Older adults stick with fitness trackers when someone helps set the goals

Wearable monitoring devices carry well-documented health benefits, yet many older adults simply stop using them, which cancels out any advantage the technology offers. Peers and health care professionals could plausibly help by explaining the purpose of the device, setting goals matched to its features, helping users understand the health data it captures, and troubleshooting the technology. Whether that kind of support actually improves adherence in older adults living in the community had never been properly examined, which is the gap this review set out to fill.

The reviewers searched seven electronic databases for articles published between January 2010 and June 2023, looking specifically for randomised controlled trials of peer-led or professional-led interventions to improve wearable adherence in community-dwelling adults aged 60 and older. Two reviewers independently extracted the data and assessed each study's risk of bias using the standard Cochrane tool. From 10,511 studies identified in the search, three trials met the criteria, together involving 154 older adults with a mean age of 65.

Two strategies stood out as effective for keeping older adults using their wearables. The first was increasing their awareness of being monitored; the second was the SystemCHANGE approach, a habit change tool built around personal goals and feedback. When older adults designed specific device-related goals collaboratively with health care professionals such as nurses and physicians, they showed a higher likelihood of sticking to the prescribed use of the device. All three included trials were rated as having a low risk of bias, which strengthens confidence in this small evidence base.

The health benefits of wearables were already well documented, and low adherence among older adults was a known problem; what was poorly understood was whether structured human support could fix it. This review suggests it can, and points to goal-setting and awareness as the active ingredients that give structure and motivation, helping the devices slot into daily routines. With only three trials and 154 participants, though, the evidence base is thin, and questions remain about which components matter most and whether peers can do the job as well as professionals.

The interesting message here is that adherence to a wearable may have less to do with the gadget itself and more to do with the scaffolding around it. Knowing that someone will see the data, and having a concrete goal the device can measure, were the two things that kept older adults wearing theirs. For anyone whose tracker enthusiasm tends to fade, or who is helping an older relative get value from one, this is a reason to think the missing piece is a goal and a check-in rather than a newer model.