The Role of Multimodal Generative AI in Older Adults’ Health Management: Systematic Scoping Review

Background: The issue of population aging has emerged as a critical global challenge, driving the imperative for effective self-care and scalable health management solutions for older adults. Against the backdrop of the accelerating application of generative artificial intelligence (GenAI) in health care, a systematic evaluation is necessary to investigate how multimodal GenAI can support older adults in maintaining health and managing well-being. Objective: This study aimed to systematically evaluate the role, application contexts, empirical impacts, and developmental potential of diverse GenAI tools across critical geriatric health domains. Methods: A comprehensive search was executed across 11 major databases, including Web of Science, Scopus, PubMed, Medline, CINAHL, Cochrane, ACM Digital Library, IEEE Xplore, ScienceDirect, APA PsycInfo, and Google Scholar, with search transparency adhering to the PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) extension. Results: A total of 28 studies met the inclusion criteria. Of the total, 82% (n=23) of the included publications were released within the last 2 years (2024‐2025). Analysis of technology revealed that over half (n=14) of the applications were based on text-driven conversational agents, while multimodal systems, leveraging generated audio, images, and sensor data, are rapidly emerging. GenAI applications were validated to support cognitive function maintenance, mental health, and chronic condition management through personalized content generation and multimodal interaction. However, current validation is primarily limited to cognitively normal, low-risk older adult populations. Persistent technical challenges include overreliance on text-based interaction, barriers in voice recognition accuracy, and suboptimal user interface adaptability. Conclusions: Preliminary evidence suggests a promising role for GenAI in enhancing older adults’ health self-management through highly personalized and multimodal interventions, particularly in cognitive and mental health support. To realize this potential and ensure equitable access, future efforts must prioritize strengthening interdisciplinary collaboration to integrate wearable technologies and edge computing, alongside establishing robust ethical frameworks to address data privacy, algorithmic bias, and the digital divide, which will be critical to building a safe, equitable, and effective environment for active aging.