertilization across engineering disciplines and social and clinical science.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=307466 PROSPERO (CRD42022307466).

Understanding how digital literacy affects the quality of life (QoL) of older adults is crucial in the context of growing digitization. Drawing on data from a survey of 2,238 community-dwelling older adults in Hunan province, China, this study investigated the association between digital literacy and QoL, including mediating mechanisms and the threshold effects of this relationship. The results indicate that digital literacy was positively correlated with QoL of older adults, and these findings remained robust after using double/debiased machine learning and instrumental variable approach. Moreover, the QoL-enhancing effect was more pronounced above a digital literacy score of 27, reflecting a threshold effect. Mediation analysis revealed that digital literacy indirectly improved QoL through two pathways: community participation and health checkup. Overall, the findings suggest developing targeted digital literacy policies for older adults, which should prioritize comprehensive digital literacy training that goes beyond basic skills. Furthermore, promoting digital literacy as a means to enhance social participation and health engagement can help support the well-being of older populations and foster active aging in an increasingly digital world.

Advancements in assistive technologies (ATs), particularly those powered by Artificial Intelligence (AI), have significantly enhanced the quality of life and independence of individuals with various disorders, thus fostering progress in education, employment, social engagement and well-being. Despite these advancements, significant challenges remain in the implementation of such technologies in various domains, emphasizing the necessity for deeper exploration of their future development. This study examines the future trends and perspectives of ATs, providing valuable insights from a national context and comparing the results with those of international Delphi research. Using a two-round Delphi method, we engaged a panel of 23 experts from Bulgaria, representing disability organizations, academia and practice. Ten future-oriented projections were assessed, while participant demographics and attitudes toward ATs were also analyzed. The survey’s statistical findings indicate a moderate consensus among the Bulgarian experts. They demonstrate cautious optimism about the use of ATs, especially AI-driven technology, for individuals with disabilities. The results are similar with those of the international study, with only few differences, highlighting the shared perspectives of experts at both national and international levels. The research offers valuable insights into emerging trends in AI-driven ATs and provides valuable knowledge for policymakers, researchers and developers seeking to align innovation with the expectations of diverse stakeholders.

The global demographic shift toward an aging population necessitates a nuanced approach to developing and adopting assistive technologies tailored for older adults. This paper synthesizes key challenges, strategies, and recommendations identified in addressing the complex landscape of technology adoption and usage among aging populations. User-centric design and co-creation initiatives are vital for developing assistive technologies that meet the needs of older adults. These initiatives involve engaging older adults in activities like workshops, focus groups, and design sessions to gather feedback and refine technology solutions, ensuring they are accessible, intuitive, and effective. Challenges such as participant selection, cultural attitudes, and trust-building mechanisms are paramount in ensuring meaningful user involvement in technology development processes. Accurate assessment of older adults' technological literacy is identified as critical for designing and implementing digital solutions. The unreliability of self-reported proficiency necessitates objective measures in assessments to counter potential biases and ensure accurate insights into user capabilities. The fragmented digital ecosystem and resulting digital divide among older adults pose significant barriers to technology adoption and usage. The role of caregivers in technology acceptance highlights the need for integrated models that encompass the caregiver perspective, reducing adoption barriers and fostering meaningful engagement with assistive technologies. Interdisciplinary collaboration and robust research standards are essential in advancing technology adoption and addressing societal inequalities. Prioritizing user-centric design, integrating caregivers into technology adoption models, and fostering collaborative efforts across disciplines can significantly improve technology acceptance and enhance the quality of life for older adults in an increasingly digital era.