Artificial Intelligence in the Management of Infectious Diseases in Older Adults: Diagnostic, Prognostic, and Therapeutic Applications

Abstract

<b>Background</b>: Older adults are highly vulnerable to infectious diseases due to immunosenescence, multimorbidity, and atypical presentations. Artificial intelligence (AI) offers promising opportunities to improve diagnosis, prognosis, treatment, and continuity of care in this population. This review summarizes current applications of AI in the management of infections in older adults across diagnostic, prognostic, therapeutic, and preventive domains. <b>Methods</b>: We conducted a narrative review of peer-reviewed studies retrieved from PubMed, Scopus, and Web of Science, focusing on AI-based tools for infection diagnosis, risk prediction, antimicrobial stewardship, prevention of healthcare-associated infections, and post-discharge care in individuals aged ≥65 years. <b>Results</b>: AI models, including machine learning, deep learning, and natural language processing techniques, have demonstrated high performance in detecting infections such as sepsis, pneumonia, and healthcare-associated infections (Area Under the Curve AUC up to 0.98). Prognostic algorithms integrating frailty and functional status enhance the prediction of mortality, complications, and readmission. AI-driven clinical decision support systems contribute to optimized antimicrobial therapy and timely interventions, while remote monitoring and telemedicine applications support safer hospital-to-home transitions and reduced 30-day readmissions. However, the implementation of these technologies is limited by the underrepresentation of frail older adults in training datasets, lack of real-world validation in geriatric settings, and the insufficient explainability of many models. Additional barriers include system interoperability issues and variable digital infrastructure, particularly in long-term care and community settings. <b>Conclusions</b>: AI has strong potential to support predictive and personalized infection management in older adults. Future research should focus on developing geriatric-specific, interpretable models, improving system integration, and fostering interdisciplinary collaboration to ensure safe and equitable implementation.

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