Understanding wearable health technology use in older adults through social and psychological factors

Abstract As populations age globally, wearable health technologies offer promising solutions to support autonomy and well-being among older adults. This study explored the adoption of smart wearable systems, such as wristbands and chest sensors, for remote health monitoring among 352 older adults (aged 60–99) in Northern Portugal. Results showed that 74.4% of participants expressed interest in using wearable systems, with safety (93.9%) cited as the main benefit. Prevention (11.4%) and improved health monitoring (6.1%) were reported less frequently and should be considered secondary factors. However, barriers included discomfort (62.7%), heaviness (31.1%), and device size (32.7%), particularly in smartwatches. Chest bands were preferred when soft, lightweight, and discreet. Technology use frequency, especially smartphone usage, emerged as a key predictor of interest, as confirmed by a decision tree machine learning model with an accuracy of 71.88%. Despite low educational levels, participants demonstrated high motivation to use features such as medication reminders (83.5%), healthy habit prompts (74.2%), and appointment alerts (70.2%). Although many respondents felt reassured by the potential of continuous monitoring, some reported concerns related to anxiety (54.9%) and over-surveillance. These findings underscore the importance of balancing technological functionality with emotional comfort. The study highlights the need for user-centered design, digital literacy initiatives, and co-creation with older users to improve adherence and usability. Tailored interventions and accessible technologies can enhance health outcomes and promote independent living among aging populations.