Governed AI-Agent Coordination for Dementia Care: Architecture, Safety Contracts, and Evidence-Derived Workflow Verification
On the map: LLM agents and tool use → Medical and scientific domain agents
Abstract (arXiv)
Dementia care increasingly involves connected sensors, medication devices, electronic records, and assistive technologies. Interoperability can transport observations but cannot maintain an accountable care state, reconcile evidence, determine who may act, or verify resolution. The shift from large language models to agentic engineering creates a systems opportunity: an external runtime can maintain memory across episodes, plan over goals and constraints, invoke tools, observe outcomes, and enforce governance. This paper presents Governed Closed-loop Agent Coordination (GCAC), an architecture for bounded agent participation in community dementia-care workflows. Evidence on care-coordination failures and policy obligations is translated into traceable system requirements. GCAC separates observation, governed memory, planning, deterministic policy enforcement, execution, and outcome monitoring through a typed event-memory-decision-action-outcome contract. A reference harness evaluates 18 evidence-derived traces covering missing records, medication conflict, caregiver reports, service failure, consent change, stale state, duplicate events, untrusted text, and suspected acute neurological change. GCAC satisfies all 18 contract oracles with zero policy-violating tool calls and correctly preserves obligations, rejects stale state, creates human hand-offs, and records workflow closure. Event-threshold and stateless-planner controls satisfy 2/18 and 1/18 oracles, respectively. Component ablations localise failures to the removed memory, policy, or versioning function. The results establish architectural conformance rather than clinical effectiveness and show how agentic systems can automate reconciliation, routing, documentation, and follow-up while preserving human authority over consequential care decisions.
Key facts. No citing papers in the map yet (data through 14 Oct 2026). Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use. Builds on 4 of its 31 references that are in the map. First posted on arXiv 22 Sep 2026.
Builds on
4 of 31 references.
References · 4
- 2022ReAct: Synergizing Reasoning and Acting in Language Modelscited by 8,695
- 2023Reflexion: Language Agents with Verbal Reinforcement Learningcited by 4,276
- 2023Generative Agents: Interactive Simulacra of Human Behaviorcited by 3,568
- 2023AutoGen: Enabling Next-Gen LLM Applications via Multi-Agent Conversationcited by 1,988
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- 2026Cerebra: A Multidisciplinary AI Board for Multimodal Dementia Characterization and Risk Assessment
- 2025AgenticAD: A Specialized Multiagent System Framework for Holistic Alzheimer Disease Management
- 2026Governed Reasoning for Institutional AI
- 2026Beyond Task Success: An Evidence-Synthesis Framework for Evaluating, Governing, and Orchestrating Agentic AI
- 2026Separating Diagnosis from Control: Auditable Policy Adaptation in Agent-Based Simulations with LLM-Based Diagnostics