Vision impairment (VI) and mental health conditions are 2 important drivers of the global burden of chronic disease in elderly persons.^1,2 Although these conditions are often treatable, they may also result in disability and decreased quality of life.^3,4 Prior studies have attempted to show an association between VI and mental health, and there is evidence that the prevalence of depression is higher in those with vision loss.⁵

Background: Chatbots have become ubiquitous in our daily lives, enabling natural language conversations with users through various modes of communication. Chatbots have the potential to play a significant role in promoting health and well-being. As the number of studies and available products related to chatbots continues to rise, there is a critical need to assess product features to enhance the design of chatbots that effectively promote health and behavioral change. Objective: This scoping review aims to provide a comprehensive assessment of the current state of health-related chatbots, including the chatbots’ characteristics and features, user backgrounds, communication models, relational building capacity, personalization, interaction, responses to suicidal thoughts, and users’ in-app experiences during chatbot use. Through this analysis, we seek to identify gaps in the current research, guide future directions, and enhance the design of health-focused chatbots. Methods: Following the scoping review methodology by Arksey and O'Malley and guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, this study used a two-pronged approach to identify relevant chatbots: (1) searching the iOS and Android App Stores and (2) reviewing scientific literature through a search strategy designed by a librarian. Overall, 36 chatbots were selected based on predefined criteria from both sources. These chatbots were systematically evaluated using a comprehensive framework developed for this study, including chatbot characteristics, user backgrounds, building relational capacity, personalization, interaction models, responses to critical situations, and user experiences. Ten coauthors were responsible for downloading and testing the chatbots, coding their features, and evaluating their performance in simulated conversations. The testing of all chatbot apps was limited to their free-to-use features. Results: This review provides an overview of the diversity of health-related chatbots, encompassing categories such as mental health support, physical activity promotion, and behavior change interventions. Chatbots use text, animations, speech, images, and emojis for communication. The findings highlight variations in conversational capabilities, including empathy, humor, and personalization. Notably, concerns regarding safety, particularly in addressing suicidal thoughts, were evident. Approximately 44% (16/36) of the chatbots effectively addressed suicidal thoughts. User experiences and behavioral outcomes demonstrated the potential of chatbots in health interventions, but evidence remains limited. Conclusions: This scoping review underscores the significance of chatbots in health-related applications and offers insights into their features, functionalities, and user experiences. This study contributes to advancing the understanding of chatbots’ role in digital health interventions, thus paving the way for more effective and user-centric health promotion strategies. This study informs future research directions, emphasizing the need for rigorous randomized control trials, standardized evaluation metrics, and user-centered design to unlock the full potential of chatbots in enhancing health and well-being. Future research should focus on addressing limitations, exploring real-world user experiences, and implementing robust data security and privacy measures.

Objectives: This study examined public discourse and sentiment regarding older adults and COVID-19 on social media and assessed the extent of ageism in public discourse.Methods: Twitter data (N = 82,893) related to both older adults and COVID-19 and dated from January 23 to May 20, 2020, were analyzed. We used a combination of data science methods (including supervised machine learning, topic modeling, and sentiment analysis), qualitative thematic analysis, and conventional statistics.Results: The most common category in the coded tweets was “personal opinions” (66.2%), followed by “informative” (24.7%), “jokes/ridicule” (4.8%), and “personal experiences” (4.3%). The daily average of ageist content was 18%, with the highest of 52.8% on March 11, 2020. Specifically, more than 1 in 10 (11.5%) tweets implied that the life of older adults is less valuable or downplayed the pandemic because it mostly harms older adults. A small proportion (4.6%) explicitly supported the idea of just isolating older adults. Almost three-quarters (72.9%) within “jokes/ridicule” targeted older adults, half of which were “death jokes.” Also, 14 themes were extracted, such as perceptions of lockdown and risk. A bivariate Granger causality test suggested that informative tweets regarding at-risk populations increased the prevalence of tweets that downplayed the pandemic.Discussion: Ageist content in the context of COVID-19 was prevalent on Twitter. Information about COVID-19 on Twitter influenced public perceptions of risk and acceptable ways of controlling the pandemic. Public education on the risk of severe illness is needed to correct misperceptions.

Objective: This study investigated the impact of driving cessation on social isolation in older adults. Method: Data were obtained from Rounds 1 through 6 of the National Health and Aging Trends Study. The study sample consisted of 6,916 Medicare beneficiaries aged 65 or above who were eligible drivers at baseline. Mixed-effects ordered logistic regression and piecewise regression were used to examine the impact of driving cessation on social isolation. Results: In multivariable mixed-effects ordered logistic regression, past-year nondrivers had a twofold increase in the odds of being in a higher social isolation category (odds ratio [OR] = 2.1, p < .001). Piecewise regression analysis showed that social isolation scores increased by 0.08 points (p = .024) following an incident of driving cessation. Discussion: Driving cessation is associated with a higher risk of social isolation in older adults. Interventions to reduce social isolation among older adults may improve public health by targeting older adults who have recently stopped driving.

Background/Objectives: Loneliness among older adults is a prevalent issue, significantly impacting their quality of life and increasing the risk of physical and mental health complications. The application of artificial intelligence (AI) technologies in behavioral interventions offers a promising avenue to overcome challenges in designing and implementing interventions to reduce loneliness by enabling personalized and scalable solutions. This study systematically reviews the AI-enabled interventions in addressing loneliness among older adults, focusing on the effectiveness and underlying technologies used. Methods: A systematic search was conducted across eight electronic databases, including PubMed and Web of Science, for studies published up to 31 January 2024. Inclusion criteria were experimental studies involving AI applications to mitigate loneliness among adults aged 55 and older. Data on participant demographics, intervention characteristics, AI methodologies, and effectiveness outcomes were extracted and synthesized. Results: Nine studies were included, comprising six randomized controlled trials and three pre–post designs. The most frequently implemented AI technologies included speech recognition (n = 6) and emotion recognition and simulation (n = 5). Intervention types varied, with six studies employing social robots, two utilizing personal voice assistants, and one using a digital human facilitator. Six studies reported significant reductions in loneliness, particularly those utilizing social robots, which demonstrated emotional engagement and personalized interactions. Three studies reported non-significant effects, often due to shorter intervention durations or limited interaction frequencies. Conclusions: AI-driven interventions show promise in reducing loneliness among older adults. Future research should focus on long-term, culturally competent solutions that integrate quantitative and qualitative findings to optimize intervention design and scalability.