Engagement of Older Adults in the Design, Implementation, and Evaluation of Artificial Intelligence Systems for Aging: A Scoping Review

Integration of artificial intelligence (AI) in health and healthcare, especially for older adults, has significantly advanced healthcare delivery. AI technologies, with capabilities such as self-learning and pattern recognition, are employed to address social isolation and monitor older adults' daily activities. However, rapid AI development often fails to consider the heterogeneous needs of older populations, which could exacerbate an existing digital divide and inequality. This scoping review examines older adults' involvement in AI system design, implementation, and evaluation of AI systems in health and healthcare literature, emphasizing the necessity of their input for beneficial AI systems. We conducted a scoping review according to PRISMA-SCR. We reviewed 17 studies, finding that half of these studies (n = 8) engaged older adults during the design phase, a small number (n = 3) during the evaluation stage, and even fewer (n = 2) involved older adults in the implementation stage. Despite AI's growing role, design processes often overlook older adults' needs. Our findings emphasize the need for inclusive, participatory design approaches to address ethical and equity challenges, enhancing user engagement and relevance. We also highlight how these approaches address the needs of older adults and improve outcomes. Specifically, we integrated evidence showing the practical benefits of these approaches for better accessibility, usability, and engagement among older adults. Although AI has potential to improve healthcare delivery, these approaches must be part of broader efforts to ensure ethical, inclusive, and equitable AI practices, especially in gerontology.