SMART HOME SENSORS FOR AMBIENT ASSISTED LIVING IN THE GERIATRIC POPULATION: CLINICAL EFFICACY, ETHICAL CONSIDERATIONS, AND SOCIOECONOMIC DISPARITIES

Authors

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6512

Keywords:

Ambient Assisted Living, Geriatrics, Health Equity, Remote Patient Monitoring, Artificial Intelligence, Bioethics

Abstract

Background: The global demographic shift toward an aging population exacerbates the clinical burden of multi-morbidity, falls, and functional decline, alongside a persistent shortage of geriatric healthcare professionals. Ambient Assisted Living (AAL) technologies utilizing edge-AI passive sensors offer a scalable, unobtrusive approach to continuous remote monitoring.

Objectives: This narrative review aims to synthesize recent clinical data regarding the efficacy of AAL systems in geriatric care while critically evaluating the ethical tensions and socioeconomic barriers impeding equitable adoption.

Methods: A comprehensive synthesis of peer-reviewed literature published between 2020 and 2026 was conducted, focusing on the biomechanical tracking of falls, longitudinal monitoring of Activities of Daily Living (ADLs), dynamic consent, privacy concerns, and digital health equity.

Results: Clinical evidence indicates AAL networks effectively identify early digital biomarkers of cognitive and physiological decline, mitigating injurious falls and reducing 30-day hospital readmissions. However, continuous domestic surveillance introduces significant ethical dilemmas concerning patient autonomy and the medicalization of the home environment. Furthermore, formidable financial constraints, algorithmic bias, and inadequate broadband infrastructure restrict AAL adoption to affluent demographics, exacerbating systemic health disparities.

Conclusions: While AAL technologies present substantial clinical utility for proactive geriatric care, their unchecked commercial deployment risks institutionalizing diagnostic inequalities. Equitable implementation requires formal public health subsidization, equity-by-design algorithmic training, and rigorous bioethical frameworks to balance clinical beneficence with patient privacy.

References

Vollmer Dahlke, D., Lee, S., Smith, M. L., Shubert, T., Popovich, S., & Ory, M. G. (2021). Attitudes toward technology and use of fall alert wearables in caregiving: Survey study. JMIR Aging, 4(1), e23381. https://doi.org/10.2196/23381

Turjamaa, R., Pehkonen, A., & Kangasniemi, M. (2019). How smart homes are used to support older people: An integrative review. International Journal of Older People Nursing, 14(4), e12260. https://doi.org/10.1111/opn.12260

Choi, Y. K., Thompson, H. J., & Demiris, G. (2020). Use of an Internet-of-Things smart home system for healthy aging in older adults in residential settings: Pilot feasibility study. JMIR Aging, 3(2), e21964. https://doi.org/10.2196/21964

Cao, L., Feng, S., Chen, K., Wu, X., & Jia, Y. (2025). An ethical model for smart home-based elder care. Nursing Ethics, 32(6), 1783–1798. https://doi.org/10.1177/09697330241312383

Facchinetti, G., Petrucci, G., Albanesi, B., De Marinis, M. G., & Piredda, M. (2023). Can smart home technologies help older adults manage their chronic condition? A systematic literature review. International Journal of Environmental Research and Public Health, 20(2), 1205. https://doi.org/10.3390/ijerph20021205

Jovanovic, M., Mitrov, G., Zdravevski, E., Lameski, P., Colantonio, S., Kampel, M., Tellioglu, H., & Florez-Revuelta, F. (2022). Ambient assisted living: Scoping review of artificial intelligence models, domains, technology, and concerns. Journal of Medical Internet Research, 24(11), e36553. https://doi.org/10.2196/36553

Flor-Unda, O., Arcos-Reina, R., Estrella-Caicedo, C., Toapanta, C., Villao, F., Palacios-Cabrera, H., Nunez-Nagy, S., & Alarcos, B. (2025). A comparative overview of technological advances in fall detection systems for elderly people. Sensors, 25(24), 7423. https://doi.org/10.3390/s25247423

Jalali, N., Sahu, K. S., Oetomo, A., & Morita, P. P. (2020). Understanding user behavior through the use of unsupervised anomaly detection: Proof of concept using Internet of Things smart home thermostat data for improving public health surveillance. JMIR mHealth and uHealth, 8(11), e21209. https://doi.org/10.2196/21209

Grammatikopoulou, M., Lazarou, I., Alepopoulos, V., Mpaltadoros, L., Oikonomou, V. P., Stavropoulos, T. G., Nikolopoulos, S., Kompatsiaris, I., & Tsolaki, M. (2024). Assessing the cognitive decline of people in the spectrum of AD by monitoring their activities of daily living in an IoT-enabled smart home environment: A cross-sectional pilot study. Frontiers in Aging Neuroscience, 16, 1375131. https://doi.org/10.3389/fnagi.2024.1375131

Majumder, S., Aghayi, E., Noferesti, M., Memarzadeh-Tehran, H., Mondal, T., Pang, Z., & Deen, M. J. (2017). Smart homes for elderly healthcare-recent advances and research challenges. Sensors, 17(11), 2496. https://doi.org/10.3390/s17112496

Hine, C., Nilforooshan, R., & Barnaghi, P. (2022). Ethical considerations in design and implementation of home-based smart care for dementia. Nursing Ethics, 29(4), 1035–1046. https://doi.org/10.1177/09697330211062980

Chimamiwa, G., Giaretta, A., Alirezaie, M., Pecora, F., & Loutfi, A. (2022). Are smart homes adequate for older adults with dementia? Sensors, 22(11), 4254. https://doi.org/10.3390/s22114254

Schoenfeld, E. R., Trimboli, T., Schwartz, K., Ayisi-Boahene, G., Bruckenthal, P., Zadok, E., Horwitz, S., & Ye, F. (2025). Engaging older adults to guide the development of passive home health monitoring to support aging in place. Sensors, 25(24), 7413. https://doi.org/10.3390/s25247413

Wilkowska, W., Offermann, J., Spinsante, S., Poli, A., & Ziefle, M. (2022). Analyzing technology acceptance and perception of privacy in ambient assisted living for using sensor-based technologies. PLOS ONE, 17(7), e0269642. https://doi.org/10.1371/journal.pone.0269642

Tian, Y. J. A., Duong, V., Buhr, E., Felber, N. A., Schwab, D. R., & Wangmo, T. (2025). Monitored and cared for at home? Privacy concerns when using smart home health technologies to care for older persons. AJOB Empirical Bioethics, 16(2), 61–76. https://doi.org/10.1080/23294515.2024.2416121

Seifert, A., Cotten, S. R., & Xie, B. (2021). A double burden of exclusion? Digital and social exclusion of older adults in times of COVID-19. The Journals of Gerontology: Series B, Psychological Sciences and Social Sciences, 76(3), e99–e103. https://doi.org/10.1093/geronb/gbaa098

Rodriguez, J. A., Clark, C. R., & Bates, D. W. (2020). Digital health equity as a necessity in the 21st Century Cures Act era. JAMA, 323(23), 2381–2382. https://doi.org/10.1001/jama.2020.7858

Sieck, C. J., Sheon, A., Ancker, J. S., Castek, J., Callahan, B., & Siefer, A. (2021). Digital inclusion as a social determinant of health. NPJ Digital Medicine, 4(1), 52. https://doi.org/10.1038/s41746-021-00413-8

Norori, N., Hu, Q., Aellen, F. M., Faraci, F. D., & Tzovara, A. (2021). Addressing bias in big data and AI for health care: A call for open science. Patterns (New York, N.Y.), 2(10), 100347. https://doi.org/10.1016/j.patter.2021.100347

Cirillo, D., Catuara-Solarz, S., Morey, C., Guney, E., Subirats, L., Mellino, S., Gigante, A., Valencia, A., Rementeria, M. J., Chadha, A. S., & Mavridis, N. (2020). Sex and gender differences and biases in artificial intelligence for biomedicine and healthcare. NPJ Digital Medicine, 3, 81. https://doi.org/10.1038/s41746-020-0288-5

Masterson Creber, R., Dodson, J. A., Bidwell, J., Breathett, K., Lyles, C., Harmon Still, C., Ooi, S. Y., Yancy, C., Kitsiou, S., & American Heart Association Cardiovascular Disease in Older Populations Committee of the Council on Clinical Cardiology and the Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; and Council on Peripheral Vascular Disease (2023). Telehealth and health equity in older adults with heart failure: A scientific statement from the American Heart Association. Circulation: Cardiovascular Quality and Outcomes, 16(11), e000123. https://doi.org/10.1161/HCQ.0000000000000123

Chadwick, H., Laverty, L., Finnigan, R., Elias, R., Farrington, K., Caskey, F. J., & van der Veer, S. N. (2024). Engagement with digital health technologies among older people living in socially deprived areas: Qualitative study of influencing factors. JMIR Formative Research, 8, e60483. https://doi.org/10.2196/60483

Khan, S., Webster, S., Puxty, J., & Robertson, M. (2026). Key challenges and barriers to digital literacy for older adults: Scoping review. JMIR Aging, 9, e80647. https://doi.org/10.2196/80647

Elechi, U., Orobator, E. T., Udoh, K., Ngozi, E. O., Uzoma, C. A. E., Forson, K. A. A. M., Akanbi, O. O., & Tarawallie, M. A. (2025). Artificial intelligence in healthcare: A narrative review of recent clinical applications, implementation strategies, and challenges. Journal of Healthcare Leadership, 17, 863–876. https://doi.org/10.2147/JHL.S553748

Downloads

Published

2026-09-10

How to Cite

Kantor, A., Raputa, K., Gościński, J., Kupiec, A., Kus, B., Tutaj, M., Kania, I., Rybicki, W., Godyń, M., & Pietrasz, M. (2026). SMART HOME SENSORS FOR AMBIENT ASSISTED LIVING IN THE GERIATRIC POPULATION: CLINICAL EFFICACY, ETHICAL CONSIDERATIONS, AND SOCIOECONOMIC DISPARITIES. International Journal of Innovative Technologies in Social Science, 3(3(51). https://doi.org/10.31435/ijitss.3(51).2026.6512

Most read articles by the same author(s)