Selecting and utilizing wearable devices

Smart wearables have increasingly become valuable tools for monitoring physical activity and other health-related parameters in older adults. Recording and monitoring physical activity plays an important role in everyday life for older adults’ health and functional ability. Physical activity is of particular importance for older adults' physical and mental health. The use of wearable technology and other digital tools have emerged as valuable methods to track health behaviours, assess functional abilities, and provide data-driven feedback for interventions. The use of wearable technology and other digital tools have emerged as valuable methods to track health behaviours, assess functional abilities, and provide data-driven feedback for interventions.

Importance of Recording Physical Activity

Physical activity has long been recognized as a key factor in promoting cardiovascular health, managing body weight, and reducing the risk of chronic conditions like diabetes, hypertension, and osteoporosis. For older adults, regular physical activity also helps prevent sarcopenia (age-related muscle loss), supports joint health, and improves balance, thereby reducing the risk of falls (Jacobson, Smith, Fronterhouse, Kline, & Boolani, 2012). It is suggested that even moderate daily exercise can lead to significant improvements in life expectancy and quality of life. Monitoring physical activity levels is critical for ensuring that older adults are meeting recommended physical activity guidelines. Wearables and activity trackers can provide personalized insights into the amount and intensity of activity, helping individuals and caregivers adjust routines to optimize health outcomes (Frey-Law et al., 2024).

Physical activity also exerts a positive influence on older adults’ mental health. Research findings show positive changes not only in their motor but also in their cognitive function. Regular exercise is associated with a reduced risk of cognitive decline and dementia, as it enhances brain plasticity, promotes neurogenesis, and improves overall mental health (Yan & Zhu, 2009). Systematic participation in physical activity is also associated with improvement in older adults’ mood in general (Kanning & Schlicht, 2010). Recording physical activity can therefore help track patterns that may influence not just physical but also cognitive function. For example, wearable technology can alert caregivers and health professionals to declines in physical activity, which may indicate cognitive changes. Monitoring physical activity levels over time could be a proactive way to detect early warning signs of cognitive impairment, thus allowing for early interventions (Lee & Lee, 2024).

Physical activity is inextricably linked, with a bidirectional association to the functional ability of older adults. In frail older adults, physical functional ability refers to their capacity to carry out activities of daily living, ensuring thus their independent living. Older people usually are classified into different levels of functioning, depending on whether or not they are able to perform:

• activities of daily life (Basic Activities of Daily Living), i.e. basic activities related to hygiene and personal care (e.g. bathing, toileting, eating, dressing, moving around the house),
• instrumental activities of daily living (Instrumental Activities of Daily Living), i.e. activities that are important for integration into society (eg using the telephone, managing money, shopping, cooking, washing, housework),
• advanced activities of daily living (Advanced Activities of Daily Living), a term added a little later and includes all those activities that are not important for survival, but are connected to social, religious or other activities that enrich the lives of the elderly.

Functional assessment of frail older adults is usually done indirectly by self-reports and by observation, as it is not always safe to perform a motor test. In contrast, fit seniors can do much more than activities of daily living and their level of motor functioning is assessed with motor tests, such as the Senior Fitness Test. Physical function tests must aim to the mobility problems of the participant, otherwise there might be ceiling or floor effects. In addition, a study by van Gameren et al. (2024) highlighted the lack of correlation between traditional measures of functional ability, like the Short Physical Performance Battery (SPPB) and actual daily gait quality in older adults. This underscores the need for continuous, real-world activity tracking rather than relying solely on clinical tests, which may not reflect an individual’s true functional ability. By recording physical activity, particularly through the use of accelerometers and wearable devices, it is possible to gain a detailed understanding of how well older adults can manage these tasks in real-world environments. For example, tracking gait patterns, movement intensity, and step counts can provide insights into mobility, balance, and strength.

Recording physical activity allows for personalized and data-driven interventions. Health professionals can use the data from wearables to tailor exercise programs and rehabilitation plans based on real-time information about an individual’s activity patterns. For frail older adults or those recovering from surgery, injury, or illness, these records provide valuable feedback that can enhance recovery outcomes. The continuous monitoring of physical activity levels can also help healthcare providers identify periods of inactivity or a decline in mobility, which could signal underlying health issues. For example, wearable data can reveal when an older adult is becoming more sedentary, potentially prompting early intervention to prevent further decline (Wardi et al., 2024).

Despite the benefits of wearable technology for recording physical activity, a major challenge is the low technological literacy among many older adults. Some may struggle with using wearables or understanding the data provided by these devices. Moreover, older adults with physical impairments may find it difficult to wear or manage these devices consistently. While wearable devices are valuable tools for monitoring health, their design must be inclusive of the needs of older adults. Wearables should be easy to use, with simple interfaces and functionalities, and provide clear, actionable feedback. Studies show that co-designing wearables with older adults can significantly improve adoption rates and user experience (Yan & Guo, 2024).

Another important concern for older adults is data privacy, especially when it comes to sharing personal health information. Wearable devices collect sensitive data, which raises questions about how this data is stored, shared, and protected. Many older users may be hesitant to adopt wearables out of fear that their data may be accessed by unauthorized parties. Addressing privacy concerns through transparent data policies and secure, user-controlled data management systems is essential for increasing older adults’ trust in wearable technology. Clear communication about how data is used and protected will help to alleviate concerns (Yang et al., 2024).

Recording physical activity in older adults is not just a matter of tracking movement; it is an essential tool for promoting health, enhancing functional ability, and preventing decline. Wearable devices and other technological solutions offer unprecedented opportunities to collect real-time data on how older adults live and move in their daily environments. While there are challenges related to technological adoption, privacy, and accessibility, the benefits far outweigh the drawbacks. Through continuous monitoring, personalized interventions, and the integration of AI and healthcare systems, physical activity tracking can significantly contribute to healthier aging populations. Ultimately, the ability to monitor, record, and respond to changes in physical activity patterns holds the promise of improved health outcomes and sustained independence for older adults.

Types of wearables used in healthcare and fitness

Smart wearables offer non-invasive ways to track daily movements, heart rate, sleep patterns, and various physiological metrics. Therefore they are very good tools not only for researchers, but also for health and fitness professionals. The problem with these devices is that they collect a very large amount of data, from various parameters. Exploiting this information requires special training and great expertise in its use. The future of physical activity monitoring lies in the integration of artificial intelligence (AI) and predictive analytics. AI can help process the vast amounts of data generated by wearables to detect patterns and make predictions about health outcomes. For instance, AI-driven models can assess changes in physical activity to predict fall risk or detect early signs of frailty.

AI-based wearables may also contribute to preventive care by identifying deviations from normal activity patterns. This predictive capability can alert healthcare providers to intervene before a serious health issue arises, thereby improving the quality of life for older adults (Pichandi et al., 2024). As healthcare systems increasingly move towards digitalization, the integration of wearable data into electronic health records (EHRs) will become critical. This will allow healthcare professionals to have a holistic view of an older adult’s health, encompassing both clinical data and real-world activity data. Ιntegrating wearable data into EHRs can create a more comprehensive understanding of an older adult’s health status, enabling more personalized and continuous care. This shift toward data-driven healthcare could lead to more proactive management of age-related conditions (Frey-Law et al., 2024) and allow frail older adults to participate in fitness sessions with more safety.

Below is a list of wearables used mainly for healthcare applications and some of them are useful for tracking physical activity too.

2. Smart Rings: Smart rings are compact wearable devices that can monitor vital signs such as heart rate, sleep patterns, and activity levels. They offer a more discreet option compared to larger wearables like smartwatches.

3. Smartwatches: Smartwatches are popular wearables with built-in sensors that monitor various health metrics, including heart rate, physical activity, and sleep patterns. They often come with additional functionalities like fitness tracking, GPS, and even ECG capabilities in advanced models.

4. Smart Clothes: These garments are embedded with sensors that can track a variety of biometric data, such as body temperature, respiratory rate, and muscle activity. Smart clothes are particularly useful in fitness and rehabilitation settings.

5. Smart Eyewear: Smart eyewear includes glasses with integrated sensors and display technologies. In healthcare, they can provide augmented reality (AR) overlays or monitor eye movements, offering potential applications in telemedicine and rehabilitation.

6. Smart Patches: These are adhesive patches embedded with sensors that monitor various physiological parameters such as glucose levels, hydration, and even medication delivery. For instance, continuous glucose monitoring (CGM) patches are frequently used by people with diabetes to track glucose levels in real-time without the need for constant blood sampling. In healthcare, they are often used for non-invasive glucose monitoring, or delivering drugs transdermally (through the skin). They are highly relevant for older adults who may require constant monitoring without invasive procedures.

7. Smart Insoles: These are shoe insoles embedded with pressure sensors that can monitor gait, posture, and balance. Some also track steps, distance, and calories burned, offering a more detailed analysis of foot mechanics. In healthcare, they are especially useful for elderly individuals or patients recovering from surgeries, they can prevent falls by detecting improper walking patterns or balance issues early on.

8. Hearing Aids with Smart Features: Modern hearing aids now come equipped with smart features, such as Bluetooth connectivity and environmental noise adjustments, which improve hearing ability based on real-time conditions. In healthcare, they assist older adults with hearing impairments by improving their quality of life and enhancing their ability to communicate. Some models are also integrated with other health-monitoring functionalities, like fall detection.

9. Smart Gloves: These gloves are embedded with sensors to monitor hand movements, grip strength, and even detect early signs of conditions like arthritis. Some smart gloves also offer haptic feedback for therapy and rehabilitation purposes. In Healthcare, they are useful in physical therapy or for individuals with reduced mobility in their hands, smart gloves can aid in rehabilitation for stroke survivors or patients with Parkinson's disease.

10. Smart Helmets: Mainly designed for athletes, these helmets can track vital signs like heart rate, impact forces (important in high-risk sports), and even brainwave activity. In Healthcare, smart helmets are used for injury prevention, particularly in detecting concussions and ensuring safety in sports or work environments that involve physical risk.

11. Smart Jewelry: Similar to smart rings, but broader in variety, smart jewelry includes bracelets, necklaces, and other wearable forms that track basic health parameters like steps, heart rate, and sleep. In healthcare, smart jewelry is often chosen for its aesthetic appeal combined with functionality, offering a stylish and discreet way to track health without the bulk of larger devices.

12. Smart Socks: These are designed to monitor pressure points, gait, and other foot-related health data, making them particularly useful for individuals with diabetes or circulatory issues. In healthcare, smart socks can help in early detection of foot ulcers, a common problem in older adults and people with diabetes, and they can also help prevent falls by identifying irregular walking patterns.

13. Smart Belts: These are belts embedded with sensors to monitor posture, sitting duration, and movement. Some smart belts can even alert the wearer to stand up after long periods of inactivity. In healthcare, these are particularly helpful for elderly individuals to monitor posture and movement, reducing the risk of falls or back problems.

14. Biosensors (Wearable Sensors): Biosensors are a class of sensors integrated into various types of wearables (patches, clothing, etc.) that can detect chemical and biological data, such as lactate levels, electrolyte balance, or hydration levels. They are extensively used in medical research and sports science, biosensors can provide detailed, real-time physiological data that are otherwise hard to capture through non-invasive means.

15. Smart Necklaces: These wearable devices are often used to monitor posture and neck activity. Some are specifically designed to vibrate when the wearer slouches, reminding them to correct their posture. Posture correction is crucial for elderly individuals to avoid back pain and other musculoskeletal issues. Smart necklaces provide a simple and non-intrusive solution.

16. Wearable Air Purifiers: These are personal devices that can be worn around the neck to purify the air around the individual, filtering out pollutants and allergens. They are especially useful for individuals with respiratory conditions or those living in areas with high pollution levels, wearable air purifiers help ensure clean air intake.

17. Smart Glasses (Enhanced Features): Beyond just smart eyewear with augmented reality (AR), some smart glasses have medical applications like visual aids for low-vision users. These devices offer image enhancements or even magnify specific areas in the field of vision. Smart glasses for healthcare applications can help individuals with vision impairments, providing assistance in navigating daily life or reading.

Scientific evidence on issues in recording physical activity, using wearables in older adults.

The above expanded list of wearables, is evidence of how technology is evolving to monitor various health metrics and help older adults maintain physical activity and wellness. Focusing on fitness wearables is crucial, especially for older adults, as these devices can help track physical activity, motivate users to stay active, and ensure they are meeting health goals.

There are however, specific issues in recording different types of physical activity, using wearables in older adults. These issues are usually related to the usability, accuracy, and specific health parameters recorded by wearables, when recording physical activity to the certain population group. Several reviews have assessed the use of wearables for older adults. Teixeira et al. (2021) conducted a critical review of wearable devices focusing on their effectiveness in monitoring physical activity and health parameters in older adults. The study identified that devices designed specifically for seniors, with adjustable features and easy data interpretation, provided the best outcomes in terms of health monitoring and physical activity encouragement. Additionally, Vargemidis et al. (2020) conducted a systematic review of wearable physical activity tracking systems for older adults, identifying parameters like ease of use, battery life, and accuracy as key factors in the adoption of these devices.

One of the main challenges identified across multiple studies is the accuracy of data when monitoring older adults with inconsistent physical activity patterns. A study by Paraschiakos et al. (2020) highlighted that inconsistencies in data due to irregular movement patterns can affect the performance of wearable sensors. Nonetheless, advancements in machine learning algorithms can help mitigate such issues, improving the accuracy of activity and health monitoring. Chow and Yang (2020) conducted a validation study on optical heart rate sensing technology in wearable fitness trackers, comparing their accuracy across different age groups. The study found that modern wearables can reliably track heart rate during moderate physical activities in both young and older adults, making them suitable for continuous health monitoring. Moreover, Olmedo-Aguirre et al. (2022) emphasized the importance of wearables in remote health monitoring for the elderly, especially those with chronic conditions. Wearable devices are capable of tracking crucial health metrics such as heart rate variability (HRV), respiratory rate, and activity levels, offering a comprehensive view of an individual’s health status.

Another important concern, when selecting the most appropriate wearables for older adults is usability. As a highly heterogeneous population, older adults may present vast variations in their ability to use devices, something that depends on their previous experience and familiarization with modern technology. A study by Martinato et al. (2021) evaluated the usability and accuracy of smartwatches for elderly users. It found that while wearable devices are effective in measuring physical activity, older adults may experience usability challenges, especially concerning data interpretation and device operation. The research concluded that wearables with simple interfaces and visual feedback mechanisms are more user-friendly for the elderly population. Similarly, Ehn et al. (2018) explored older individuals' experiences with activity monitors, highlighting that providing real-time feedback on health parameters can motivate them to increase their daily physical activity. However, the need for user training and familiarization with the devices remains crucial for widespread adoption among people of old age. Furthermore, wearable technologies for health monitoring must address social acceptance issues among older users. Li et al. (2019) proposed the Smart Wearable Acceptance Model (SWAM), emphasizing the importance of perceived usefulness and ease of use in the successful adoption of these technologies among older populations.

In conclusion, smart wearables offer tremendous potential for monitoring physical activity and other health parameters in older adults. Devices that prioritize usability, accuracy, and simplicity are more likely to be adopted and provide reliable data. The future of smart wearables in healthcare will likely see greater integration with machine learning technologies to enhance data accuracy and offer personalized health recommendations.

In the last decade, virtual reality (VR) systems have gained popularity. These systems provide users with the most realistic simulation experience by completely immersing them in a computer-generated world. To achieve this, users wear a head-mounted display (HMD) that provides a stereoscopic image corresponding to their position. This image can be refined by adding audio and sensory stimuli. Nowadays, VR is no longer solely utilised as a gaming tool, it can also be employed in healthcare, rehabilitation and within sports (Mandal, 2013; Kaplan et al, 2019).

VR can be integrated with Augmented Reality (AR). AR is a technology that overlays 3D computer-generated information or images onto the real world, thereby creating a fusion of the physical and virtual worlds. This is achieved through the use of apps and hardware, such as AR glasses. The integration of virtual reality (VR) and augmented reality (AR) is referred to as extended reality (XR). In XR, the digital and physical worlds will be merged, enabling users to interact with digital content in a 360° environment (Greengard, 2019).

In recent years, virtual reality (VR) has emerged as a powerful tool for promoting active lifestyles among healthy seniors over 55. Far from being a technology exclusively for the young, VR is proving to be an engaging and effective means for older adults to enhance their physical, cognitive, and social well-being.

Physical Benefits

VR offers a unique opportunity for seniors to engage in physical activities that might otherwise be challenging or inaccessible. Through "exergames" - a combination of exercise and gaming - older adults can participate in a wide range of virtual sports and activities (Wang, 2023) These immersive experiences not only provide cardiovascular benefits but also improve balance, mobility, and overall functional fitness (Wang, 2023; ).

A 12-week study demonstrated significant improvements in physical functioning among seniors who participated in VR training programs. The engaging nature of VR exercises encourages longer periods of activity, potentially leading to better health outcomes (Wang, 2023).

Cognitive Stimulation

Virtual reality isn't just about physical exercise; it's also a powerful tool for cognitive engagement. VR experiences can challenge and stimulate the mind in various ways:

• Spatial Awareness: Navigating virtual environments helps maintain and improve spatial cognition.
• Memory Enhancement: Exploring historical sites or recreating past experiences can stimulate memory and recall.
• Problem-Solving: Interactive VR games often involve puzzles and challenges that keep the mind sharp.

These cognitive benefits are particularly important as they may help in maintaining mental acuity and potentially reducing the risk of cognitive decline (Ramalho et al, 2024).

Social Engagement

One of the most promising aspects of VR for seniors is its potential to contribute to social connections. Many VR platforms offer multiplayer experiences, allowing older adults to interact with friends and family regardless of physical distance (Kalantari et al, 2023). This feature is especially valuable for maintaining social ties and combating feelings of isolation.

Research has shown that older adults respond positively to social interactions in VR settings (Lin et al, 2018). These virtual social experiences can be particularly beneficial for those with limited mobility or those living in remote areas, providing a sense of community and shared experiences.

Exploring New Horizons

For active seniors, VR opens up a world of possibilities:

• Virtual Travel: Explore distant locations or revisit favorite places without the physical strain of travel (Ramalho et al, 2024).
• Learning Opportunities: Engage in virtual workshops, lectures, or skill-building exercises (Kalantari et al, 2023).
• Cultural Experiences: Attend virtual concerts, museum tours, or theatrical performances (Kalantari et al, 2023).

These experiences not only provide entertainment but also contribute to lifelong learning and personal growth.

Based on the search results, several types of VR exercises have shown effectiveness for seniors:

Exergames

VR "exergames" - a combination of exercise and gaming - have emerged as particularly beneficial for older adults. These games blend physical activity with interactive, game-like elements to increase engagement.

Tailored Fitness Programs

VR fitness programs specifically designed for seniors have shown promise:

• Low-impact exercises adapted for older adults
• Personalized routines accommodating different fitness levels
• Programs focusing on improving balance, mobility, and cardiovascular health

Mind-Body Exercises

VR-based mind-body exercises have demonstrated benefits for both mental and physical health of older adults:

• Virtual Tai Chi
• VR meditation sessions (typically 5-15 minutes long)
• Other mindfulness practices in immersive environments

Functional Fitness Training

A 12-week study found VR-based training improved several aspects of functional fitness in older adults:

• Upper and lower body flexibility
• Upper body strength
• Cardiorespiratory fitness
• Balance and agility (Wang 2023)

Some of the Top VR Fitness Games for Seniors

• Beat Saber: This rhythm-based game gets you moving to the beat of the music. Wielding two virtual lightsabers, you'll slice through beats as they fly towards you. It's a fun way to improve coordination and get a light cardio workout.
• BoxVR: BoxVR offers a variety of workouts designed by professional fitness instructors. It combines boxing moves with rhythm gameplay for a full-body workout. The intensity can be adjusted, making it suitable for seniors of all fitness levels.
• Dance Central: Dance Central is a great way to have fun while exercising. Follow the virtual dancers' moves and dance to popular music tracks. It's a fun way to improve balance and coordination.
• Walkabout Mini Golf: This game provides a relaxing, low-impact workout. Walk around beautiful virtual golf courses and swing your club to hit the ball. It's a fun way to stay active and improve your range of motion.
• Les Mills Body Combat: Encouraged by real life look instructors Les Mills Body Combat offers a variety of workouts including boxing, dance, and high-intensity interval training (HIIT). The intensity can be adjusted, making it suitable for seniors of all fitness levels.
• Rec Room: Rec Room offers a variety of activities including paddleball, dodgeball, and charades. It's a fun way to stay active and socialize with others in a virtual environment (The Role of Virtual Reality in Promoting Healthy Aging and Active Lifestyles | FXMedia: Solutions for Metaverse, 2024)

While specific optimal "doses" of VR exercise are still being researched, studies have shown positive results with sessions ranging from 75-90 minutes, conducted twice weekly over 12-week periods (Wang, 2023)]. The key is to provide engaging, safe, and adaptable VR experiences that encourage regular participation and address the unique needs of older adults.

Wearable technology has the potential to improve health monitoring and management among older adults by enabling real-time tracking of physical activities, health metrics, and disease symptoms. Incorporating smart wearables into the lives of individuals over the age of 55 can offer profound benefits in promoting physical activity, health tracking, and overall motivation. Wearables such as fitness trackers, smartwatches, and other health-monitoring devices enable users to set achievable goals, track their progress in real-time, and receive personalized feedback to sustain motivation. However, training older adults to effectively use wearables presents several challenges due to physical, cognitive, and technological factors. Below there is an effort to present the main barriers when training older adults to use effectively wearables in fitness sessions, while suggesting possible solutions for enhancing user adoption and efficacy. There is also some practical strategies for using the above technologies to engage older adults and enhance their well-being.

Issues in training older adults to use wearables

Training older adults to use wearable technology requires addressing both physical and cognitive limitations, as well as technological and psychological barriers. To ensure successful adoption, training should be tailored to individual needs, focusing on usability, simplicity, and relevance. Involving older adults in the design and testing of these devices will further improve their accessibility and ease of use. Finally, offering sustained support and addressing concerns around privacy and security can increase confidence and reduce resistance, making wearables a valuable tool for enhancing the health and well-being of older populations.

As people age, their physical limitations are apparent in their fine motor skills and dexterity that tend to deteriorate, which can make interacting with small wearable devices challenging. Wearables like smartwatches, fitness trackers, and health monitors often require precise touch gestures, button pressing, or screen swiping. Older adults may struggle with these actions due to reduced hand mobility or tremors, a common issue for those with arthritis or Parkinson’s disease. Wearables designed with larger, more tactile buttons or voice activation could alleviate some of these physical barriers. Some studies have recommended co-designing wearables with elderly participants to improve usability and accessibility (Kimura et al., 2024). Cognitive impairments, such as memory loss and decreased attention span, are also significant barriers to training older adults. Remembering how to operate a device, charge it, or interpret the data can be difficult. Training programs often rely on complex instructions, which can overwhelm users with cognitive decline. Simplified interfaces and personalized training methods (e.g., one-on-one training sessions or instructional videos) could support cognitive needs. Studies suggest breaking the training into small, digestible steps to accommodate memory and learning limitations (Yan & Guo, 2024).

A significant proportion of older adults have low levels of technological literacy, which creates a gap in their ability to adopt wearables effectively. Many older individuals may have had limited exposure to smartphones, tablets, or other digital interfaces, which exacerbates their difficulty in understanding and using wearables. Training older adults to use wearables often requires overcoming their apprehension toward technology. Research suggests that older adults need sustained support and encouragement to build confidence. Additionally, trainers should prioritize patient, hands-on guidance rather than traditional lecture-style instruction (Gao et al., 2024).

While the benefits of wearables are clear, certain barriers hinder their full adoption among older adults. Many older adults experience what is termed “technological anxiety,” which refers to the stress or discomfort associated with learning and using new technologies. This fear can prevent them from fully engaging with the wearable, even if they understand its potential health benefits. Common issues reported by older adults, include device complexity, data interpretation challenges, and concerns about battery life. Peng et al. (2021) noted that older adults are more likely to use wearables that offer simple interfaces and clear instructions. Additionally, Chow and Yang (2020) highlighted the importance of offering introductory tutorials and visual feedback mechanisms to assist elderly users in learning how to operate the devices effectively.

To address this technological anxiety, faced by older adults, trainers can foster a positive learning environment that emphasizes the benefits of wearables rather than focusing on their technical complexity. Studies suggest that using peer mentoring programs, where older adults train one another, can reduce anxiety and improve adoption rates (Yan & Guo, 2024). Involving older adults in the design process of wearables ensures that the devices are user-friendly for their specific needs. Accessibility features like larger fonts, voice-activated commands, and simplified displays should be prioritized to ease usability concerns. Many older adults benefit from user-centered designs that simplify device interactions. Providing clear feedback on the device’s functionality and offering error correction options can prevent frustration (Liang, 2024). Table 1 summarizes examples of typical issues that the older adults raise as barriers in using wearables.

Older adults may not perceive wearables as necessary or relevant to their lives, especially if they do not feel a direct connection between the technology and their well-being. This perceived lack of relevance can hinder motivation to learn how to use these devices. Trainers should focus on framing wearables as tools that can directly enhance the user’s independence, safety, and quality of life. Demonstrating the specific health benefits that wearables can offer, such as fall detection or heart rate monitoring, can increase user engagement (Wall et al., 2024). Older adults often express concerns about privacy when using digital health tools, fearing that their personal data could be misused. Wearables, especially those that track sensitive health data, can increase anxiety about data breaches, identity theft, or third-party access to their personal information. Clear communication about privacy policies, data security, and user control over data sharing is critical in training sessions. Explaining how wearables protect privacy and ensuring trust through transparency can help mitigate these concerns (Pichandi et al., 2025).

Training programs should be adapted to the needs of older adults by being more personalized and flexible. For instance, smaller group settings and individualized coaching have been shown to enhance the learning experience for older adults. Offering longer training sessions that allow participants to practice at their own pace, as well as follow-up support sessions, can lead to better retention and user comfort with the technology. Additionally, employing adaptive learning technologies that adjust to the user’s learning pace may be beneficial (Lee et al., 2024).

Tracking Progress, Setting Realistic Goals and Providing Feedback

Tracking progress is a major benefit of wearable technology, allowing individuals to see the results of their efforts over time. Research findings suggest that older adults appreciate the ability to view their progress directly on their wearable devices, since it reinforces their motivation to remain active (Ehn et al., 2018). Wearables display key metrics such as steps taken, calories burned, active minutes, and even heart rate variability. The data is often represented visually, using graphs and charts that make it easy for individuals to understand their daily performance relative to their goals. Furthermore, it has been proved that wearables encourage sustained behaviour change by offering timely feedback, such as congratulatory notifications or reminders to keep moving (Moore et al., 2021). The feedback provided by wearables is usually in the form of:

• Daily Progress Notifications: Inform users of how close they are to reaching their step or activity goal.
• Weekly Reports: Summarize overall performance, displaying trends such as an increase in physical activity or improved sleep.
• Heart Rate Alerts: Notify users when their heart rate exceeds or drops below a safe range during exercise.

The form of the feedback that the wearables offer may be used as a critical tool to set goals. One of the most important things in setting goals, in any population, is to set achievable and realistic goals. Following this rule in setting goals is important for the self-efficacy of 55+ individuals, which in turn is essential to maintaining long-term engagement with physical activity. According to a study by Kononova et al. (2019), setting daily step targets using wearable devices significantly increased activity levels in older adults. Wearables provide several built-in functionalities that enable users not only to set goals but also to customize their goals based on their health status, previous activity levels, and personal fitness objectives.

Decisions on goal selection should be based on the functional fitness and participants’ needs in order to be realistic and achievable. However, goals should have to be specific and this is a feature that may be achievable only if we take into account not only the goal type, but also specific features of the available wearables that the participants may easily read. Table 2 is an example of the goals that could be set based on the wearable features.

Selecting the best wearable for older adults

Selecting the best wearable for older clients requires the fitness professional to have a good knowledge background on the wearables available in the market. The fitness instructor should know which wearables are reachable to the older participants, what are their main features and what is their fitness relevance, that is how they could be used for setting goals and provide feedback. Below is a list of wearables commonly used in fitness area. For each wearable, there are common trademarks and a summary description of their features. There are also some hints for use in fitness settings.

1. Fitness Trackers (Activity Bands)

Description: Devices like Fitbit, Garmin, or Xiaomi Mi Bands are designed to track daily steps, distance traveled, calories burned, and heart rate. These devices often come with additional features like sleep tracking, GPS, and sometimes even VO2 max measurements.

• Fitness Relevance: Fitness trackers are particularly useful for seniors as they offer goal-setting features (e.g., 10,000 steps a day), motivate physical activity, and provide a clear picture of daily fitness achievements.

2. Smartwatches (Fitness-Focused)

Description: Devices like the Apple Watch, Samsung Galaxy Watch, and Garmin Forerunner integrate fitness tracking with smartwatch capabilities. Many smartwatches include sensors for heart rate monitoring, oxygen saturation (SpO2), and even ECG, making them suitable for more in-depth health tracking.

• Fitness Relevance: These devices encourage users to stay active through reminders and goals like daily activity rings or custom workout plans. For older users, it offers both fitness motivation and health monitoring (e.g., abnormal heart rate alerts).

3. Heart Rate Monitors (Chest Straps and Armbands)

Description: Devices like Polar H10 and Wahoo Tickr are worn around the chest or arm to provide accurate heart rate data during workouts.

• Fitness Relevance: Heart rate monitoring is crucial in ensuring seniors exercise within a safe heart rate zone, making it suitable for cardiac rehabilitation or general fitness goals. These are often more accurate than wrist-based sensors.

4. Smart Shoes & Insoles (Fitness)

Description: Devices like Under Armour’s smart shoes or smart insoles (e.g., Digitsole) track running metrics such as pace, stride length, and even foot pressure.

• Fitness Relevance: Smart shoes or insoles help in tracking walking or running biomechanics, which can prevent injury and encourage older adults to maintain proper walking posture. They can also help monitor daily steps more accurately.

5. GPS Running Watches

Description: These are specialized fitness devices, like Garmin Forerunner or Polar Vantage, that are designed for runners and hikers. They come with advanced features like GPS, heart rate zones, and running cadence analysis.

• Fitness Relevance: Ideal for more active older adults who enjoy walking, jogging, or hiking, these watches provide data on distance, speed, and heart rate, motivating users to achieve fitness milestones and improve cardiovascular health.

6. Smart Rings (Fitness-Focused)

Description: Devices like Oura Ring and Motiv Ring can track physical activity, sleep quality, heart rate variability (HRV), and even body temperature. While smaller than smartwatches, they offer a comprehensive overview of physical activity.

• Fitness Relevance: Smart rings are discreet yet powerful for seniors who might not want to wear bulkier devices. They are particularly good for tracking passive activities like walking and provide data on recovery and sleep, ensuring overall well-being.

7. Posture Monitoring Wearables

Description: Devices like Upright GO are designed to monitor and correct posture by vibrating when the user slouches.

• Fitness Relevance: These devices help older adults maintain good posture, which is essential for preventing back pain and injuries, especially during physical activities or exercises that involve body movements.

8. Wearable Resistance Bands

Description: Some fitness wearables come in the form of smart resistance bands (e.g., Tangram Smart Rope) which track repetitions, speed, and calories burned during strength exercises.

• Fitness Relevance: Wearable resistance bands are ideal for low-impact strength training exercises, which are important for older adults to maintain muscle strength and joint health. Tracking reps can motivate seniors to improve strength over time.

9. Body Composition Monitors

Description: Smart scales or body composition monitors (e.g., Withings Body+ or Garmin Index) can track weight, muscle mass, fat percentage, and water retention. Some also sync with fitness apps or wearables to provide a more holistic view of fitness.

• Fitness Relevance: For older adults, monitoring body composition helps in ensuring muscle mass retention and preventing sarcopenia (age-related muscle loss). These devices also help set realistic fitness goals.

10. Smart Hydration Trackers

Description: Devices like HidrateSpark monitor your water intake and remind you to stay hydrated by syncing with fitness apps and providing data on your hydration status.

• Fitness Relevance: Hydration is crucial for maintaining physical performance, especially for seniors who might forget to drink water. Smart water bottles or hydration trackers ensure they stay properly hydrated during workouts and throughout the day.

Table 3 is an effort to compare popular fitness wearables for older adults. The devices included are:

• Fitness Relevance: A versatile fitness tracker suitable for older adults, with features like heart rate monitoring, stress tracking, and sleep analysis, encouraging daily movement.
• Apple Watch Series 9: Combines fitness tracking with advanced health features, making it ideal for older adults, especially with fall detection and ECG monitoring.
• Garmin Forerunner 45: Excellent for older adults who enjoy running or walking. Its simple interface and accurate GPS and heart rate metrics provide motivation for fitness goals.
• Oura Ring: A discreet smart ring that monitors daily activity, heart rate variability (HRV), and sleep, offering passive wellness tracking, ideal for seniors who prefer less intrusive wearables.
• Polar H10: This highly accurate chest strap heart rate monitor is perfect for seniors engaged in more intense cardio activities, ensuring they stay within a safe heart rate zone.

In conclusion, smart wearables offer a range of functionalities that can help older adults track their progress, set goals, and stay motivated. The combination of goal-setting, progress tracking, feedback, and social engagement features makes these devices an effective tool for promoting long-term physical activity and health maintenance in the 55+ population. By addressing the common barriers and providing appropriate guidance, older adults can reap the full benefits of smart wearables in maintaining an active and healthy lifestyle.

The recommendations below may help trainers to enhance the effectiveness of smart wearables as fitness tools for older adults, helping them to lead active, healthy, and independent lives. Ultimately, these recommendations empower trainers to use wearable technology more effectively, making their sessions safer, more motivating, and more closely aligned with the unique needs of older adults. This personalized, data-driven approach not only enriches the client’s fitness journey but also enhances the trainer’s capacity to deliver high-quality, impactful fitness services.

• Understand Your Client’s Needs and Limitations
  Prioritize wearables that align with each older adult’s unique fitness goals, health status, and technological comfort level. Assess their physical and cognitive abilities to ensure the selected devices are practical and accessible. Simplified interfaces and large display screens may benefit clients with reduced vision or dexterity.
• Involve Clients in Goal Setting
  Involve older adults in setting personalized and realistic goals using wearables. Goals such as step counts, moderate-intensity activity targets, or specific health parameters can enhance motivation and provide clear, attainable benchmarks for progress.
• Provide Comprehensive, Hands-On Training
  Many older adults may lack experience with digital technology. Deliver step-by-step, hands-on instruction, and consider using larger visuals or simplified tutorials to demonstrate device operation. Reinforce learning by encouraging clients to practice regularly under supervision until they are comfortable.
• Encourage Regular Usage and Consistent Feedback
  Motivation can be bolstered by regular tracking of progress through daily summaries or weekly reports. Set up notifications and personalized feedback to celebrate milestones, which can reinforce positive behaviour changes and make wearables feel more integrated into their lives.
• Address Privacy and Security Concerns
  Older adults often worry about data privacy, especially with health information. Reassure them by explaining how data is securely managed and clarify that they control what data is shared. Highlight devices that prioritize user-controlled data sharing and feature transparent privacy policies.
• Promote Simple Wearable Options for Specific Needs
  For clients who may feel overwhelmed by complex devices, suggest single-function wearables like heart rate monitors or step counters that provide straightforward, goal-oriented tracking. Focus on one or two health indicators to avoid overwhelming them with data.
• Offer Adapted and Continual Support
  Continue providing support even after initial training. Check in regularly to answer questions, troubleshoot issues, or refresh skills. Consider follow-up sessions to ensure clients remain comfortable and engaged with their wearable technology.
• Leverage Data for Customized Interventions
  Use the data collected from wearables to tailor fitness sessions and adjust plans. Monitoring metrics like heart rate variability or activity levels allows for responsive interventions, helping older adults stay within safe limits and achieve optimal health outcomes.
• Be Sensitive to Technological Anxiety
  Recognize and address any anxiety related to using new technology by fostering a supportive learning environment. Patiently guide older adults through difficulties, focusing on the benefits and reassuring them that mistakes are part of the learning process. Peer mentoring or group settings can also provide a supportive atmosphere and boost confidence.

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