Artificial intelligence (AI) methods, including machine learning (ML), are transforming healthcare by enabling personalized interventions that integrate multimodal data to support rehabilitation, preventive care, and remote monitoring. Despite their broad potential, older adults remain underrepresented in model development, raising concerns about bias and limited generalizability. As AI/ML adoption expands, it is essential to critically appraise emerging tools to ensure ethical, equitable, person-centered implementation in aging populations and long-term randomized evaluations. A structured MEDLINE search identified randomized controlled trials (RCTs) published between January 2023 and December 2025 that evaluated AI/ML-based interventions in adults ≥ 65 years. Of 31 records identified, 19 underwent abstract screening, seven underwent full-text assessment, and four articles were identified as meeting all criteria for inclusion, which focused on scalability, clinical impact, and methodological rigor. Across postoperative rehabilitation and preventive care, AI/ML interventions demonstrated meaningful clinical benefits. Transformative applications of AI/ML described robotic systems quantifying weight-bearing, algorithm-guided paired rehabilitation interventions, paired exercises in geriatric hip fracture rehabilitation, smartphone platforms delivering continuously personalized exercise programs, and conversational chatbots providing tailored vaccine counseling. The included RCTs show that AI-driven interventions can enhance physical recovery, support psychosocial well-being, and improve uptake of preventive measures compared with conventional approaches. Key considerations for future implementation include digital health literacy, long-term follow-up, and potential bias arising from healthier or more motivated study populations. As evidence grows, geriatric innovation must prioritize safety, ethics, and equitable access to ensure that technological precision enhances, rather than replaces, person-centered care.

Older adults undergoing surgery are at increased risk for complications, functional decline, and prolonged recovery due to frailty and other age-related vulnerabilities. To address these challenges, we developed the Care Coordination and Optimization in Geriatric Surgery (COGS) program, a pilot initiative integrating comprehensive geriatric assessment and targeted optimization into routine surgical care for Veterans. Using the Risk Analysis Index-Clinical (RAI-C) to identify higher-risk patients, the COGS team-comprising geriatric providers, nursing, and surgical staff-provides individualized evaluation and interventions focused on nutrition, mobility, medication safety, cognition, and social support. By embedding geriatric expertise directly into the surgical clinic, the program fosters collaboration among surgeons and geriatricians, improving communication and supporting shared decision-making about surgical readiness. Early experience demonstrates that COGS is both feasible and well-received, enhancing the coordination of care for older Veterans and aligning surgical decisions with patients' goals and overall health status. Expansion of the program to additional surgical specialties and evaluation of short and long-term outcomes are underway. The COGS model demonstrates how integrating geriatrics principles within surgical care can promote safer, more goal-aligned surgery for older adults.

Most visits to the emergency department (ED) by persons living with dementia (PLWD) who are then discharged back into the community are preventable. However, care partners and other caregivers of the over 6 million PLWD residing in the United States lack the supports, services and timely access to clinical care to address many common needs in the community. Thus, care partners resort to taking the PLWD to the ED, a sub-optimal environment that can be traumatic to the PLWD, increase iatrogenesis, and ultimately may not resolve the underlying reason for the visit. Longitudinal nurse-led telephonic care (NLTC) provided following an ED visit with community discharge may present an effective and efficient model for health systems to support care partners, decant busy EDs, and provide high-quality, person and family-centered impactful care to support PLWD and their care partners. This paper describes the development of an NLTC program being implemented as part of the Emergency Departments LEading Transformation of Alzheimer's and Dementia Care (ED-LEAD) trial, a factorially designed embedded pragmatic clinical trial in 79 EDs. The NLTC program utilizes components of two previously tested programs, the Aliviado Dementia Care quality improvement program, and the Emergency Medicine Palliative Care Access (EMPallA) nurse-led telephonic palliative and transitional care program to support PLWD and their care partners. Successful implementation of the NLTC program may lead to increased uptake of NLTC programs by health systems, improving quality of care and quality of life for PLWD and their care partners.

Older adults with hip fracture face a sudden decline in health, yet most never receive palliative care. This study used ethnography to examine how palliative care is woven into surgical care, revealing strengths in primary palliative care integration as well as unmet needs such as psychosocial and caregiving challenges.