JMIR Publications

ABSTRACT

Background:

Smart technologies, including wearables and voice-activated devices offer innovative solutions to support the independence and well-being of older adults. These technologies have the potential to detect falls, support daily activities, and provide health guidance. However, the co-adaptation process between older adults and these technologies, that ensures innovations learn and adjust together over time to better meet the aging population’s unique needs, remains underexplored.

Objective:

This review aims to comprehensively review and analyze existing literature to investigate the extent and nature of the co-adaptation process between older adults and smart technologies. Specifically, it investigates how these two entities evolve together to enhance the older adults' experience and the utility of the technology. The primary research question addressed is the nature and extent of scientific literature exploring the co-adaptation between wearable and voice-activated smart technologies and older adults, and how these interactions evolve over time to improve user experiences.

Methods:

Following the JBI Reviewer's Manual and PRISMA-ScR guidelines, this scoping review examined peer-reviewed articles from ten databases, and included forward and backwards searches. Empirical studies published since 2000 were included if they involved: a) individuals aged 55 years or older living independently; and b) focused on interactions and adaptations between older adults and smart technologies like wearables and voice-activated virtual assistants in interventions of at least 2 months. Data extraction was informed by the Selection, Optimization, with Compensation (SOC) framework and the Sex- and Gender-Based Analysis Plus (SGBA+) theoretical framework, employing a directed content analysis approach.

Results:

Out of a total of 15621 titles and abstracts screened, three articles met the inclusion criteria. Study populations were mostly female and aged 73-83 from the US, and engaged with voice-activated virtual assistants accessed through smart speakers and wearables. Users frequently used simple commands such as inquiries related to music and weather, and integrated the devices into their daily routines, adjusting interaction styles such as speaking tone and phrases for improved engagement. However, ongoing communication barriers between users and devices often led to frustration, due to the devices’ inability to recognize cues or provide personalized responses. The findings underline the need for further research to address the limitations of small sample sizes, limited diversity, and a narrow focus on technology types. Recommendations emphasized inclusivity for individuals with impairments and deeper exploration of usage patterns and diverse user expertise levels across various devices and settings.

Conclusions:

This scoping review offers a comprehensive overview of current evidence on the interaction between smart technologies and older adults over time, emphasizing the need for inclusivity and the exploration of diverse user patterns. Future research should aim for broader demographic representation and examine a wider range of technologies to fully understand and improve the co-adaptation process.