Wearables with a step goal move older adults most, apps lift overall activity

Physical activity tends to fall with age, and keeping older people moving is one of the most reliable ways to protect both physical and mental health in later life. Digital tools, from smartphone apps to wearable trackers, promise a cheap and scalable way to deliver exercise encouragement without a coach in the room. Plenty of trials have tested individual e-Health programmes, but they rarely compare one type against another. This review set out to rank the approaches and identify which kind of digital intervention actually raises activity in older adults.

The authors searched the literature up to July 2025 for randomised controlled trials of e-Health exercise programmes in healthy older people, with physical activity levels and daily step counts as the outcomes. Sixteen studies covering 2,296 participants qualified. Because few trials compared digital approaches head to head, the team ran a network meta-analysis, a technique that combines direct and indirect comparisons so that different intervention types can be ranked against each other and against control groups. Effect estimates with their uncertainty ranges were calculated for each comparison.

For overall daily physical activity, the strongest performer was the computer phone-based intervention, in which participants received a tablet preloaded with an app offering recommendations on healthy habits and physical activity; its effect size against control was 0.47. For daily steps, the winner was the wearable intervention, which combines devices such as pedometers and accelerometers with motivational instructions aimed at a daily step goal, with an effect size of 1.06 against control. Both estimates carried wide uncertainty ranges, which is common when trials are pooled indirectly. No other e-Health format topped either outcome.

e-Health interventions were already known to nudge health behaviours in a positive direction; this analysis adds a ranking of which formats work best for which outcome. It suggests the right tool depends on the goal: app-based guidance for lifting overall activity, wearables with step targets for raising step counts. Open questions remain about how long the gains last once a programme ends, which specific components drive the effect, and whether the findings extend to older people with health conditions, since these trials enrolled healthy participants. It also cannot say whether any particular commercial app or tracker outperforms another.

If you are an older adult wanting to move more, or helping a parent to, this is a reason to think a tracker with a daily step target is a sensible bet for building steps, while a simple app offering activity guidance may do more for overall movement. The effects are averages across varied programmes, so the motivation and goal-setting wrapped around the device likely matter as much as the gadget itself. None of this changes the basic point that any increase in activity counts.