The World Health Organization (WHO) estimates that the global population aged 60 years and older will increase from 12% to 22% between 2015 and 2050, with the most dramatic increase in low- and middle-income countries (LMICs) [1]. This will change the age composition in populations globally. Demographic aging refers to shifts in the age composition of populations where the proportion of the population that consists of older people grows significantly. The fact that people are now living longer than ever and that they are expected to continue doing so is the result of positive developments in public health and survival [2]. Yet, demographic aging is also one of the key challenges of our time [3].

This concern is caused by how demographic aging will impact nation states. As people grow older, they tend to become increasingly reliant on both formal and informal care. For instance, older people are more likely to have functional limitations, need assistance with everyday tasks, and need medical care [4-6]. Moreover, older individuals have lower incomes, which compound the challenges of their increasing need for care [7]. As a result, nation states have a variety of systems in place to care for older people, including systems of shouldering the cost of that care.

In countries where welfare and care systems are heavily subsidized, demographic aging is predicted to lead to heavy financial strain and a decreased quality of life for older people, unless solutions that cater to the need to maintain good health and affordable health care into a longer set of retirement years are developed [8]. Still, the adverse consequences of demographic aging will be even greater in LMICs. In LMICs, welfare systems often function poorly or are nonexistent, meaning that the burden of caring for older people falls on families or on the older individuals to care for themselves. This has caused concerns that LMICs will “grow old before growing rich” [7].

To neutralize the overwhelming demand for health care, solutions are needed to enable older people maintain their health for longer and postpone or avoid disability and dependency [1,9,10]. Against this background, interest in technology that enables older people to age in place while maintaining their dignity and quality of life has grown rapidly over the past 2 decades [11].

Aging in place is a concept that refers to the shared responsibility of individuals and public authorities to enable older people to continue to live safely, relatively independently, and comfortably in the community either in their current home or in appropriate housing, regardless of age, income, or level of competence [1,12-14]. The idea is that policies and public services should address the challenges posed by demographic aging by finding alternatives to traditional forms of older adult care and creating solutions that are less resource-intensive. In welfare states where health and care services are heavily subsidized, this shift toward less resource-intensive solutions generally refers to options that maintain a high quality of life for older people while simultaneously preventing or delaying the need to relocate to a nursing home or becoming dependent on care [15], as well as to solutions that minimize the use of resources in nursing homes and other forms of formal care, without compromising their quality. Meanwhile, in LMICs, the main challenge is that welfare systems are weak and even nonexistent. Assistive technology and related services are marginal and not available for the majority, particularly for the poor rural populations. Ensuring assistive technology for all, including the growing number of older adults, requires resources and build-up of competence through a sustainable systems approach [16]. In this context, innovations are needed in service delivery, and community-based models as well as adaptation of existing assistive technology and development of new and contextually relevant assistive technology are needed to ensure that older people live well and as autonomously as possible [17].

Technologies that enable aging in place encompass a wide variety of technologies designed to monitor or support the health and activities of older people or strengthen their contact with others [11,15]. In some cases, older people are the intended users, but technology can also be used to establish links between older adults and their circles of care. Technologies for aging in place include both high- and low-tech solutions, including but not limited to mobility devices, information and communication technologies, assistive technologies, sensor technology, telemedicine, health monitoring, games, wearables and medication reminders, and the internet of things [15,18-27].

Alongside the interest in technology that can enable older people to age in place, the number of publications on this topic has increased dramatically. In this context, literature reviews can be important tools for researchers as well as practitioners, policy makers, and decision makers who need to navigate current debates and access syntheses of the available evidence. Yet, to date, there is no review of the available published reviews that provide an overview of the range and characteristics of the evidence on technology for aging in place.

While reviews of reviews on technologies for aging in place do exist, they typically limit the scope to health conditions, diseases, technologies, or caring practices, for instance, by focusing on the self-efficacy of older people using technology to self-manage chronic obstructive pulmonary disease, hypertension, heart failure, or dementia at home [28]; on the effects of digital technologies on older people’s access to health and social care [29]; on the promotion of physical activity in older people using mobile health (mHealth) and eHealth technologies [30]; or on how mHealth technology may support aging in place [31] and procedures of user-centered usability assessment for digital solutions [32].

The objective of this review of reviews is to explore the characteristics and the range of evidence on technologies for aging in place by conducting a scoping review of reviews in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) [33]. The PRISMA-ScR checklist is available in Multimedia Appendix 1.

By exploring the included reviews, we are particularly interested in what year and in which journals they are published, which review methods that characterize reviews in this field, and whether there are any reviews that are explicitly concerned with LMICs. By LMICs, we mean the countries identified by the Organization for Economic Co-operation and Development as having low-income or middle income economies, which may be updated from time to time by the Organization for Economic Co-operation and Development [34]. In exploring the range of evidence presented in reviews on technologies for aging in place, we are particularly interested in which types of populations, technologies, and problems they have been concerned with.

We included literature reviews in English about technology for older people or older adult care, including informal care, that we were able to access. To ensure the quality of our sources, we limited our scope to peer-reviewed literature reviews that have been published in academic journals. For the same reason, we only included reviews where the methods were clearly described. We did not apply any limits to the year of publication.

Our method of selecting databases included making a list of the most relevant journals in the field that the authors were aware of (Multimedia Appendix 2). The complete list was sent to a panel of experts consisting of members from the WHO and the International Society of Gerontechnology, who were asked to add any potentially relevant journals missing from the list. After the list was considered complete, the authors identified the databases where these journals were indexed. The final selection of databases was Web of Science (Table 1), PubMed (Table 2), and Scopus (Table 3). The searches in Web of Science and Scopus were conducted on September 13, 2022, and the search in PubMed was conducted on September 14, 2022.

A search consisting of the terms “older people” and “technology for ageing in place” with alternate terms was conducted using Boolean operators and truncation. The search was adapted to the rules for each database.

The search resulted in a total of 7274 identified studies, that is, 3131 from Scopus, 2402 from PubMed, and 1741 from Web of Science. We used Covidence (Veritas Health Innovation) to organize the review process. After 1827 duplicates were identified and removed, 5447 studies were screened using the eligibility criteria (see Textbox 1). The original list of eligibility criteria contained items 1-7. However, after we identified a retracted paper, we decided to add exclusion criterion 8 “retracted paper.” The title and abstract screening resulted in the exclusion of 4973 studies. The full-text screening resulted in the further exclusion of 130 studies, and the remaining 344 studies were included in the data charting process. Figure 1 illustrates this process.

The data were extracted using the data extraction template feature in Covidence. The extraction of data was organized in line with our objectives and research questions. Tables 4 and 5 provide an overview of the relationship between the research questions and the extracted data.

All authors participated in the choice of databases and establishing the search terms and eligibility criteria. EL constructed the search string and conducted the final search. All authors participated in the screening process. The full-text papers were extracted by the authors JMB, MG, and AHE. All authors participated in the data synthesis and presentation of the findings.

Multimedia Appendix 3 shows an overview of the data and sources that correspond to this section. The number of reviews of evidence on technology for aging in place has increased dramatically over the past few years (Table 6). The earliest review included in our search was published in 2001 [35]. A total of 20 reviews were published between 2001 and 2010. By comparison, 142 reviews were published between 2015 and 2020. Note that the table only includes reviews published before September 13, 2022, when our search was conducted.

From 2020 to 2021, there was a near doubling in number of reviews. Since our search was conducted at the beginning of September 2022, the figure does not show the full extent of published reviews in 2022. However, it is likely that the trend will continue upwards. The included reviews were published in 183 unique journals. Of those, most journals have only published 1 or 2 reviews since 2001. Only 12 journals have published more than 5 reviews in total since 2001 (Table 7).

The reviews refer to 15 unique types of review methods. Of these, the most common were systematic reviews (n=144) and scoping reviews (n=60). The third most common review method was to provide a detailed account of the procedures but refrain from referring to a specific type of review method (n=98). While there were only 13 integrative reviews and 6 narrative reviews, the fact that most other review methods only occurred once or twice made the narrative reviews common by comparison (Table 8).

Only 1 review referred explicitly to LMICs [36]. This review aimed to identify policy gaps in the delivery and availability of assistive health technology and medical devices for aging populations, particularly in LMICs, and found that practical, life-enhancing support for older people through assistive health technology, medical technology, and related health and social services is a neglected issue.

In exploring the range and characteristics of reviews on technology for aging in place, we found that the number of reviews, as well as the pace at which they are published, has increased dramatically over time. While some journals such as JMIR Aging, Disability and Rehabilitation: Assistive Technology, the Journal of Medical Internet Research, and The Journal of Medical Informatics have published more reviews on this topic than others, the literature is scattered over 183 unique journals. Most reviews on this topic are systematic reviews (n=144).

In exploring the range of reviews on technology for aging in place, we identified 3 principal ways that reviews have dealt with populations. Specifically, the 3 ways are describing the population in terms of older people or different types of caring roles (n=253), in terms of people affected with a particular health condition or diagnosis (n=73), or not specifying the population (n=43). These may be considered as methods of conceptualizing populations. We identified 88 unique types of technology that the reviews have dealt with. We also found that there are strong tendencies for reviews to synthesize the evidence on broad and unspecific categories of technology such as “ICT” or “robots” rather than to concentrate on a particular device (a notable exception is a review on personal alarms [183]). Moreover, we identified 5 strategies that the reviews draw on to conceptualize technology. Those strategies are to (1) refer to technology by using descriptive technical terms; (2) conceptualize technology by way of the purpose of the technology about a disease or health issue; (3) refer to technologies in terms of their purpose in caring services or practices; (4) use umbrella terms that broadly refer to the use of technology to enable older people to age in place; and (5) use concepts that refer to the technology as part of caring services, strategies, and practices. We also identified 4 principal types of problems and 49 unique subtypes of problems that the reviews have dealt with. The four principal types are problems related to (1) different types of care services or caring practices, (2) the management of health problems or diseases, (3) the experience of aging in place, and (4) the research and development of technology. The evidence map (Multimedia Appendix 6) demonstrates the relationships between the populations, technologies, and problems studied in the reviews and illustrates the gaps. Notably, many of the reviews on the most studied technologies and problems draw on studies that are not specific to older people or the context of aging in place, either by not specifying the population at all or by including studies on patients of all ages, meaning that topics studied only by such reviews should also be considered gaps.

Despite the many methodological strengths of the design of a scoping review of reviews, there are some limitations to be considered. These include the potential for bias in the review process, the difficulty ensuring the quality and reliability of the included reviews, and the potential for the review to be influenced by the perspectives and priorities of the researchers conducting the review. Considering the broad eligibility criteria chosen for this review, the results may be considered representative of the characteristics and range of evidence on technologies for aging in place. However, the inclusion of more databases could have expanded the data set even further, and potentially relevant literature that does not use the term aging in place explicitly may have been missed. Moreover, this review has not sought to explore or synthesize the results of the included reviews nor have we considered the quality of the included reviews.

The number of published reviews on this topic in the past few years in combination with the rate at which they are published suggests that redundancies and a lack of fruitful synergies between them are likely. The breadth of variation concerning how reviews have dealt with populations, conceptualizations of types of technology, and problems demonstrates the conceptual differences that must be bridged to remedy this problem.

Together, these results underscore the necessity for improved coordination and collaboration among reviews while also recognizing the potential benefits of more standardized vocabularies.

The insights gained from the methods of dealing with populations, strategies for conceptualizing types of technology, and the types of problems identified in this study may be used methodologically to identify commonalities and connections that may otherwise be obscured by differing conceptual frameworks.

There is an urgent need for an examination of the current state of the art in knowledge regarding technology for aging in place in LMICs. Developing a deeper understanding of the conditions surrounding aging in LMICs, especially in Africa, and the implications those conditions have for the roles that technology may play and not play in the lives of older people and their circles of care should be an essential focus of the research agenda.