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One of the central social challenges of the 21st century is society's aging. AI provides numerous possibilities for meeting this challenge. In this context, the concept of digital twins, based on Cyber-Physical Systems, offers an exciting prospect. The e-VITA project, in which a virtual coaching system for elderly people is being created, allows the same to be assessed as a model for development. This white paper collects and presents relevant findings from research areas around digital twin technologies. Furthermore, we address ethical issues. This paper shows that the concept of digital twins can be usefully applied to older adults. However, it also shows that the required technologies must be further developed and that ethical issues must be discussed in an appropriate framework. Finally, the paper explains how the e-VITA project could pave the way towards developing a Digital Twin for Ageing. [ABSTRACT FROM AUTHOR]

Background: Technological advances in robotics, artificial intelligence, cognitive algorithms, and internet-based coaches have contributed to the development of devices capable of responding to some of the challenges resulting from demographic aging. Numerous studies have explored the use of robotic coaching solutions (RCSs) for supporting healthy behaviors in older adults and have shown their benefits regarding the quality of life and functional independence of older adults at home. However, the use of RCSs by individuals who are potentially vulnerable raises many ethical questions. Establishing an ethical framework to guide the development, use, and evaluation practices regarding RCSs for older adults seems highly pertinent., Objective: The objective of this paper was to highlight the ethical issues related to the use of RCSs for health care purposes among older adults and draft recommendations for researchers and health care professionals interested in using RCSs for older adults., Methods: We conducted a narrative review of the literature to identify publications including an analysis of the ethical dimension and recommendations regarding the use of RCSs for older adults. We used a qualitative analysis methodology inspired by a Health Technology Assessment model. We included all article types such as theoretical papers, research studies, and reviews dealing with ethical issues or recommendations for the implementation of these RCSs in a general population, particularly among older adults, in the health care sector and published after 2011 in either English or French. The review was performed between August and December 2021 using the PubMed, CINAHL, Embase, Scopus, Web of Science, IEEE Explore, SpringerLink, and PsycINFO databases. Selected publications were analyzed using the European Network of Health Technology Assessment Core Model (version 3.0) around 5 ethical topics: benefit-harm balance, autonomy, privacy, justice and equity, and legislation., Results: In the 25 publications analyzed, the most cited ethical concerns were the risk of accidents, lack of reliability, loss of control, risk of deception, risk of social isolation, data confidentiality, and liability in case of safety problems. Recommendations included collecting the opinion of target users, collecting their consent, and training professionals in the use of RCSs. Proper data management, anonymization, and encryption appeared to be essential to protect RCS users' personal data., Conclusions: Our analysis supports the interest in using RCSs for older adults because of their potential contribution to individuals' quality of life and well-being. This analysis highlights many ethical issues linked to the use of RCSs for health-related goals. Future studies should consider the organizational consequences of the implementation of RCSs and the influence of cultural and socioeconomic specificities of the context of experimentation. We suggest implementing a scalable ethical and regulatory framework to accompany the development and implementation of RCSs for various aspects related to the technology, individual, or legal aspects., (©Cécilia Palmier, Anne-Sophie Rigaud, Toshimi Ogawa, Rainer Wieching, Sébastien Dacunha, Federico Barbarossa, Vera Stara, Roberta Bevilacqua, Maribel Pino. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 18.06.2024.)