Spatial, and Physical Interaction for Remote XR Communication for Emotional Well-Being in Older Adults: A Systematic Review

This systematic review synthesizes evidence on how extended reality, spatial interaction, and haptic systems support remote social engagement and emotional well-being among older adults. Guided by PRISMA, it analyzes 45 studies covering older participants, intergenerational dyads, and younger comparators. Avatar-based communication, immersive co-presence, and culturally relevant environments enhanced by spatialized audio, refined haptics, and task-oriented activities improve social presence and positive affect. However, most effects are short-term and lack longitudinal validation or consistent real-world application. Persistent challenges include headset comfort, interaction complexity, sensory mismatch, and learning burden, particularly for the oldest users. External validity remains limited by privacy concerns, low digital literacy support, and the under-representation of rural or cognitively impaired populations. This review proposes an inclusive and sustainable strategy grounded in participatory co-design, staged longitudinal deployment with home monitoring, adaptive interfaces responsive to cognitive and sensory abilities, and integration with telehealth.