New Horizons in artificial intelligence in the healthcare of older people

Abstract

Artificial intelligence (AI) in healthcare describes algorithm-based computational techniques which manage and analyse large datasets to make inferences and predictions. There are many potential applications of AI in the care of older people, from clinical decision support systems that can support identification of delirium from clinical records to wearable devices that can predict the risk of a fall. We held four meetings of older people, clinicians and AI researchers. Three priority areas were identified for AI application in the care of older people. These included: monitoring and early diagnosis of disease, stratified care and care coordination between healthcare providers. However, the meetings also highlighted concerns that AI may exacerbate health inequity for older people through bias within AI models, lack of external validation amongst older people, infringements on privacy and autonomy, insufficient transparency of AI models and lack of safeguarding for errors. Creating effective interventions for older people requires a person-centred approach to account for the needs of older people, as well as sufficient clinical and technological governance to meet standards of generalisability, transparency and effectiveness. Education of clinicians and patients is also needed to ensure appropriate use of AI technologies, with investment in technological infrastructure required to ensure equity of access.

Keywords: ageing; artificial intelligence; health; older people; technology.

Figure 1

An explanation of machine learning, deep learning and neural networks, drawing on explanations provided by Sidey-Gibbons and Sidey Gibbons [2].

Figure 2

A summary of emerging applications of AI in healthcare, with examples of their use in the care of older people [5, 10–15].

Figure 3

A summary of key findings from discussions with PPI group members regarding the areas of potential for AI in the care of older people.

Figure 4

The life cycle of an AI tool and the questions that should be considered at each stage to ensure that older peoples’ values are accounted for.

Figure 5

A summary of the key findings from discussions with our PPI group regarding their concerns about the use of AI in their healthcare.