Editor's note: The rapid advancement of artificial intelligence is reshaping nearly every facet of human existence. This series will take an in-depth look at this transformative force, examining how AI is redefining the way we live, work and interact.

Seniors operate a mechanized vehicle that helps them move around at a smart elderly care center in Beijing in March. JU HUANZONG/XINHUA

Ye Cuihua, 79, doesn't head to the county clinic when she feels a flutter in her chest. She glances at her wrist. Within seconds, her smartwatch syncs with an app called Ant AQ telling her that her blood pressure is slightly elevated. It follows by providing advice to reduce her salt intake, keep monitoring, and call her doctor if the symptoms persist.

"It feels like having someone at home who can always answer," Ye said.

Across China, this scene is playing out with increasing urgency. As the nation's population aged 65 and above doubled from 7 percent to 14 percent in just 23 years — a demographic shift that took France a century to endure — the medical system is hitting a breaking point. The solution isn't just more hospitals; it is "triage at home" powered by artificial intelligence.

China's medical system has long suffered from a basic imbalance: the best doctors and equipment cluster in big cities, while smaller towns and the countryside make do with less.

"For older patients like us, getting care often means a long bus ride, hours of waiting, and the nagging uncertainty of not knowing whether a symptom is serious enough to justify the trip," Ye said.

A man learns about smart glasses during an expo of senior care products in Shenzhen, Guangdong province, in September. LIANG XU/XINHUA

AI does not fix all of that, but it is beginning to reshape a critical moment that comes before any hospital visit, that is, the moment a person decides whether to go at all.

"For many older adults, the hardest question is not what treatment do I need, but do I need to see a doctor in the first place," Ye added.

AI tools are able to cross-reference symptoms, health records and basic readings from wearable devices, offering preliminary guidance that can turn vague aches and worries into something a person can act on.

Cai Juan, a caregiver at Taikangzhijia, a senior care facility in Wuhan, Hubei province, has witnessed a noticeable change in health awareness among residents in recent years. "Residents who once ignored mild discomfort or panicked over minor symptoms now tend to consult a digital tool first," she said.

"It doesn't replace the doctor," she added. "But it eases the anxiety and sometimes catches things that would have been left too long."

An elderly woman conducts a basic checkup at a community center in Huzhou, Zhejiang province, in January. [Photo provided to CHINA DAILY]

For elderly users, though, the meaning of these tools runs deeper than efficiency. They also introduce a new kind of presence into daily life.

At Kangyuxuan, a private elderly care home in Beijing, some residents have built routines around their digital assistants, including checking medication schedules, logging sleep, or simply asking questions about a twinge in the knee.

Staff members say these interactions, while practical on the surface, carry an emotional undertone as well.

"They are not just using a tool," said Cui Xiaohan, a caregiver at the elderly care home. "They are getting used to being responded to."

In a country where family structures are changing fast and millions of elderly people live alone or with minimal daily company, that responsiveness matters. AI systems — always available, never impatient — can partially fill the silences left by absent children or overworked caregivers. This does not mean technology replaces human relationships. But it suggests that care, as older people actually experience it, is increasingly a hybrid affair — part human, part machine.

A senior woman participates in setting up and testing an elderly care robot that can perform basic health checkups, monitor health status and offer companionship at a welfare center in Hangzhou, Zhejiang province, in March last year. YAO YINGKANG/FOR CHINA DAILY

None of this, however, is seamless.

Although smartphone adoption among Chinese adults aged 60 and above has grown rapidly — with internet penetration reaching 53.7 percent by the end of 2025 — digital literacy remains a barrier, with many seniors struggling to navigate cluttered app interfaces, fragmented platforms and unfamiliar interaction patterns.

"A system can be brilliant under the hood, but if a 75-year-old cannot figure out how to use it, that brilliance counts for little," Cui said.

Some platforms have begun introducing simplified layouts, voice commands and even dialect recognition — adjustments that sound minor but determine whether a tool actually gets used.

"In February, Ant AQ, an app developed to help the elderly with health checks and medical consultation, started to provide a mode that is more suitable for the elderly," said Shen Yunfang, head of communications at Ant Health.

"Specifically speaking, we developed a mode that is able to understand different dialects, considering that many of the elderly could not speak in standard Mandarin," she said.

An elderly woman practices a baduanjin exercise routine at a robot-assisted elderly care center in Beijing in March. JU HUANZONG/XINHUA

Compared with younger users, however, many older adults remain wary of advice delivered by an algorithm.

In Wuhan, Ye described her approach plainly, "I read what it tells me, but I still need a doctor to confirm."

AI may serve as a useful first step, but for most elderly users it does not carry the authority of a physician. It operates within a broader ecosystem in which human judgment still has the final word.

The rise of health AI is forcing a rethink of what "access" means. For decades, access to healthcare was measured in physical terms — how many hospitals, how many doctors, how far to the nearest clinic. Increasingly, it also has a digital dimension, that is, whether people can obtain, understand and act on health information.

For older populations, this opens real possibilities — medical knowledge delivered directly to the home, reducing the need for travel. But it also risks creating new kinds of exclusion, shutting out those who cannot navigate the technology.

A senior woman tries a physical therapy robot in Beijing in March. JU HUANZONG/XINHUA

The upshot is that the success of health AI may depend less on how smart it gets, and more on how accessible it is to use.

For seniors like Ye, she monitors her health more often now and seeks guidance earlier than she once did. "I used to wait and see," she said. "Now I check first."

At a systemic level, though, the transformation is still unfinished. AI can speed things up, widen the net and support better decisions. But it cannot resolve the inherent uncertainties of medicine, and it is in no position to shoulder complex clinical judgment.

The future of AI in elderly care may lie not in replacement but in coexistence — algorithms alongside physicians, digital tools alongside lived experience.

As China continues to age, that coexistence will likely become a defining feature of its healthcare landscape.