Frailty assessments are crucial to evaluate the risk of adverse events and the health and social care needs of older adults, yet their administration remains resource-intensive and typically relies on coarse clinical outcomes, such as task completion times, which may overlook biomechanical indicators of functional decline. To address this, we present a robotic framework that guides older adults through standardised frailty and fall-risk tests while capturing clinical scores and additional frailty-related metrics, offering a deeper insight into a user's condition. The system uses a Behaviour Tree architecture that coordinates perception, decision-making, interaction, and measurement modules. Using vision-based skeleton tracking, the robot evaluates established clinical tests, including the Short Physical Performance Battery (SPPB) and the Timed Up and Go (TUG). The framework was co-designed with healthcare professionals and evaluated in situ during six months in a rehabilitation centre's research lab with N=81 older adults. Robot-derived measurements were compared against therapist assessments and clinical reference instruments, including a gait analysis walkway and an inertial measurement unit (IMU). Results showed excellent agreement for most test completion times and gait-related parameters (ICC>0.9). And, substantial agreement for the overall SPPB score comparing the robot and the therapist (k=0.67) and moderate agreement comparing the robot and the IMU (k=0.55). The findings highlight that social robots can provide reliable and objective frailty assessments in healthcare settings while enabling the collection of relevant mobility indicators beyond conventional outcomes.
Addressing the global caregiver shortage through socially assistive robots necessitates a deep understanding of their psychological and physiological impacts on older adults during human-robot interaction (HRI). This study addresses whether social robots can serve as effective interaction partners compared to humans, and if "positive prompts" can similarly enhance these interactions. We conducted a comparative study with 35 participants (aged 70+). Our multi-modal analysis, integrating facial expression data, heart rate variability, and subjective questionnaires, revealed no significant differences in overall stress levels between human and robot interactions. Facial expression analysis confirmed that the robot was accepted as a valid interaction partner, while physiological data showed slightly lower heart rates during robot interactions, suggesting a more relaxed state compared to human-led sessions. These findings indicate that social robots can engage older adults without inducing psychological strain and are capable of alleviating caregiver burden by performing structured tasks, such as health-sensing surveys. Future work should address the identified "appearance-content mismatch" in robot design to facilitate even more natural and effective interactions.
Hana Yamamoto, Carlotta Julia Mayer, Charlotte Raithel +5
The shortage of healthcare staff is a challenge in geriatric care. To address this, robots can be integrated into care settings to provide assistance and emotional support. A promising application is walking guidance, particularly benefiting older adults as navigation skills deteriorate with aging. As walking guidance involves direct contact, the aim of this study is to understand how older adults perceive and respond to different touch modes during guided walking. 24 older adults (68 - 88 yrs.) walked four times a ten-meter trajectory guided by the robot TIAGo Pro in four contact conditions: no physical contact (NC); physical contact through holding the robot's wrist with the hand (HH); physical interaction through linking arms with the robot (LA); and physical contact through resting the forearm on the robots forearm (FC). A multimodal assessment approach included electrocardiogram, electrodermal activity, contact force, distance to robot, and questionnaires. Physiological results reveal a slight increase in stress levels during robot interaction. Behavioural and subjective measures, however, show overall acceptance of robotic touch. The two conditions corresponding to larger interaction forces (HH and FC) were associated with lower relative distances between participant and robot, indicating a higher trust and confidence. Questionnaire responses supported these findings, evidencing greater perceived safety, trust and comfort in these conditions. This study provides insights for the design of robotic walking guidance assistance, indicating that gentle, stable touch is preferred by older adults in comparison to contactless interaction.
Leonie Leven, Marko Ackermann, Christian Werner +4
Demand for older-adult and patient care is growing rapidly as populations age worldwide. Foundation models are increasingly being integrated into robots and interactive agents, with the promise of more flexible communication and personalized assistance. However, care settings require reliable and workflow-compatible systems with accountable human oversight, and it remains unclear whether current embodied systems can translate technical advances into clinical impact. This Perspective synthesizes foundation model-based care robots across three areas: design features, user experience, and evidence for care-related outcomes. Current systems most commonly use foundation models as conversational and reasoning layers within voice-centered socially assistive embodiments, while multimodal grounding and physical autonomy remain limited. Empirical evaluations report positive usability and engagement benefits, but reliability failures persist across the interaction pipeline such as hallucinations and conversational breakdowns. Evidence for care impact remains concentrated in proximal outcomes such as cognitive engagement and participation, with limited evidence for validated clinical or care-related changes. We argue that future research should transition toward care-specific evaluation standards, accountable autonomy, and integration into care workflows to support more responsive and responsible care technologies.