Effect of Active and Assisted Living technologies on psychosocial well-being in older adults: systematic review

TL;DR

This paper reviews how Active and Assisted Living technologies affect the mental and social well-being of older adults, finding mixed results and a need for better frameworks.

Contribution

The study provides a systematic review of AAL technologies' psychosocial effects, emphasizing the need for a unified conceptual framework.

Findings

AAL technologies were linked to health-related quality of life and depression outcomes in older adults.

Few studies focused on fear of falling, loneliness, and self-management of chronic conditions.

The review highlights methodological limitations and the need for validated measures in future research.

Abstract

In a rapidly aging society, the concept of psychosocial well-being becomes increasingly relevant, independent of health. Indeed, psychosocial well-being is closely related to autonomy, independence, and self-efficacy. Technological approaches that support older adults in leading active, healthy, and independent lives are framed within the concept of Active and Assisted Living (AAL). However, evidence regarding their impact on psychosocial well-being remains limited.

This systematic review evaluates the psychosocial effects of AAL technologies in older adults.

We included intervention studies reporting psychosocial outcomes related to older adults’ use of AAL technologies. We excluded studies involving participants receiving continuous on-site healthcare assistance or with moderate to severe mental health problems, technologies restricted to basic home automation or lacking advanced data processing and automation, and interventions focused on rehabilitation after acute events. Studies using not-validated measures or without quantitative evaluation of outcomes were also excluded. Searches were conducted in MEDLINE, HealthSTAR, Cochrane Central Register of Controlled Trials, IEEE Xplore, APA PsycArticles, Scopus, and Web of Science from inception to January 2025. Key attributes of eligible publications were critically discussed using a 2 × 2 logic which frames findings by both technological performance and psychosocial outcome.

Of 6,349 records identified, 15 independent studies were included. AAL solutions targeted promotion or guidance of physical activity, self-management of chronic conditions, fostering healthy and safe habits or distraction from pain. Twelve studies assessed health-related quality of life (HRQoL) and close concepts. Depression was the second most investigated outcome, followed by fear of falling, with QoL and loneliness also reported.

This review offers a critical analysis of both the findings and the methodologies employed in the selected studies, acknowledging the complexity of drawing unequivocally positive or negative conclusions regarding the impact of AAL technologies on the psychosocial well-being of older adults. The results highlight the need for a shared conceptual framework to inform the design, assessment, and validation of technologies intended to support daily living.

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