Digital Learning Assistant Using Artificial Intelligence for Elderly Health Literacy: A Systematic Review
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Abstract
This review focuses on the use of digital learning assistants (DLAs) powered by Artificial Intelligence (AI) in supporting health literacy of older adults. The objectives of this review are to examine the characteristics of existing studies, identify the types of AI-based DLAs and design approaches employed, and synthesize reported outcomes related to health literacy and self-care among older adults. Following the PRISMA 2020 guidelines, 17 studies published between 2011 and 2025 were retrieved from six databases and reviewed. The interventions studied included chatbots, virtual coaches, conversational agents, voice assistants, and integrated systems. Overall, the tools enhanced functional health literacy, self-care, health provider communication, and psychosocial outcomes such as loneliness and stress relief. The most successful initiatives applied geragogy principles, culturally and linguistically tailored approaches, and co-design strategies to strengthen trust and enhance usability. Remaining challenges include low digital literacy levels in older adults, brief program length, scalability, and persistent ethical issues of privacy and misinformation. DLAs powered by AI can meaningfully contribute to diminishing health literacy gaps in the aging population. Integrating these tools with primary health care, community health centers, and educational programs for older adults is a practical suggestion. Future studies should focus on randomized controlled trials, longitudinal studies, cross-cultural research, and meaningful engagement of older adults in participatory design. The evidence presented showcases the potential of designed DLAs to promote equitable and informed aging.
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