Digital Innovation in Frailty Prevention: Unlocking Social, Legal and Economic Benefits in Ageing Populations

Contemporary welfare states face critical challenges in sustaining high-quality care amid the “polycrisis,” including population ageing, fiscal constraints, healthcare staff shortages, and economic instability. Traditional care models, which are often reactive and hospital-centric, are becoming increasingly unsustainable. There is a need to validate preventive approaches that use advanced technologies, examining not only their clinical outcomes but also their social and economic implications, including the unintended consequences they may generate.

This Research Topic analyses the potential of digital and data-driven approaches to frailty prevention, including but not limited to Active Assisted Living (AAL) and Ecological Momentary Assessment (EMA). By enabling the detection of subtle, daily changes in health and activity, these technologies offer a means to identify frailty markers early. The collection aims to move beyond technical features and to examine the value proposition of such systems, assessing how early intervention may produce cost savings for public health systems, support compliant data governance, and improve social welfare for older adults and their families, while remaining attentive to the tensions, asymmetries, and unanticipated effects that may also arise.

The goal of this Research Topic is to investigate the evidence base for the benefits of digital frailty monitoring, as well as the social, ethical, and economic tensions it may produce. Potential issues include three thematic strands, but are not limited to:

(1) The Economic Case: Cost-Efficiency and Health Systems Sustainability

- Evidence on how early frailty detection affects hospital admission rates and emergency room visits, including studies reporting null or contested findings.
- Analyses of the economic impact of delaying institutionalization on long-term care public expenditure, including possible cost-shifting onto households and informal carers.
- Studies on the Social Return on Investment (SROI) and cost-effectiveness of AAL and EMA tools in national health systems.
- Resource allocation trade-offs and strategies for increasing system efficiency, including tensions between technological investment and workforce-based care.
- Business models for the sustainable scaling of preventive digital health technologies.

(2) The Social Dividend: Wellbeing, Independence, and Caregiver Support – and Their Limits

- Studies focused on how continuous monitoring supports ageing in place and extends independence, as well as how it may generate new forms of dependency on technological infrastructures and providers.
- Assessments of the psychological and social effects of non-intrusive monitoring, including perceived safety and reduced anxiety, alongside concerns relating to surveillance, autonomy, dignity, and the erosion of privacy in domestic settings.
- The impact of technology in alleviating the burden on informal caregivers and professional staff, as well as its potential to displace human contact or to redistribute care responsibilities along lines of gender, class, and migration status.
- Strategies to prevent the digital divide and ensure fair distribution of health benefits across socioeconomic groups, alongside analyses of how AAL and EMA may inadvertently reinforce existing inequalities.
- The role of digital tools in reducing social isolation and loneliness among older adults, as well as the risk of intensifying stigmatization associated with frailty labelling.
- Sociological and critical perspectives, including those drawing on critical gerontology and science and technology studies, which interrogate the assumptions about ageing, risk, and the user embedded in monitoring technologies.

(3) Policy, Law and Ethics as Enablers of Socioeconomic Benefits

- Comparative studies on reimbursement models and insurance policies that incentivize prevention over cure, including their distributive effects.
- The role of privacy and personal data protection compliance, as well as ethical governance, as prerequisites for system viability and user trust, and as sites of contestation between users, providers, and regulators.
- Co-creation and participatory research involving older adults and caregivers to ensure technologies meet real-world social needs, including critical reflection on the limits of participation and on whose voices are foregrounded or excluded.
- Policy recommendations for integrating digital frailty monitoring into national, regional and local ageing policies, alongside analyses of implementation difficulties and resistance.
- Legal frameworks addressing liability and data ownership in AI-driven care systems.

We welcome papers that provide theoretical insights, policy and legal analyses, and empirical evidence regarding the transition from reactive to preventive care systems. We particularly seek contributions that quantify or critically analyze the outcomes of these interventions across the three thematic strands, encompassing both their anticipated benefits and any negative or unexpected social and economic effects. Submissions reporting null findings, contested implementations, or accounts of non-use and resistance are equally encouraged. We are looking forward to selecting manuscripts demonstrating a wide range of approaches – from health economics and sociology to law and public health – to enhance personalization in social and health services and to strengthen critical understanding of the conditions under which digital frailty monitoring is developed, deployed, and evaluated.

This Research Topic welcomes submissions of the following article types: Brief Research Report, Case Report, Classification, Clinical Trial, Community Case Study, Conceptual Analysis, Data Report, FAIR² Data, General Commentary, Hypothesis and Theory, Methods, Mini Review, Opinion, Original Research, Perspective, Policy Brief, Policy and Practice Reviews, Registered Report, Review, Study Protocol, Systematic Review, and Technology and Code.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Clinical Trial
• Community Case Study
• Conceptual Analysis
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Clinical Trial
• Community Case Study
• Conceptual Analysis
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Policy and Practice Reviews
• Policy Brief
• Registered Report
• Review
• Systematic Review
• Technology and Code

Keywords: Ageing in Place, Active Assisted Living, Ambient Assisted Living, Cost-Effectiveness Analysis, Digital Health Implementation, Ecological Momentary Assessment, Frailty Prevention, Health Economics, Informal Caregivers, Preventive Care, Social Policy

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.