Data scarcity challenges the development and implementation of innovative healthcare solutions. In geriatrics, fall-related injuries are a major cause of hospitalization, functional decline, and mortality in older adults. Optimizing post-operative discharge planning can mitigate these outcomes, but limited data hinders predictive model development. Here, we explored generative machine learning approaches to augment data from the SURGE-Ahead project (Supporting SURgery with Geriatric Co-Management and AI), an initiative addressing geriatric perioperative care. Data from the German geriatric trauma register (AltersTraumaZentrum; ATZ) were incorporated using two strategies: (i) combining SURGE-Ahead and ATZ register data with imputation (ComImp) and (ii) generating synthetic data from SURGE-Ahead alone or combined SURGE-Ahead and the ATZ register datasets with Adversarial random forests (ARF). Predictive models, including multinomial logistic regression, random forest, and a prior-fitted transformer (TabPFN), were trained and evaluated using standard performance metrics: accuracy, area under the receiver operating characteristic curve (ROC AUC), Brier score, and the logistic loss. Ran
To support aging-in-place, adult children often provide care to their aging parents from a distance. These informal caregivers desire plug-and-play remote care solutions for privacy-preserving continuous monitoring that enabling real-time activity monitoring and intuitive, actionable information. This short paper presents insights from three iterations of deployment experience for remote monitoring system and the iterative improvement in hardware, modeling, and user interface guided by the Geriatric 4Ms framework (matters most, mentation, mobility, and medication). An LLM-assisted solution is developed to balance user experience (privacy-preserving, plug-and-play) and system performance.
Gait speed is a widely used indicator of functional health and mobility decline, yet in clinical practice it is commonly measured manually using a stopwatch, which limits scalability and measurement frequency. Privacy-preserving and maintenance-free sensing approaches can enable more routine and less burdensome assessments in real-world care settings. This paper presents the design, implementation, and real-world deployment of a fully passive, battery-free gait-speed monitoring system based on ultra-high-frequency (UHF) RFID. Compared with camera- and wearable-based approaches, the proposed system preserves patient privacy by avoiding video capture and biometric data, while eliminating battery maintenance. The system employs a dual-antenna configuration and an edge-based peak-detection algorithm to estimate gait speed in real time from received signal strength indicator (RSSI) streams. By leveraging antenna-beam symmetry and asymmetric signal processing, the method improves robustness to noise, plateau regions, and multiple local maxima. We evaluate the system during routine outpatient care across three clinical sites using 966 trials, achieving an 87.7% measurement success rate. C
The rapid increase in the world's aging population to 16% by the year 2050 spurs the need for the application of digital health solutions to enhance older individuals' independence, accessibility, and well-being. While digital health technologies such as telemedicine, wearables, and mobile health applications can transform geriatric care, their adoption among older individuals is not evenly distributed. This study redefines the "digital divide" among older health care as a usability divide, contends that user experience (UX) poor design is the primary adoption barrier, rather than access. Drawing on interdisciplinary studies and design paradigms, the research identifies the main challenges: visual, cognitive, and motor impairment; complicated interfaces; and lack of co-creation with older adults, and outlines how participatory, user-focused, and inclusive notions of design can transcend them. Findings reveal that older persons easily embrace those technologies that are intuitive, accessible, and socially embedded as they promote autonomy, confidence, and equity in health. The study identifies the effects of the design attributes of high-contrast screens, lower interaction flow, mul
Traumatic Brain Injury (TBI) is a major contributor to mortality among older adults, with geriatric patients facing disproportionately high risk due to age-related physiological vulnerability and comorbidities. Early and accurate prediction of mortality is essential for guiding clinical decision-making and optimizing ICU resource allocation. In this study, we utilized the MIMIC-III database to identify geriatric TBI patients and applied a machine learning framework to develop a 30-day mortality prediction model. A rigorous preprocessing pipeline-including Random Forest-based imputation, feature engineering, and hybrid selection-was implemented to refine predictors from 69 to 9 clinically meaningful variables. CatBoost emerged as the top-performing model, achieving an AUROC of 0.867 (95% CI: 0.809-0.922), surpassing traditional scoring systems. SHAP analysis confirmed the importance of GCS score, oxygen saturation, and prothrombin time as dominant predictors. These findings highlight the value of interpretable machine learning tools for early mortality risk stratification in elderly TBI patients and provide a foundation for future clinical integration to support high-stakes decision
An emergent challenge in geriatric care is improving the quality of care, which requires insight from stakeholders. Qualitative methods offer detailed insights, but they can be biased and have limited generalizability, while quantitative methods may miss nuances. Network-based approaches, such as quantitative ethnography (QE), can bridge this methodological gap. By leveraging the strengths of both methods, QE provides profound insights into need-finding interviews. In this paper, to better understand geriatric care attitudes, we interviewed ten nursing assistants, used QE to analyze the data, and compared their daily activities in real life with training experiences. A two-sample t-test with a large effect size (Cohen's d=1.63) indicated a significant difference between real-life and training activities. The findings suggested incorporating more empathetic training scenarios into the future design of our geriatric care simulation. The results have implications for human-computer interaction and human factors. This is illustrated by presenting an example of using QE to analyze expert interviews with nursing assistants as caregivers to inform subsequent design processes.
Objectives-Geriatric clinical care is a multidisciplinary assessment designed to evaluate older patients (age 65 years and above) functional ability, physical health, and cognitive wellbeing. The majority of these patients suffer from multiple chronic conditions and require special attention. Recently, hospitals utilize various artificial intelligence (AI) systems to improve care for elderly patients. The purpose of this systematic literature review is to understand the current use of AI systems, particularly machine learning (ML), in geriatric clinical care for chronic diseases. Materials and Methods-We restricted our search to eight databases, namely PubMed, WorldCat, MEDLINE, ProQuest, ScienceDirect, SpringerLink, Wiley, and ERIC, to analyze research articles published in English between January 2010 and June 2019. We focused on studies that used ML algorithms in the care of geriatrics patients with chronic conditions. Results-We identified 35 eligible studies and classified in three groups-psychological disorder (n=22), eye diseases (n=6), and others (n=7). This review identified the lack of standardized ML evaluation metrics and the need for data governance specific to health
Embolic stroke during cardiopulmonary bypass (CPB) is strongly influenced by cannula induced flow disturbances that govern emboli transport and aortic wall loading. This study quantifies how aortic cannula orientation affects embolic distribution and atherosclerotic plaque disruption risk across patient specific, age-dependent aortic anatomies under clinical CPB conditions. A validated computational fluid dynamics and Lagrangian particle tracking (CFD-LPT) framework was applied to four patient-specific aortic models representing pediatric, adolescent, adult, and geriatric anatomies. Two clinically relevant cannula orientations: perpendicular (90 deg) and angled (30 deg), were evaluated under varying blood viscosities (1.5 to 3.5 cP) and embolus sizes (0.5 to 2.5 mm). Aortic branch exit percentage, wall pressure, and wall shear stress (WSS) were quantified. The 30 deg angled cannula reduced embolic transport into the aortic branches by 18 to 50 percent compared with perpendicular cannulation, with the largest reduction observed in the geriatric model. Perpendicular cannulation produced concentrated jet impingement, resulting in significantly elevated posterior wall pressure (24 perc
Background: LLMs enable patient-facing conversational agents, creating a pathway toward digital twins that capture older adults' lived experiences and behavioral responses across time. A central barrier is personality drift -- inconsistent trait expression across repeated interactions -- which undermines reliability of generated trajectories and intervention-response simulation in geriatric care. Objective: To develop ELDER-SIM, a multi-role elderly-care conversational platform for building personality-stable digital twin agents, and to propose a psychometric validation framework for quantifying personality consistency in LLM-based agents. Methods: ELDER-SIM was implemented via n8n workflow orchestration with local LLM inference (Ollama/vLLM), integrating (1) Big Five (OCEAN) trait specifications, (2) a Cognitive Conceptualization Diagram (CCD) grounded in Beck's CBT framework, and (3) a MySQL-based long-term memory module. Ablation studies across four conditions -- Baseline, +Memory, +CCD, and +LoRA (fine-tuned on 19,717 instruction pairs from CHARLS) -- were evaluated via Cronbach's $α$, ICC, and role discrimination accuracy. Results: Reliability was acceptable to excellent acros
Physical activity during hip fracture rehabilitation is essential for mitigating long-term functional decline in geriatric patients. However, it is rarely quantified in clinical practice. Existing continuous monitoring systems with commercially available wearable activity trackers are typically developed in middle-aged adults and therefore perform unreliably in older adults with slower and more variable gait patterns. This study aimed to develop a robust human activity recognition (HAR) system to improve continuous physical activity recognition in the context of hip fracture rehabilitation. 24 healthy older adults aged over 80 years were included to perform activities of daily living (walking, standing, sitting, lying down, and postural transfers) under simulated free-living conditions for 75 minutes while wearing two accelerometers positioned on the lower back and anterior upper thigh. Model robustness was evaluated using leave-one-subject-out cross-validation. The synthetic data demonstrated potential to improve generalization across participants. The resulting feature intervention model (FIM), aided by synthetic data guidance, achieved reliable activity recognition with mean F1-
To overcome the limitations of manual administrative coding in geriatric Cardiovascular Risk Management, this study introduces an automated classification framework leveraging unstructured Electronic Health Records (EHRs). Using a dataset of 3,482 patients, we benchmarked three distinct modeling paradigms on longitudinal Dutch clinical narratives: classical machine learning baselines, specialized deep learning architectures optimized for large-context sequences, and general-purpose generative Large Language Models (LLMs) in a zero-shot setting. Additionally, we evaluated a late fusion strategy to integrate unstructured text with structured medication embeddings and anthropometric data. Our analysis reveals that the custom Transformer architecture outperforms both traditional methods and generative \acs{llm}s, achieving the highest F1-scores and Matthews Correlation Coefficients. These findings underscore the critical role of specialized hierarchical attention mechanisms in capturing long-range dependencies within medical texts, presenting a robust, automated alternative to manual workflows for clinical risk stratification.
The need to improve geriatric care quality presents a challenge that requires insights from stakeholders. While simulated trainings can boost competencies, extracting meaningful insights from these practices to enhance simulation effectiveness remains a challenge. In this study, we introduce Multimodal Epistemic Network Analysis (MENA), a novel framework for analyzing caregiver attitudes and emotions in an Augmented Reality setting and exploring how the awareness of a virtual geriatric patient (VGP) impacts these aspects. MENA enhances the capabilities of Epistemic Network Analysis by detecting positive emotions, enabling visualization and analysis of complex relationships between caregiving competencies and emotions in dynamic caregiving practices. The framework provides visual representations that demonstrate how participants provided more supportive care and engaged more effectively in person-centered caregiving with aware VGP. This method could be applicable in any setting that depends on dynamic interpersonal interactions, as it visualizes connections between key elements using network graphs and enables the direct comparison of multiple networks, thereby broadening its implic
The increasing global aging population has intensified the demand for reliable health monitoring systems, particularly those capable of detecting critical events such as falls among elderly individuals. Traditional fall detection approaches relying on single-modality acceleration data suffer from high false alarm rates, while conventional machine learning methods require extensive hand-crafted feature engineering. This paper proposes a novel multi-modal deep learning framework, MultiModalFallDetector, designed for real-time elderly fall detection using wearable sensors. Our approach integrates multiple innovations: a multi-scale CNN-based feature extractor capturing motion dynamics at varying temporal resolutions; fusion of tri-axial accelerometer, gyroscope, and four-channel physiological signals; incorporation of a multi-head self-attention mechanism for dynamic temporal weighting; adoption of Focal Loss to mitigate severe class imbalance; introduction of an auxiliary activity classification task for regularization; and implementation of transfer learning from UCI HAR to SisFall dataset. Extensive experiments on the SisFall dataset, which includes real-world simulated fall trials
This article describes the implementation of a technological solution aimed at improving the recording of physiological signals in the elderly population residing in geriatric facilities. The developed system consists of a smart device equipped with sensors for body temperature, heart rate, and blood oxygen levels. This device establishes an Internet connection to transmit data to a cloud-based platform for storage. Within this platform, a dashboard has been created to visualize real-time values captured by the sensors, along with additional functionalities such as user management and the configuration of personalized alerts, which are transmitted to the solution's users through the instant messaging system called Telegram.
Developed nations are undergoing a profound demographic transformation, characterized by rapidly aging populations and declining birth rates. This dual trend places unprecedented strain on healthcare systems, economies, and social support structures, creating complex biological, economic, and social challenges. This paper argues that current, often siloed, policy responses, such as pronatalist initiatives that overlook the equally urgent needs of older adults, are inadequate for addressing these interconnected issues. We propose that a comprehensive, transdisciplinary framework is essential for developing sustainable and ethical solutions. Through a review of demographic drivers, policy responses, and technological advancements, we analyze the limitations of fragmented approaches and explore the potential of innovative interventions. Specifically, we examine the role of artificial intelligence (AI) and robotics in transforming geriatric care. While these technologies offer powerful tools for personalizing treatment, enhancing diagnostics, and enabling remote monitoring, their integration presents significant challenges. These include ethical concerns regarding data privacy and comp
Voice-controlled interfaces can support older adults in clinical contexts -- with chatbots being a prime example -- but reliable Automatic Speech Recognition (ASR) for underrepresented groups remains a bottleneck. This study evaluates state-of-the-art ASR models on language use of older Dutch adults, who interacted with the Welzijn.AI chatbot designed for geriatric contexts. We benchmark generic multilingual ASR models, and models fine-tuned for Dutch spoken by older adults, while also considering processing speed. Our results show that generic multilingual models outperform fine-tuned models, which suggests recent ASR models can generalise well out of the box to real-world datasets. Moreover, our results indicate that truncating generic models is helpful in balancing the accuracy-speed trade-off. Nonetheless, we also find inputs which cause a high word error rate and place them in context.
Physical therapy (PT) is crucial in helping older adults manage chronic conditions and weakening muscles, but older adults face increasing challenges that can impact their PT experience, including increased fatigue, memory loss, and mobility and travel constraints. While current technology attempts to facilitate remote care, they have limitations and are used in-practice infrequently. Mixed reality (MR) technology shows promise for addressing these challenges by creating immersive, context-aware environments remotely that previously could only be achieved in clinical settings. To bridge the gap between MR's potential and its practical application in geriatric PT, we conducted in-depth interviews with three PT clinicians and six older adult patients to understand challenges with PT care and adherence that MR may address. Our findings inform design considerations for supporting older adults' needs through MR and outline technical requirements for practical implementation.
Building and deploying machine learning solutions in healthcare remains expensive and labor-intensive due to fragmented preprocessing workflows, model compatibility issues, and stringent data privacy constraints. In this work, we introduce an Agentic AI framework that automates the entire clinical data pipeline, from ingestion to inference, through a system of modular, task-specific agents. These agents handle both structured and unstructured data, enabling automatic feature selection, model selection, and preprocessing recommendation without manual intervention. We evaluate the system on publicly available datasets from geriatrics, palliative care, and colonoscopy imaging. For example, in the case of structured data (anxiety data) and unstructured data (colonoscopy polyps data), the pipeline begins with file-type detection by the Ingestion Identifier Agent, followed by the Data Anonymizer Agent ensuring privacy compliance, where we first identify the data type and then anonymize it. The Feature Extraction Agent identifies features using an embedding-based approach for tabular data, extracting all column names, and a multi-stage MedGemma-based approach for image data, which infers
Mental disorders including depression, anxiety, and other neurological disorders pose a significant global challenge, particularly among individuals exhibiting social avoidance tendencies. This study proposes a hybrid approach by leveraging smartphone sensor data measuring daily physical activities and analyzing their social media (Twitter) interactions for evaluating an individual's depression level. Using CNN-based deep learning models and Naive Bayes classification, we identify human physical activities accurately and also classify the user sentiments. A total of 33 participants were recruited for data acquisition, and nine relevant features were extracted from the physical activities and analyzed with their weekly depression scores, evaluated using the Geriatric Depression Scale (GDS) questionnaire. Of the nine features, six are derived from physical activities, achieving an activity recognition accuracy of 95%, while three features stem from sentiment analysis of Twitter activities, yielding a sentiment analysis accuracy of 95.6%. Notably, several physical activity features exhibited significant correlations with the severity of depression symptoms. For classifying the depress
The release of SAM 3D Body is a recent development in human mesh recovery, demonstrating improved performance in producing clean, topologically coherent meshes from single images. By leveraging the Momentum Human Rig (MHR), it achieves robustness to occlusion and diverse poses. However, our evaluation reveals a specific and consistent limitation: the model struggles to reconstruct detailed anthropometric deviations, particularly in populations exhibiting distinctive morphological alterations such as geriatric muscle atrophy, scoliosis, or pregnancy, even when these features are prominent in the input image. In this paper, we investigate this phenomenon not as a failure of the model's capacity, but as a byproduct of the "perception-distortion trade-off". We posit that the architectural reliance on the low-dimensional parametric MHR representation, combined with semantic-invariant conditioning (DINOv3) and annotation-based alignment, creates a pervasive "regression to the mean" effect. We analyze these mechanisms to understand why individual biological details are smoothed out. Furthermore, we state our contributions by proposing specific, constructive pathways for future work, such