Barriers to Digital Health Adoption in Older Adults: Scoping Review Informed by Innovation Resistance Theory

Older adults' resistance to digital health is not simply a lack of adoption but a complex, emotionally grounded process involving functional, psychological, and identity-based barriers. This review applies IRT to primary care digital health, shifting the focus from adoption facilitators to resistance mechanisms and integrating co-occurrence patterns into a conceptual model. The synthesis reveals interacting factors of usability, self-efficacy, anxiety, trust, and legitimacy concerns that reinforce avoidance, suggesting that implementation strategies should extend beyond technical usability to rebuild trust, preserve relational care, and align digital solutions with older adults' values. Review limitations include the predominance of Western-based studies and limited longitudinal data on how resistance evolves.