Editorial: Assistive technologies in aging and disability

Population ageing is driving the reorientation of health and social care systems globally [1], intensifying the demand for assistive technologies (AT) and access to digital health tools that can support independence, participation, and well-being [2,3]. While this research topic focuses primarily on older adults, the contributions represent a broader spectrum: access to assistive technology throughout the life course is part of equitable access to healthy and active lifestyles, and dignified ageing for all [4][5][6]. Without consideration for systemic inequities in accessing AT, emerging evidence and innovations related to AT risk amplifying these disparities rather than alleviating them [4,5,[7][8][9][10][11][12]. This special edition brings together a diverse collection of articles reflecting a wide range of populations for whom ageing and AT are urgent priorities. Common topics of representation and equity, digital literacy, smart systems, and privacy, explored within data collection and research design that are both user-centred and psychosocially-informed, unify these 15 studies.A central need in disability-inclusive ageing research is the capacity to distinguish between the unique experiences of ageing with a disability, compared to acquiring disability as a result of the ageing process. Improving the representation of both experiences in data and evidence enables more appropriate policy and innovation advancements in AT that address different support needs and structural barriers. Three contributions indicate that failure to attend to these differences can lead to inequitable outcomes in social participation, healthcare access, and the widening of digital exclusion [4,7,11]. As global population longevity accelerates ageing, addressing these socio-demographic differences in research settings is critical to avoiding exclusionary practices downstream, such as the generation of inappropriate health guidance or unusable AT [4,8].Digital health literacy and the widening digital divide appear across this topic as critical determinants of whether innovations translate into improved outcomes [7,10,11,13]. Studies consistently report low levels of digital health literacy among older adults, particularly those with chronic health conditions or disabilities, shaped by personal, economic, social, and environmental factors [7,9], such as inequitable access to broadband and digital devices [7]. Without deliberate efforts to improve accessibility, usability, and support, digital health risks reinforce a type of "data poverty," wherein older adults and people with disabilities remain underrepresented in research and emerging data and become locked out of benefitting from subsequent advances in policies and technical innovation [5,9]. These concerns are powerfully illustrated by a case study on inaccessible COVID-19 home tests, which revealed substantial gaps in resources for accessible product development during a public health emergency [8]. While the initiative successfully improved test accessibility, it also generated expert networks, documented best practices, and validated a framework for future accessibility-focused innovation, demonstrating how equity-oriented approaches can yield lasting benefits beyond crisis response [8].Equity considerations extend beyond health and AT into legal, social, and occupational domains. One contribution examines the role of AT in fulfilling disability justice as a fundamental human right, outlining its importance at the population-and individual-level for operationalising Article 13 of the UN Convention on the Rights of Persons with Disabilities [4]. A multi-country study further analysed how gender and national development context intersect to shape access to assistive products, highlighting the need for intersectional data collection and equity-driven approaches to policymaking [5].Rapid advances in digital, Artificial Intelligence (AI)-enabled, and sensor-based technologies introduce opportunities as well as risks. Smart systems promise scalable solutions to workforce shortages in long-term care by alleviating some caregiving tasks [4,14,15]. However, their success depends on aligning with real-world needs and earning trust from users. Across this topic, authors emphasise that technical innovation must not outpace users' willingness or ability to engage, and that specific design considerations are needed for populations with low digital literacy or limited access to technology [7,[9][10][11]. In this sector, ambient data collection and continuous monitoring systems are emerging as useful tools for primary users, caregivers, and researchers, yet privacy concerns with such systems remain a key barrier to scaleup. For example, research applying the World Health Organization's Intrinsic Capacity framework shows how wearable motion sensors can capture locomotion, vitality, cognition, and psychological and sensory dimensions of functional ability, offering potential for early detection, anomaly identification, and personalised intervention [16]. Similarly, reviews of sensor-based applications to enhance independence in daily life illustrate a progression from fall detection to predictive modelling and preventative care, as well as personalised interventions that are increasingly capable of meaningfully engaging with the social and emotional dimensions of ageing, in addition to the physical and cognitive dimensions [12]. While predictive and personalised capabilities are valuable for proactive planning and reducing reliance on intensive medical services, authors also caution that the use of AI in monitoring raises ethical and privacy concerns among users that must be carefully addressed, especially in shared or multi-resident environments [12]. These approaches also raise critical questions about how data are collected, governed, and protected, particularly among vulnerable older adults with limited digital literacy and capacity to provide informed consent [6,16]. Broader analyses of smart elderly care services, including a review of developments in China, similarly highlight applications in monitoring, smart homes, emotional companionship, and medical services, while emphasising the need to simplify interfaces and strengthen data privacy to ensure sustainable implementation [14].User-centred design processes that foreground a meaningful understanding of user needs are foundational to this topic. They exemplify a method of building trust and aligning priorities between designers and users. One contribution applies the double-diamond model (discover, define, develop, and deliver) to the design of mobility scooters for older adults, demonstrating how structured innovation frameworks can improve design efficiency while remaining responsive to dynamic needs, such as those related to ageing societies [17]. Research in telehealth also touches on the importance of trust and the role of co-design, where users are active participants in the design process. Research from Saudi Arabia found that fear or dislike of technology was a major barrier to telehealth use among older adults, highlighting the need for user-friendly designs and trust-building to increase adoption [10]. One contribution from the United Kingdom similarly reports mixed experiences among people with disabilities, with benefits including improved accessibility, but persistent barriers related to connectivity, device access, and some disability-specific challenges, particularly for users with sensory impairments [11]. These studies agree that telehealth should complement, rather than replace, face-to-face care through hybrid models and should be co-designed with users with unique needs [10,11].Emerging AT are frequently piloted in the context of physical functioning and rehabilitation, with research illustrating the complexity of translating new innovations into meaningful outcomes. Engaging with psychosocial dimensions of well-being, as emphasised across this topic [6,7,[9][10][11][12]14,16,18], is a critical component to design efficacy that has historically been underrepresented in design research. One contribution examining virtual reality-based rehabilitation for stroke survivors shows that adoption is shaped as much by emotional, motivational, and social factors as by technical performance [18]. A qualitative study examining companion robots in dementia care demonstrates how technology can relieve some caregiving tasks, provided caregivers are empowered to use it effectively [15]. Instead of replacing human care, robot-assisted sessions fostered stimulation, engagement, reciprocity, and shared emotional experiences, supporting a person-centred approach for people living with mild cognitive impairment and dementia [15]. Another contribution demonstrates how transformational leadership strategies enable better integration of AT in workplaces and, as a result, foster self-confidence and self-efficacy among AT users, as measured by individual well-being and a sense of inclusion rather than a sole focus on productivity [6]. Taken together, these findings characterise AT not as standalone tools, but as interventions embedded within broader social and care ecosystems, and further emphasise the utility of a holistic understanding of AT: one that integrates emotional and psychological well-being, social context, individual preferences, and structural constraints as core determinants of adoption and impact [7,13,15,18].This editorial concludes the research topic by emphasising that innovation in assistive technology for ageing and disability must advance within a framework that upholds representation, equity, privacy and inclusive design practices. Factoring emotional and social dimensions into AT research and development is critical to effectively expanding AT access and adoption. The contributions presented here offer not only technological and population insights but also guidance on research design to better support equitable access to AT amid increasing global demand.