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Volume 13
Issue 17
10.3390/healthcare13172253
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Systematic Review

Remote Virtual Interactive Agents for Older Adults: Exploring Its Science via Network Analysis and Systematic Review

by
Michael Joseph Dino
1,2,*,
Chloe Margalaux Villafuerte
2,
Veronica A. Decker
1,
Janet Lopez
1,
Luis Ezra D. Cruz
3,
Gerald C. Dino
3,
Jenica Ana Rivero
4,
Patrick Tracy Balbin
2,
Eloisa Mallo
5,
Cheryl Briggs
6,
Ladda Thiamwong
1 and
Mona Shattell
1
1
College of Nursing, University of Central Florida, 6825 Lake Nona Blvd, Orlando, FL 32827, USA
2
Research Development and Innovation Center, Our Lady of Fatima University, 120 McArthur Highway, Marulas, Valenzuela 1440, Philippines
3
The Libraries, De La Salle University, 2401 Taft Avenue, Malate, Manila 0922, Philippines
4
School of Nursing, Southern Institute of Technology, 133 Tay Street, Invercargill 9810, New Zealand
5
Natural Science Department, Our Lady of Fatima University, 4176-A, MacArthur Highway, San Fernando 2000, Pampanga, Philippines
6
Nicholson School of Communication and Media, University of Central Florida, 2405 Aquarius Agora Dr, Orlando, FL 32816, USA
*
Author to whom correspondence should be addressed.
Healthcare 2025, 13(17), 2253; https://doi.org/10.3390/healthcare13172253
Submission received: 13 August 2025 / Revised: 3 September 2025 / Accepted: 5 September 2025 / Published: 8 September 2025
(This article belongs to the Special Issue Recent Advances and Innovation in Telehealth Use Among Older Adults)
Versions Notes

Abstract

Background: The global rise in the aging population presents significant challenges to healthcare systems, especially with increasing rates of chronic illnesses, mental health issues, and functional decline among older adults. In response, holistic and tech-driven approaches, such as telehealth and remote virtual interactive agents (VIAs), are potential emerging solutions to support the physical, cognitive, and emotional well-being of older adults. VIAs are multimodal digital tools that provide interactive and immersive experiences to users. Despite its promise, gaps still exist in the insights that explore ways of delivering geriatric healthcare remotely. Objective: This systematic review examines the existing literature on remote virtual interventions for older adults, focusing on bibliometrics, study purposes, outcomes, and network analysis of studies extracted from major databases using selected keywords and managed using the Covidence application. Methods and Results: Following five stages, namely, problem identification, a literature search, data evaluation, data analysis, and presentation, the review found that the studies on remote VIAs for older adults (2013–2025) were mostly from a positivist perspective, multi-authored, and U.S.-led, mainly showing positive outcomes for most studies (n = 13/15) conducted in home settings with healthy older participants. The dominance of positivist, US-led studies reflect an epistemological stance that emphasizes objectivity, quantification, and generalizability. VIAs, often pre-programmed and internet-based, supported health promotion and utilized visual humanoid avatars on personal devices. Keyword and network analysis additionally revealed four themes resulting from the review: Health and Clinical, Holistic and Cognitive, Home and Caring, and Hybrid and Connection. Conclusion: The review provides innovative insights and illustrations that may serve as a foundation for future research on VIAs and remote healthcare delivery for older adults.
Keywords: virtual interactive agents; avatar; remote care; telehealth; older adults; systematic review; network analysis virtual interactive agents; avatar; remote care; telehealth; older adults; systematic review; network analysis

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MDPI and ACS Style

Dino, M.J.; Villafuerte, C.M.; Decker, V.A.; Lopez, J.; Cruz, L.E.D.; Dino, G.C.; Rivero, J.A.; Balbin, P.T.; Mallo, E.; Briggs, C.; et al. Remote Virtual Interactive Agents for Older Adults: Exploring Its Science via Network Analysis and Systematic Review. Healthcare 2025, 13, 2253. https://doi.org/10.3390/healthcare13172253

AMA Style

Dino MJ, Villafuerte CM, Decker VA, Lopez J, Cruz LED, Dino GC, Rivero JA, Balbin PT, Mallo E, Briggs C, et al. Remote Virtual Interactive Agents for Older Adults: Exploring Its Science via Network Analysis and Systematic Review. Healthcare. 2025; 13(17):2253. https://doi.org/10.3390/healthcare13172253

Chicago/Turabian Style

Dino, Michael Joseph, Chloe Margalaux Villafuerte, Veronica A. Decker, Janet Lopez, Luis Ezra D. Cruz, Gerald C. Dino, Jenica Ana Rivero, Patrick Tracy Balbin, Eloisa Mallo, Cheryl Briggs, and et al. 2025. "Remote Virtual Interactive Agents for Older Adults: Exploring Its Science via Network Analysis and Systematic Review" Healthcare 13, no. 17: 2253. https://doi.org/10.3390/healthcare13172253

APA Style

Dino, M. J., Villafuerte, C. M., Decker, V. A., Lopez, J., Cruz, L. E. D., Dino, G. C., Rivero, J. A., Balbin, P. T., Mallo, E., Briggs, C., Thiamwong, L., & Shattell, M. (2025). Remote Virtual Interactive Agents for Older Adults: Exploring Its Science via Network Analysis and Systematic Review. Healthcare, 13(17), 2253. https://doi.org/10.3390/healthcare13172253

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