JMIR Publications

ABSTRACT

Background:

The accelerated aging of the global population, projected to include 1.5 billion people over 60 by 2050, poses significant challenges to conventional eldercare systems. While aging in place is widely advocated for preserving independence, traditional home care models often struggle to meet complex needs. This gap is exacerbated by the diminishing capacity of informal support networks. Smart home technologies offer a viable pathway to augment care; however, their widespread adoption is impeded by a confluence of usability challenges, privacy concerns, and socioeconomic barriers.

Objective:

This scoping review aimed to examine how smart home technologies could meet the diverse needs of older adults aging in place, identify the key determinants influencing their adoption and sustained use.

Methods:

This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the PRISMA-ScR guidelines. To ensure comprehensive coverage, a systematic search was performed across eleven databases (PubMed, Web of Science, Embase, CINAHL, Cochrane Library, APA PsycInfo, CNKI, Wanfang, VIP, SinoMed, and OpenGrey) targeting literature published between January 2008 and December 2024. Studies were included if they investigated smart home technologies used by older adults (aged 60 and above) living at home and examined relevant needs and adoption determinants. Study selection and data extraction were guided by the Population–Concept–Context (PCC) framework. Thematic analysis was applied to synthesize findings and identify core themes, adoption determinants, and existing gaps in the evidence base.

Results:

A total of 24 studies met the inclusion criteria, with most published after 2015 and primarily conducted in China, the United States, and European countries. The technologies examined ranged from basic sensor-based systems to integrated smart aging platforms. Older adults expressed three core priorities for technology use: health management, safety and emergency support, and support for independent living. Together, these accounted for more than 60 percent of the identified needs. Key facilitators of adoption included strong social support, better digital skills, and a clear perception of usefulness. In contrast, adoption was often limited by challenges such as complex user interfaces, affordability issues, privacy concerns, and cultural resistance. Notably, few studies addressed long-term usage patterns or sustainable implementation models, and the needs of socioeconomically vulnerable groups were insufficiently represented in the current evidence base.

Conclusions:

This review highlighted three primary demands among older adults: health management, safety and emergency support, and the ability to live independently. The adoption of smart aging technologies is influenced by supportive factors such as perceived usefulness and social support, as well as obstacles including usability difficulties, limited digital skills, and privacy concerns. Addressing existing evidence gaps call for a shift from technology-centered approaches to context-aware, user-driven systems grounded in older adults’ everyday experiences. Open Science Framework Registration: https://doi.org/10.17605/OSF.IO/E27KH