Digital health divide by age: smartphone and wearable adoption patterns and perceived utility to improve health
J Micek, L Kraemer, J Konzok, J Pangratz, R Lutzke, M Wester, J Pec, C Brummer, A Hermann, L S Maier, A Muehlberger, C SchachAbstract
Background
The digital health divide between age groups may limit the reach and effectiveness of smartphone- and wearable-based prevention strategies in routine care.1 Older adults show lower adoption and greater perceived barriers to mobile health apps, patient portals, and wearable devices compared with younger adults, despite potential benefits.2,3
Purpose
Age-related differences in adoption, attitudes, and information preferences are under-characterised in multimorbid hospital cohorts; this study examines these patterns to inform potential interventions.4
Methods
In this cross-sectional study, a 58-item questionnaire was administered to patients and visitors at a tertiary hospital. Three pre-specified age groups (<40, 40–59, ≥60 years) were compared regarding demographics, education, smartphone and tracker use, perceived impact on health behaviour, and usefulness ratings of health information sources.
Results
Among 1206 participants (mean age 63±15 years, 34% female), education levels were broadly similar, yet disparities emerged in net household income, with higher income ranges more prevalent in middle-aged participants than in younger and older participants. Wearable tracker adoption showed an age gradient, with lower uptake in older adults (60.3% in participants <40 years vs. 36.3% in those ≥60 years), while 21.9% of seniors expressed interest in using a tracker (Table). Younger adults more frequently reported regular smartphone use (65.5% vs. 72.2% vs. 44.9%) and more often perceived smartphones as helpful for achieving health goals (19.8% vs. 13.7% vs. 9.0%). Negative attitudes were most frequent in <40y, with 20.7% stating that smartphones prevent healthy living (vs. 13.0% and 6.8%) and 55.2% preferring to spend less time on their phone (vs. 28.8% and 13.3%). Perceived usefulness of health information sources (Figure) differed significantly across age groups overall and for each modality; older adults (≥60 years) consistently rated digital channels as less helpful, with only 5.6% finding social media helpful for improving health compared with 38.8% of <40-year-olds and 9.6% vs. 18.1% endorsing live webinars, while middle-aged adults showed intermediate patterns and seniors preferred traditional formats.
Conclusion
Digital prevention tools are widely used among younger persons, but a digital health divide by age shapes adoption and perceived utility. Seniors report lower uptake and greater scepticism towards digital media, yet show substantial interest in trackers and maintain a relevant interest in specific online media. This highlights an opportunity for age-adapted design, targeted digital literacy support, and integration of trusted traditional channels to make digital prevention tools more inclusive across the lifespan.