Irrelevant Gadgets or a Source of Worry: Exploring Wearable Activity Trackers with Older Adults
Dimitri Vargemidis, Kathrin Gerling, Vero Vanden Abeele, Luc Geurts, Katta Spiel · 2021 · ACM Transactions on Accessible Computing · doi:10.1145/3473463
Summary
This qualitative study explores older adults' perspectives on wearable activity trackers and physical activity (PA), addressing a gap in research that typically focuses on system performance rather than user perspectives. The researchers conducted a two-part study: first, focus groups, interviews, and co-design sessions with 24 independently living older adults (average age 79) in Belgium, followed by an online survey with 41 older adults (average age 69). During co-design sessions, nine participants crafted paper prototypes of their ideal wearables. Through thematic analysis of 615 discussion instances, two main themes emerged: (1) physical activity is personal and complex, shaped by individual preferences, health conditions, social relationships, built environment, and safety concerns; and (2) wearables are an emotional technology that can trigger anxiety when resembling medical devices or pressure users to perform. The study challenges the assumption that wearable activity trackers are inherently beneficial for older adults, finding that most participants did not perceive currently available systems as useful due to misalignment with their actual needs and preferences.
Key findings
The research reveals a fundamental mismatch between wearable activity tracker design and older adults' lived experiences. Key findings include: (1) Older adults already possess body awareness—they "listen to their bodies" to gauge appropriate activity levels and do not require technology to tell them whether they are active enough. (2) Wearables triggered negative emotions through association with medical monitoring devices; participants reported anxiety about potentially worrisome health data and stigma from wearing devices that marked them as "old" or "ill" to peers. (3) Goal-setting and competition features, central to most commercial trackers, were perceived negatively—older adults expressed that they "don't need to perform anymore" and found comparisons with others discouraging rather than motivating. (4) Barriers to PA (pain, injury, unsafe environments, lack of partners) cannot be addressed by step-counting technology. (5) Preferred activities (gardening, dancing, volunteering, cycling) are poorly supported by trackers focused on walking. (6) Survey respondents (10 years younger on average) showed less association between wearables and medical devices, suggesting age-related differences in perception. (7) Six of nine co-design participants created watch-like prototypes, emphasizing familiarity and avoiding medicalized aesthetics.
Relevance
This paper provides crucial guidance for designers of wearable technology targeting older adults. The core message is that technology designed for younger, fitness-oriented audiences may be irrelevant or actively harmful for older users. Practitioners should consider: (1) Supporting diverse activities beyond walking—gardening, dancing, swimming, volunteering all constitute meaningful PA for older adults. (2) Avoiding medicalized aesthetics that trigger anxiety and stigma; designs should resemble familiar objects like watches rather than health monitors. (3) Replacing competitive goal-setting with "compassionate" approaches that lift users up rather than shame them for periods of inactivity due to illness or pain. (4) Recognizing that many older adults are informed non-users who have thoughtfully decided wearables do not serve their needs—this is not a problem to solve but a preference to respect. (5) Addressing the social and environmental barriers to PA (safe walking routes, exercise partners, accessible facilities) rather than placing sole responsibility on individuals. The paper provides six design questions that researchers and developers should ask when creating PA technology for older adults.
Tags: wearables · older adults · physical activity · participatory design · co-design · thematic analysis · activity trackers · aging · qualitative research