AI may miss the mark for older adults

28 August 2026

Health and medicine, Sustainable impact, Faculty of Medical and Health Sciences, Doctoral

Nearly 76 percent of artificial intelligence tools developed to assess and manage pain in older adults are still at the proof-of-concept stage, a new study has found.

Older people risk being overlooked as AI-powered healthcare tools become more common, says lead author Rhoda Ilenwabor, a PhD candidate at Waipapa Taumata Rau, University of Auckland.

The study reviewed the global use of AI in pain assessment and management. AI can analyse facial expressions to help identify pain in people who cannot easily communicate their symptoms, including those living with dementia or recovering from a stroke. Automated facial analysis and machine learning can also help track symptoms and tailor treatment.

While research in the field is expanding rapidly, few tools are ready for routine use and many have not been developed specifically for older adults, Ilenwabor says.

The study involved a review of existing research, bringing together evidence from 96 previously published studies on AI and pain care for older adults. While nearly 76 percent of AI tools reviewed were still in the early stages of development, only 5.5 percent were considered ready for integration into clinical practice.

None of the studies reviewed had been conducted in New Zealand.

Most systems used machine learning, a type of AI, to identify and predict pain using information such as facial expressions, voice, images, video and other characteristics.

Pain in older adults is often invisible, can be difficult to recognise, and is not always adequately assessed or treated.

PhD candidate Rhoda Ilenwabor Waipapa Taumata Rau, University of Auckland.

"AI may eventually help, but only if these tools are developed and tested with older adults, not simply adapted for them later."

Two-thirds of the studies reviewed included mixed-age populations rather than focusing specifically on older adults, raising concerns about how well the tools would work for the group most likely to experience chronic pain.

The findings also raise questions about whether AI tools developed overseas would perform equally well for New Zealand's diverse population, including Māori and Pacific communities.

The review highlights a growing disconnect between the rapid development of AI tools for pain assessment and management and the number ready for use in
healthcare settings.

PhD candidate Rhoda Ilenwabor Waipapa Taumata Rau, University of Auckland.

Ilenwabor says AI should complement, rather than replace, healthcare professionals.

"AI can support pain care for older adults, but it is not there to replace clinical judgement. These tools need to be clinically validated, equitable and developed with older adults from the beginning."

The research recommends involving older people and healthcare professionals in developing and testing AI tools before they are introduced into routine care.

Ilenwabor's next study will explore whether New Zealand healthcare professionals see a role for AI in assessing and managing pain in older people.

The paper, 'Artificial intelligence in pain assessment and management for older adults: A scoping review', was co-authored by School of Pharmacy Associate Professor Mohammed Mohammed and Professor Nataly Martini.

• Read the study
  

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