Beyond Translation: AI as Sustainable Care Communication Infrastructure for Global Aging Societies

As aging societies intensify pressure on care systems, sustainable elder care increasingly depends on effective communication across diverse cultural, linguistic, and relational contexts. While artificial intelligence (AI) is rapidly integrated into care environments, existing research largely frames communication as a functional, cognitive, or technology adoption problem, overlooking its role as a culturally embedded and relational care practice. Addressing this gap, this study examines the knowledge structure and evolution of AI-supported communication in elder care through a bibliometric and thematic synthesis of 564 Web of Science publications from 2005 to 2026.

The findings reveal a rapidly expanding field organized around five major strands: AI as functional communication support, cognitive and dementia-related communication challenges, caregiver-centered relational infrastructures, human-centered and ethical AI adoption, and an underdeveloped focus on cultural and lived-context dimensions. Despite technological advancements, socio-cultural aspects of communication remain peripheral within the field’s core structure.

In response, this study introduces the concept of care communication infrastructure, reconceptualizing AI as a system that enables context-sensitive, culturally responsive, and dignity-preserving communication in everyday care practices. From a sustainability perspective, this reframing emphasizes that long-term care systems cannot be resilient or scalable without addressing communication as a foundational socio-technical infrastructure. The study contributes by bridging fragmented research streams and providing a conceptual direction for designing AI systems that support not only efficiency, but also cultural diversity, relational care, and sustainable aging societies.