Global Health & Medicine 2026;8(3):215-221.
From companion technologies to social care infrastructure: A multi-level perspective on loneliness-related support in dementia care in an era of artificial intelligence (AI)
Uenishi M, Song PP
Loneliness and social isolation are important psychosocial concerns in dementia care, but they are difficult to address through pharmacological treatment or episodic social activities alone. Companion technologies, including socially assistive robots, humanoid and conversational robots, avatars, virtual agents, and artificial intelligence (AI)- enabled companions, are increasingly discussed as possible aids for engagement and interaction. However, current evidence does not justify treating these technologies as standalone interventions that directly reduce loneliness in people with dementia. We argue that these technologies may be more appropriately considered not only as devices or interventions, but also as potential components of social care infrastructure: tools that can encourage individual engagement and mediate human relationships but that need to be integrated into care ecosystems. We propose the multi-level care with social technologies (MCST) model, which consists of three connected layers: individual engagement, relational interaction, and the care ecosystem. The model emphasizes that loneliness-related support is produced through the interaction between technology, human facilitation, care workflows, ethical governance, and feedback-based adjustment. This approach is especially relevant as dementia care systems face workforce constraints and an increasing need for home-based care, while psychosocial needs remain and may be overlooked in routine care. AI-enabled and large-language-model-based companions may expand possibilities for personalization and continuous engagement, but dementia-specific evidence remains preliminary and safety concerns are substantial. Future research should validate the MCST model in real-world dementia care and establish evaluation frameworks that address psychosocial outcomes, sustained use, safety, privacy, human oversight, and accountability.
DOI: 10.35772/ghm.2026.01063
Full Text: 
