Abstract
The rapid proliferation of wearable health technologies for older adults has not been matched by sustained adoption. Whilst existing literature predominantly focuses on theoretical acceptance models, it provides limited empirical guidance for practitioners seeking to improve usability. This systematic review analyses the usability and acceptance of wearable health devices amongst older adults aged 65 and older to identify usability challenges. Adhering to PRISMA protocols, we systematically searched Web of Science, CINAHL Complete, PubMed Central, Scopus, JMIR, IEEE Xplore, MDPI, SpringerLink, Taylor & Francis, and the ACM Digital Library for studies published between 2014 and 2025 evaluating the usability and/or acceptance of consumer wearable health technologies. Data extraction focused on usability challenges, acceptance frameworks, device ergonomics, and ecosystem integration. Of the 446 records identified, 11 studies involving 727 participants met the inclusion criteria. Key findings revealed predominant reliance on psychological models over engineering‐focused usability research. Significant gaps emerged in physical design studies despite their influence on long‐term use. Unstandardised training approaches limited scalability, and fragmented methodologies impeded evidence synthesis. Future research requires standardised evaluation frameworks, materials‐focused usability studies, and longitudinal analyses. We propose an interdisciplinary research agenda bridging behavioural science and engineering design to enhance evidence‐based development for geriatrics.