Digital Health Approaches to Geriatric Rehabilitation: A Narrative Paper

Rapid population ageing is widening the gap between geriatric rehabilitation needs and constrained care capacity. Digital health offers new ways to deliver rehabilitation beyond traditional settings, but its role and limitations in geriatric practice remain unclear. To provide a narrative synthesis of how digital health can support geriatric rehabilitation, highlighting advances, challenges, and future directions. We conducted a narrative review of digital health approaches in geriatric rehabilitation, informed by the authors' clinical and technical expertise, synthesizing evidence on telemedicine, mobile health, wearable sensors, exergames, extended-reality platforms, and artificial intelligence (AI)-enabled systems across rehabilitation domains. Digital health interventions can support continuous monitoring, motor and cognitive training (including gamified exercise), behavioral self-management, and remote clinician oversight. Studies in selected older populations show feasibility, safety, and short- to medium-term improvements in mobility, frailty, pain, and cardiorespiratory fitness. However, the evidence base is fragmented, often excludes frail older adults and those with cognitive or multisensory impairment, and frequently focuses on surrogate sensor-derived outcomes, with limited long-term data on independence, falls, or quality of life. Persistent challenges include usability and digital-literacy barriers, the "grey digital divide," limited interoperability and workflow integration, and unresolved issues of data governance, privacy, and algorithmic transparency. Digital health has potential to augment geriatric rehabilitation and support healthy ageing, but its benefits are unlikely to be equitably realized without intentional design and implementation. Priorities include human-centered and co-design approaches, pragmatic trials, integration with rehabilitation workflows, and robust ethical and regulatory frameworks for data-driven and AI-enabled care.