Fancier activity trackers got older adults moving; simple step counters did not

Physical activity delivers substantial health benefits, yet older adults are less active than the rest of the population, which makes any tool that reliably gets them moving worth testing properly. Wearable trackers are the obvious candidate, but they are not all the same: simple pedometers count steps, while accelerometers capture movement and its intensity more fully. Whether these devices actually increase activity in people aged 65 and over, and whether the type of device matters, had not been pooled and formally examined.

The review searched MEDLINE, Embase and CINAHL for trials that randomly assigned people aged 65 and over to use a wearable activity tracker with the intent of increasing physical activity. Trials were allowed to include co-interventions such as goal-setting counselling or a continued physical therapy programme. Nine trials with a combined 939 participants qualified: four used accelerometers, four used pedometers, and one compared the two. Physical activity outcomes were then pooled statistically across the trials.

Accelerometer-based interventions produced a statistically significant increase in physical activity, with a standardised effect of 0.43, and the trials behind that figure barely disagreed with each other. Pedometer interventions did not reach significance, with a smaller standardised effect of 0.17 and more inconsistency across studies. The authors flag that most included trials carried a high risk of bias, which limits confidence in both findings. They call for high quality studies that isolate the effect of the accelerometer itself.

This pooling suggests the type of wearable, not merely wearing one, may shape whether older adults move more, a distinction earlier work rarely drew. Because many trials bundled trackers with coaching or other support, the accelerometer effect cannot be cleanly attributed to the device alone. It is also possible that better pedometer trials would close the gap, given the inconsistency around that estimate. The overall picture is encouraging for wearables in this age group but far from settled.

If you or a parent are weighing up a wearable to build activity, this is a reason to note that the pooled evidence favours richer motion-sensing trackers over a bare step counter, at least among the over-65s studied. It is equally worth knowing that the underlying trials were biased enough that neither result should be treated as final. And since the devices were often paired with human support, the gadget alone may not be the active ingredient.