Twice a week at a senior care facility in Singapore, a few dozen elderly men and women with dementia gather in a large sunlit room with Dexie, a humanoid robot, who leads their morning exercise session.
“Open and close your hands. Hold both arms up,” Dexie instructs. “We will do this eight times. 1-2-3-4-5-6-7-8. Good!”
Since Dexie arrived at The Salvation Army Peacehaven Jade Circle Arena two years ago, residents look forward to the robot leading their exercises, bingo, and sing-along sessions, Barbara Marie Nonis, an 83-year-old, told Rest of World. “It’s fun and something different,” she said.
Dexie’s pre-programmed routines also have another effect. Nur Syamimi Binte Akram, a staff nurse who has worked with Peacehaven residents for more than 20 years, gestured to a petite woman with a shock of curly, white hair: “Some residents like this lady wander around,” she told Rest of World. “But when there’s Dexie, she sits down.”
Studies show that AI companions like Dexie can be just as effective in reducing loneliness as interacting with another person. For Singapore, where an aging population is rapidly becoming the majority and elders are getting lonelier, authorities see the potential of AI tools to assist in preventive illness care, a key emphasis of the city-state’s health care system.
By 2030, one in four Singaporeans will be over 65, requiring eldercare. Currently, about one in 10 seniors above the age of 60 has some form of dementia, according to government data; by 2030, the total number of elders with dementia is expected to increase fivefold.
In response, the Singapore government has made mental health and well-being a key priority on the national agenda. The country has a dire shortage of nurses, Health Minister Ong Ye Kung said last year, partly due to high attrition rates during the pandemic. Singapore has since made up for that shortage — in 2023, public hospitals hired 4,000 nurses, primarily from the Philippines, Malaysia, and Myanmar. But that’s not enough. In the next five years, at least 6,000 more nurses need to be hired annually to meet the projected health care demands of the country’s aging population.
To fill the manpower gap further, the government is turning to AI. Singapore is an early adopter of AI, using generative AI tools in schools, government agencies, and the courts. It also uses a machine learning–based monitoring system for the elderly that alerts caregivers to any unusual behaviors, such as falls.
“When technology fills the care deficit and starts replacing real human connection, that should concern us.”
In October last year, seven health care and social sector partners introduced SoundKeepers, a three-year pilot program to develop an AI tool using voice biomarkers to detect early signs of depression among seniors. There are subtle differences between the acoustic properties — such as changes in pitch or tone — of individuals with depression and those without, Lee Eng Sing, co-principal investigator of SoundKeepers, told Rest of World.
Researchers hope that once developed, the AI tool will be able to detect subsyndromal depression (SSD), a largely unaddressed health risk among seniors, where symptoms of depression are present but not severe enough to be diagnosed as major depression. Research suggests at least 13% of seniors in Singapore are affected by SSD, Mythily Subramaniam, another co-principal investigator of SoundKeepers, told Rest of World.
The SoundKeepers project aims to collect voice samples from 600 seniors aged 55 and above to build an SSD-detecting AI. While American, Chinese, and Canadian startups have already developed voice biomarker technology to recognize depression, Lee said he hopes the project’s AI tool will detect SSD’s more subtle nuances in the country’s multilingual population. This would likely make it the first of its kind worldwide.
“The potential is immense,” said Lee. He envisions that the AI tool could be available in accident and emergency departments and call centers, to help doctors and helpline volunteers quickly assess the urgency of distress calls and refer patients to the appropriate psychiatric help.
In 2024, the government committed over 1 billion Singapore dollars ($730 million) to boost AI capabilities over the next five years. Among the many eldercare AI projects in the pipeline is a generative AI application called MemoryLane for the elderly to document their life stories. The project is being piloted at several St Luke’s ElderCare Active Ageing Centres. Khoo Teck Puat, a local hospital, has developed a generative AI–based tool to create “visual pillboxes” to remind seniors of their pill regimens, while RoboCoach Xian, a robot trainer, is helping senior citizens stay healthy through physical exercise routines.
Patient privacy is a concern, and researchers from the SoundKeepers project, for example, are cautious in their collection of sensitive personal data, especially since some seniors may not be able to make independent authorization decisions. The voice samples they collect will be anonymized and stored in a secure central storage terminal, Lee said. If the AI tool is developed, it will be used only in health care settings, he added.
“We don’t want people to use it unlawfully. So even when we use it in the community, it must be to licensed people, with permission from the person to record their voices,” Lee said. “Otherwise, it will be dangerous.”
Current safeguards in Singapore include the Personal Data Protection Act and the AI in Healthcare Guidelines. But there are other risks as well. Parasocial relationships with care robots can worsen loneliness in the long term if the robots take the place of interaction with humans, Kathryn Muyskens, from the NUS Centre for Biomedical Ethics in Singapore, told Rest of World. “When technology fills the care deficit and starts replacing real human connection, that should concern us,” she said.
For now, at the Peacehaven Jade Circle Arena facility, Hill Cyril Rodney, an 86-year-old resident, was impatiently waiting for Dexie to arrive for a bingo game.
“I don’t care for the robot … Makes no difference to me,” he told Rest of World, while he and other residents checked off the numbers on their bingo boards as Dexie called them out. “But I like it when she plays bingo with us.”
