Challenges addressed and technological aspects
Insights from the AAL Legacy study
Challenges addressed
At the heart of the AAL Programme was a commitment to tackling the real-life challenges faced by Europe’s ageing population. Over the years, funded projects consistently responded to a broad and evolving spectrum of societal needs, shaped by shifting user priorities, demographic changes, and advances in technology. Despite their diversity, these needs can be grouped into nine interconnected societal challenges that reflect both the practical and emotional dimensions of ageing.
Below is a short explanation of each challenge in the context of the AAL Programme:
Social isolation & loneliness: promoting meaningful social connection and emotional wellbeing by fostering communication, community engagement, and shared activities—especially for individuals at risk of being cut off from family or society.
Daily living & independence: enabling older adults to carry out everyday tasks safely and with confidence—such as eating, dressing, and navigating their homes—by providing intuitive technologies that adapt to evolving physical and cognitive abilities.
Cognitive decline & mental health: addressing memory loss, dementia, depression, and emotional wellbeing through cognitive stimulation, therapeutic interfaces, and assistive systems that reduce disorientation and enhance quality of life.
Physical function & mobility support: preserving physical function and mobility with tools that assist movement, support rehabilitation, and prevent falls. This includes wearable devices, robotic supports, and interactive training systems.
Safety & emergency response: detecting and responding to risks such as falls, health crises, or home hazards in real time. Systems in this category provide discreet oversight, alerts, and escalation pathways for timely intervention.
Caregiver burden reduction: supporting caregivers by reducing the physical, emotional, and logistical strain of daily care. This includes tools for remote monitoring, assistance with routine tasks, and systems that promote shared responsibility while preserving the autonomy of the person receiving care.
Chronic disease management: helping older adults manage long-term health conditions like diabetes, COPD, or heart disease through personalized monitoring, early warning systems, and digital health coaching that can prevent complications and reduce hospital visits.
Environmental adaptation: creating safer, more responsive living spaces through technologies like smart lighting, environmental sensors, and accessible layouts that adjust to the user’s needs and support ageing in place.
Sensory impairments: supporting those with declining hearing, vision, or multi-sensory function through adaptive interfaces, enhanced feedback mechanisms, and assistive technologies that help maintain awareness and interaction.
Among these, preventing social isolation and loneliness was the most frequently addressed challenge, appearing in nearly half of the supported initiatives (43%). Close behind was the goal of helping older adults maintain their independence in everyday activities (38%), followed by efforts to slow cognitive decline and address mental health concerns (28%). Many projects also tackled mobility and physical functioning (26%), while others concentrated on real-time safety monitoring (23%), supporting caregivers (22%), or helping people manage chronic diseases (18%). Though less common, adapting the home environment (9%)—through features like smart lighting or barrier-free design—and compensating for sensory impairments (5%) remained important in more specialized use cases.
Over time, the thematic landscape broadened significantly. Earlier projects were largely focused on clinical monitoring of conditions like heart failure, COPD, or diabetes. In later phases, however, there was a noticeable shift toward addressing psychosocial wellbeing, functional ability, and support for informal care—not as separate topics, but as interconnected parts of the ageing experience.
Solutions developed
To address these challenges, project teams tended to converge on a recurring set of nine solution archetypes.
Monitoring & Alert Systems: real-time tracking of key health or activity indicators—such as movement or heart rate—with alert features that notify caregivers or emergency services when risks are detected.
Social Interaction Platforms: tools designed to foster social connection, such as video call systems, digital storytelling, peer engagement features, and virtual communities that reduce loneliness and promote engagement.
Cognitive & physical training solutions: therapeutic solutions that offer brain or body exercises, often gamified, using virtual reality (VR), augmented reality (AR), or sensor-based feedback to maintain or improve function.
Assistive devices & wearables: hardware tailored to individual needs—ranging from tremor-reducing gloves and smart prosthetics to wearable ECG sensors or fall-detecting wristbands.
Smart Home automation systems: adaptive home technologies that make daily life safer and more convenient, including voice-controlled lighting, motion sensors, and smart appliances that respond to user needs.
Telehealth & remote care: platforms that enable remote medical consultations, biometric monitoring, and chronic disease management—supporting both patients and healthcare providers at a distance.
Mobility & navigation aids: devices that help older adults move safely indoors and outdoors, including smart walkers, GPS systems, real-time route guidance, and fall-prevention supports.
Medication management solutions: systems that support safe and timely medication intake, including smart pillboxes, mobile reminders, and alert systems that reduce missed doses and prevent health complications.
Robotic assistants: physical or virtual robots that provide care, mobility support, therapy assistance, or companionship—ranging from robotic exoskeletons to avatar-based helpers.
One of the most widespread components across projects was the monitoring and alert system (40%). What began as basic fall detectors quickly progressed into sophisticated tools that use predictive analytics to detect early signs of frailty or health deterioration—sometimes days before a visible crisis. These systems became the backbone of many integrated care models.
Another major focus was the creation of social interaction platforms (34%). These ranged from simple video-calling interfaces to rich, interactive ecosystems featuring storytelling, peer-matching, coaching, and gentle reminders, all designed to reduce isolation and keep users engaged.
There was steady growth in cognitive and physical training tools (21%), particularly exergames and virtual-reality-based systems, as scientific evidence confirmed the benefits of regular activity in delaying cognitive and physical decline. Projects also introduced assistive wearables (19%), becoming more precise and clinically reliable—from wristbands that reduce tremors to smart textiles equipped with ECG sensors.
Meanwhile, Smart home automation (9%) gained traction, offering adaptive lighting, energy efficiency features, and voice-activated devices that made homes safer and more responsive to users’ changing needs.
The COVID-19 pandemic accelerated innovation in telehealth and remote care (20%), prompting the development of platforms that integrate biometric data, video consultations, and remote symptom tracking to deliver healthcare at home.
In more specialised domains, projects introduced mobility and navigation aids (9%), from GPS-enabled smart walkers to indoor positioning systems. Increasingly, initiatives explored the use of robotic assistants (9%)—whether physical robots that support mobility or virtual agents that offer social presence and guidance. Other solutions focused on medication management (5%), helping users organise and adhere to treatment plans through reminders, alerts, and smart dispensers.
While early projects usually delivered a single type of solution, later collaborations often combined multiple approaches into integrated service packages aligned with local healthcare systems.
Evolution in used technologies
As the focus of the projects evolved, so too did the technologies that supported them. Basic sensor technologies like motion detectors and pressure pads were already in use by 2008, but the underlying intelligence was limited. By 2021, however, most projects incorporated machine learning to personalise services, assess risks, or recognise user intentions. More than half also used cloud-based systems connected to electronic health records, allowing for scalable and flexible data processing.
This technological evolution was not limited to devices and algorithms alone—it also transformed how systems connect, scale, and remain trustworthy. Early solutions were often closed and fragmented, but over time, a shift toward interoperability took hold. Common standards like FHIR®, universAAL, and MQTT made it possible for devices from different vendors to operate together, allowing regions to expand or adapt existing platforms without starting from scratch. At the same time, the maturation of privacy-preserving architectures and explainable AI enabled project teams to navigate growing regulatory demands—such as the EU AI Act and Medical Device Regulation—while maintaining user trust and fostering continued innovation.
In sum, the programme marked a clear transition—from hardware-focused monitoring tools to data-driven, cloud-enabled ecosystems capable of anticipating decline, coordinating care, and continuously improving through real-world feedback. These advancements now underpin many of the integrated, publicly supported services being scaled across European regions, offering a template for the future of healthy ageing.