Background

Most people wish to grow old in their familiar surroundings. Various technologies have the potential to support this desire by promoting health and safety. The concept of “aging in place” describes the possibility of living securely and autonomously in one’s own home, regardless of individual abilities. Apps and wearables can foster both aging in place and healthy aging. Despite their great potential, it remains unclear which apps and wearables of sufficient quality are truly suitable for supporting the health and independence of older adults.

This research project, conducted by the ZHAW School of Health Professions in collaboration with the Institute on Ageing at Bern University of Applied Sciences, addressed the following questions: How can apps and wearables provide support in everyday life? What are the benefits and drawbacks of their use? What requirements should they meet? And what is the quality of apps and wearables available in Switzerland?

 The overarching aim of the project was to provide an overview and clear recommendations for the use of widely applicable apps and wearables that support healthy aging and independent living in later life. These recommendations are grounded in quality considerations, expected benefits, and the needs and attitudes of both primary and secondary users.

Approach

The project combined different methodological approaches and was structured into three work packages:

1. The expected benefits, needs, as well as potential barriers and facilitators of using apps were examined through qualitative focus groups and expert interviews with:
   
   a) older adults living at home,
   b) family members,
   c) healthcare professionals and physicians, and
   d) experts and stakeholders.
   
   
2. A scoping review provided an overview of apps and wearables available in Switzerland. The scoping search was based on:
   
   a) a web crawler for app store searches,
   b) wearable-specific apps, product reviews, and additional online searches to identify devices.
   
   Following an adapted PRISMA approach, apps and wearables were included for quality assessment. Their quality was evaluated by researchers using a checklist that incorporated the criteria of eHealth Switzerland, as well as ethical aspects, data security, and usability.
   
   
3. Based on the findings, the researchers developed recommendations for usage.

Results

Most older adults were regularly using apps—mainly for staying in touch with friends or family and managing daily tasks. All groups – older adults, family members, and professionals – saw significant potential in apps and wearables for early detection of illness, as a complement to healthcare, for promoting physical activity, and for everyday self-management. At the same time, barriers were identified: many applications were not user-friendly or sufficiently tailored to older users; concerns about data protection and security were raised; financial obstacles and a lack of support outside the family environment were noted; and challenges arose from installation, use, and the rapid pace of app development.

The scoping review identified more than 14,000 apps and 34 wearables supporting areas such as daily living, access to information, communication, activity and mobility, safety and emergency management, health and well-being, and early detection and diagnostics. Of these, 142 apps and 31 wearables met the inclusion criteria and were examined in detail. Their quality varied considerably. Common weaknesses included a lack of transparency, unclear legal frameworks, and uncertainty about long-term availability. Furthermore, name or provider changes often made continuous use and discoverability more difficult. Nevertheless, for every benefit or need identified in the focus groups, at least one app of adequate quality was found.

Building on both studies, the research team developed recommendations for the use of apps and wearables in the everyday lives of older adults. These recommendations were discussed and refined in a workshop involving older adults, family members, healthcare professionals, and experts.