Australia’s Royal Commission into Aged Care found a broken system. Now, technology companies are promising artificial intelligence (AI) will fix everything, from staff shortages to older people’s loneliness.

This is known as agetech, an industry projected to reach a global value of A$170 billion by 2030. But its promised “fixes” obscure what is actually breaking aged care.

In our new study, we analysed how 33 agetech companies selling AI for aged care in Australia, East Asia, Europe and North America market their products, including monitoring tools and companion robots.

We found their websites, promotional materials and product descriptions depict aged care as inefficient, understaffed and overwhelmed by a growing ageing population. Older people are too frail or too many. Care workers are overstretched. Human care is flawed.

And AI is presented as the answer. As the agetech industry grows, governments are also subscribing to this vision of technological rescue.

Yet our research shows these narratives distract from structural problems and reinforce ageism, even as Australia’s new Aged Care Act commits to a stronger focus on dignity and autonomy.

Before we accept AI as the cure, we need to understand what we are being sold.

The cure on offer

The companies we studied claim AI will predict falls before they happen, detect health changes humans miss, eliminate incompetence, and deliver “unprecedented” improvements in safety and quality.

It sounds revolutionary. But it is also a carefully constructed narrative. In the marketing materials, aged care is consistently framed as a failure of efficiency and public delivery.

Promotional images show older people sitting passively, struggling with mobility aids, or being reduced to body parts attached to monitoring devices. They are represented through statistics: fall rates, malnutrition prevalence, hospitalisation risk.

According to the companies, older people are incidents waiting to happen and data sources to be mined. One company promises to transform intimate daily activities such as showering into “trackable metrics” for “optimal care”.

Care workers fare no better. Their labour is “time-consuming” and “error-prone”. With AI as the solution, care workers become the problem: well-meaning but unreliable, requiring technological oversight. Several companies market systems that track staff movements and automatically report delays to managers.

The rise of techno-solutionism

Agetech companies selling their wares paint the aged care sector as fundamentally broken, plagued by rising costs and inefficiencies.

By contrast, AI systems – featuring 24/7 monitoring, predictive analytics and automated alerts – are presented as objective and inherently superior.

This narrative reflects techno-solutionism: presenting social problems in ways that make technical fixes appear inevitable.

But AI is far from neutral. Models used to train AI are frequently based on datasets that exclude older people or overrepresent younger and healthier groups. Both AI design and implementation rely on stereotypical ideas of older people as technophobic and passive.

AI is not the salvation

The aged care crisis stems from decades of social and political choices about how we value care and ageing. The royal commission documented this in detail: systemic neglect, regulatory failures, a funding model that incentivises cost-cutting over quality, and pervasive societal ageism.

AI solutionism frames the crisis as technical rather than social or political, burying the fact that broader reforms are needed.

AI systems are said to eliminate work. But they require substantial human labour to function and can create as much work as they remove.

Care staff must learn new systems, interpret data, and respond to constant notifications and false alarms. They suddenly have to oversee technologies that need ongoing calibration and maintenance.

Studies show this increases worker stress, as staff juggle care responsibilities with tech troubleshooting – all with limited training and time. Much of this labour remains invisible.

Alongside this, the relational aspects of care – noticing subtle changes in mood, building trust over time – get marginalised because they can’t be easily measured or automated.

Older people suffer the consequences. When care is organised around efficiency metrics and cost reduction, residents become problems to be managed rather than people with diverse histories, preferences and needs.

No single tech will fix this

Aged care faces serious challenges. It does need repair – but the fixes must take many forms, most of which have nothing to do with AI.

These include staff ratios that allow proper time for meaningful conversations, helping residents feel less lonely. Wages that reflect the value and complexity of care work. Funding models that prioritise dignity, agency and authentic participation in decisions about care.

Regulatory frameworks must hold providers accountable for quality of life, wellbeing and inclusion, not just compliance metrics. Aged care should also include community-based models that keep older people connected to neighbourhoods.

The best role AI can play is through supporting care practices that include and empower older people and staff, centring their voices and experiences.

If we let AI companies define what is broken, we also let them define what repair looks like. That may leave our systems more profitable, but far less caring and humane.

The authors acknowledge Naseem Ahmadpour, Alex Broom and Kalervo Gulson from the University of Sydney for their contributions to the research project.

Barbara Barbosa Neves, Senior Horizon Fellow, AI and Ageing, University of Sydney; Alexandra Sanders, Sociology Research Assistant, University of Sydney; Monash University, and Geoffrey Mead, Research Fellow, Faculty of Arts and Social Sciences, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

People with hip and knee osteoarthritis are advised to wear “appropriate footwear” to minimise their pain.

Does that mean heels are out? Does it matter if you wear runners or something a little stiffer? How about using insoles?

Our research, including our latest clinical trial published today in Annals of Internal Medicine, provides some answers.

We show that stable, more supportive shoes aren’t necessarily the best option, despite what you might have heard.

What is osteoarthritis?

Osteoarthritis is a condition that affects the tissues in and around a joint, including bone, cartilage, ligaments and muscles. It is more common in older people, and people with excess body weight. It causes joint pain and stiffness, and can lead to disability.

About 2.35 million Australians have osteoarthritis and this number is predicted to increase as the population ages and obesity rates rise.

Osteoarthritis commonly affects the hip and knee joints, making it difficult to walk. There is no cure, so self-management is important.

That includes wearing the right type of shoes.

How can shoes affect symptoms?

There are many causes of osteoarthritis, but excessive force inside the joint when someone is walking is thought to play a role. Excessive joint forces can also increase the chance of osteoarthritis worsening over time.

Shoes are our connection to the ground and can influence how forces are transmitted up the leg during every step. Some shoe features are particularly important.

Shoes with higher heels increase joint forces. For example, shoes with six-centimetre heels increase knee forces by an average 23% compared to walking barefoot.

Some shoes come with supportive features, such as insoles that support the arches. Other supportive features include being made with a stiffer material in the sole or heel.

Many people, and clinicians, think these stable and supportive shoe features are best for people with osteoarthritis.

But biomechanical research shows shoes with these supportive features actually increase knee force by up to 15% compared to shoes without them. Arch-supporting insoles also increase knee force by up to 6% when added to shoes.

So, are flatter, flexible shoes without stable supportive features – such as ballet flats – better for knee and hip osteoarthritis?

Not necessarily. We also need to look at people’s pain.

What we found

Our biomechanical research from 2017 in people with knee osteoarthritis showed flat flexible shoes reduced knee forces by an average 9% compared to stable supportive shoe styles.

This suggests flat flexible shoes could be better for osteoarthritis. To find out, we conducted two clinical trials to look at people’s pain levels.

Our new clinical trial involved 120 people with hip osteoarthritis.

They were randomised to wear different types of flat flexible shoes, such as flexible ballet flats, or different types of stable supportive shoes, such as supportive runners. People were asked to wear their shoes for at least six hours a day. After six months we measured the change in hip pain when they walked.

We found flat flexible shoes were no better than stable supportive shoes for reducing hip pain.

These findings differ to those from our 2021 clinical trial in 164 people with knee osteoarthritis. In that trial, we found wearing stable supportive shoes for six months reduced knee pain when walking by an average 63% more than wearing flat flexible shoes.

It’s unclear why findings differed between the knee and hip. But it might be because joint forces are higher in knee compared to hip osteoarthritis, and so there may be greater potential for stable supportive shoes to reduce knee forces, and therefore knee pain.

In both trials, more complications, such as foot pain, were reported by people who wore flat flexible shoes. This might be because these shoe styles provide less protection for the feet.

So which shoes should I wear?

For people with knee osteoarthritis, stable supportive shoes are likely to be more beneficial than flat flexible ones.

For people with hip osteoarthritis, neither shoe type is better than the other for improving hip pain.

But for all older people – including those with hip and knee osteoarthritis – it is sensible to avoid ill-fitting shoes, as well as shoes with high or narrow heels, due to an increased risk of falls.

For younger people with knee or hip osteoarthritis but who are not at risk of falls, it may still be advisable to avoid high heels given their potential to increase joint forces.

Who should you talk to?

If you are concerned about your hip or knee osteoarthritis, talk to your GP or other health-care provider, such as a podiatrist or physiotherapist.

Other non-surgical treatments, such as exercise, weight management, nutrition and some pain medicines can help.

Kade Paterson, Associate Professor of Musculoskeletal Health, The University of Melbourne and Rana Hinman, Professor in Physiotherapy, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Half of people in the UK use a wearable device, such as a fitness tracker or smartwatch. These devices collect data relating to health and physical activity levels – including heart rate, step count and sleep quality. With the emergence of AI, such devices will probably become even more sophisticated – potentially able to diagnose our health problems before our GP.

But while wearables can be really useful when it comes to understanding many aspects of your heart health, they still have many shortcomings – so it’s important not to rely on them for everything.

A key strength of modern wearables is the fact that they record such a wide range of useful data, and track trends over time. This makes them perfect for measuring whether any lifestyle changes you’ve made are working for you, and what effects they might be having. For instance, your wearable can tell you if your health kick has had a measurable affect on your sleep quality or blood pressure.

In addition to measuring step count and physical activity, many of the most commonly worn wearables collect cardiovascular data via photoplethysmography (PPG). This is where a light located at the back of the wearable interacts with tiny blood vessels in the skin to give an estimate of changes in blood volume. These changes can be used to accurately measure heart rate, rhythm and blood oxygen levels.

Many currently available devices are also able to record electrocardiographic (ECG) data. This also records your heart’s electric activity, including heart rate and rhythm.

This is why some wearables, particularly those with ECG technology, could be useful in cardiology consultations.

There are currently limitations to the ECGs a cardiologist would normally use to diagnose heart rhythm issues. These ECG monitors only record heart rhythm data for a limited period, such as 24 or 72 hours. This could mean doctors don’t get a full picture of heart health.

But since many people who own a smartwatch or fitness tracker wear them for many hours of the day and over many weeks, this means their wearable may be recording at the time when cardiac symptoms – such as palpitations – occur. This means wearables may overcome the inherent limitations with clinical ECG recordings.

For instance, a recent study demonstrated that smartwatches can reliably detect atrial fibrillation (a heart rhythm disorder that increases risk of stroke) in patients at risk of the condition. And wearables can also be useful for regularly and accurately monitoring daytime blood pressure.

So, wearables have the ability to provide data that is highly useful to a cardiologist in helping determine a probable diagnosis. But just how much can we rely on this data?

Wearable limitations

Most wearables that detect blood pressure do so via PPG data, which measures blood pressure differently to an inflatable blood pressure cuff. Wearables may also only provide a blood pressure range rather than absolute results. This means a patient may not know whether their “true” blood pressure is normal or not.

The British and Irish Hypertension Society, which formally validates and endorses cuff-based blood pressure monitors, currently doesn’t have a framework to validate wearables. This means no wearables on the market which provide blood pressure monitoring have been officially validated.

There’s also a lack of standardisation across the market for how different wearables produce data for particular metrics. This means it’s possible different devices could give different readouts – even if they’re looking at the same person. If wearables are to be integrated into the healthcare system in future, then standardised, validated methods would be needed.

There are also potential issues in how wearables are positioned within the market with regard their medical capabilities.

Some are advertised as having medical-grade measuring capabilities. However, the majority of devices on the market have not been approved as medical devices by regulatory bodies. This distinction is important for the average consumer to understand, so they don’t trust the device’s data more than they should.

While wearables can be extremely useful for understanding many aspects of your day-to-day heart health, there’s still much about them that will need to be improved before they become a standard part of cardiac care.

Quality assurance and compatibility across different brands will be key, as will ensuring a patient’s data is both reliable and accessible to healthcare staff on their electronic health records.

These are important issues that must be addressed soon if wearable technology is to become a standard part of NHS treatment by 2035, as outlined in the NHS’s ten-year plan for England.

Kevin O'Gallagher, MRC Clinician Scientist and Consultant Cardiologist, King's College London

This article is republished from The Conversation under a Creative Commons license. Read the original article.