Remote Virtual Interactive Agents for Older Adults: Exploring Its Science via Network Analysis and Systematic Review

Background: The global rise in the aging population presents significant challenges to healthcare systems, especially with increasing rates of chronic illnesses, mental health issues, and functional decline among older adults. In response, holistic and tech-driven approaches, such as telehealth and remote virtual interactive agents (VIAs), are potential emerging solutions to support the physical, cognitive, and emotional well-being of older adults. VIAs are multimodal digital tools that provide interactive and immersive experiences to users. Despite its promise, gaps still exist in the insights that explore ways of delivering geriatric healthcare remotely. Objective: This systematic review examines the existing literature on remote virtual interventions for older adults, focusing on bibliometrics, study purposes, outcomes, and network analysis of studies extracted from major databases using selected keywords and managed using the Covidence application. Methods and Results: Following five stages, namely, problem identification, a literature search, data evaluation, data analysis, and presentation, the review found that the studies on remote VIAs for older adults (2013-2025) were mostly from a positivist perspective, multi-authored, and U.S.-led, mainly showing positive outcomes for most studies (n = 13/15) conducted in home settings with healthy older participants. The dominance of positivist, US-led studies reflect an epistemological stance that emphasizes objectivity, quantification, and generalizability. VIAs, often pre-programmed and internet-based, supported health promotion and utilized visual humanoid avatars on personal devices. Keyword and network analysis additionally revealed four themes resulting from the review: Health and Clinical, Holistic and Cognitive, Home and Caring, and Hybrid and Connection. Conclusions: The review provides innovative insights and illustrations that may serve as a foundation for future research on VIAs and remote healthcare delivery for older adults.