فناوری‌های پوشیدنی و فعالیت بدنی سالمندان در ایران: یک مرور روایتی از فرصت‌ها و چالش‌ها

Introduction

The world is experiencing an unprecedented demographic shift toward population aging. By 2050, the number of individuals aged 60 years and older is projected to exceed 2 billion, with low- and middle-income countries, including the Islamic Republic of Iran, facing the fastest growth rates . Physical inactivity is one of the most critical modifiable risk factors in older adults, contributing to sarcopenia, falls, cardiovascular diseases, type 2 diabetes, cognitive decline, depression, and premature mortality. Despite WHO recommendations of at least 150 minutes of moderate-intensity aerobic activity per week, more than 68% of Iranian older adults (age ≥ 75) and 60–80% globally fail to meet these guidelines. Consumer-grade wearable technologies including smartwatches, fitness bands, smart rings, and sensor-equipped garments have emerged as promising, scalable, and cost-effective tools to monitor, motivate, and sustain physical activity in older populations. These devices provide real-time feedback, goal setting, gamification, social connectivity, and remote monitoring capabilities. However, their real-world effectiveness, acceptability, and long-term adherence among older adults, particularly in developing countries with cultural and economic constraints, remain incompletely understood. This narrative review aimed to synthesize global and Iranian evidence on the applications, opportunities, barriers, and policy implications of wearable technologies in promoting physical activity among older adults from a sports management and gerontological perspective.

Methods

This study used a narrative review approach. A comprehensive literature search was conducted for publications from 2015 onwards in major international databases (PubMed, Scopus, Web of Science, Google Scholar) and Persian-language databases (MagIran, SID, IranDoc, Civilica, Noormags). combinations of terms related to “wearable technology”, “fitness tracker”, “smartwatch”, “older adults”, “elderly”, “physical activity”, and their Persian equivalents were used. Inclusion criteria comprised original research, reviews, qualitative studies, and those that (a) involved participants with a mean age ≥ 60 years or where at least 50% were aged ≥ 60, (b) utilized consumer-grade wearable devices (e.g., Fitbit, Xiaomi, Garmin, Apple Watch, Samsung, Huawei, Oura Ring), and (c) reported outcomes related to physical activity, exercise behavior, sedentary time, or associated health parameters. Over 200 records were screened, and 110 high-quality sources (87 English-language and 23 Persian-language publications) were selected for in-depth thematic synthesis following Braun and Clarke’s (2021) six-phase approach.

Results

Wrist-worn devices (fitness bands and smartwatches) dominated the literature (used in >85% of studies), followed by hip/waist clip-on pedometers, smart rings, sensorised socks/garments, and skin patches(5). Meta-analytic evidence from 42 randomized trials indicates that wearable-based interventions increase daily steps by an average of 1,238–1,800 steps and moderate-to-vigorous physical activity by 30–60 minutes per week. Emerging evidence from Iranian studies and similar low- to middle-income contexts supports the potential of wearable technologies to enhance physical activity monitoring and motivation in older adults, particularly through affordable consumer devices; for instance, interventions incorporating activity trackers have demonstrated improvements in cardiovascular endurance, quality of life, and balance among sedentary older adults, alongside growing interest in sensor-based strategies for fall prevention and postural compensation. Key mechanisms of effectiveness include immediate biofeedback, personalized goal setting, gamification elements (badges, streaks), vibration reminders after prolonged inactivity, and social features allowing data sharing with family or coaches. Secondary benefits encompass improved sleep quality, reduced systolic blood pressure (4–10 mmHg), enhanced self-efficacy, and lower depressive symptoms. Nevertheless, substantial barriers persist across multiple domains. Technical issues involve reduced accuracy in darker skin tones, tremor-affected wrists, and loose-fitting devices. Psychological and cognitive barriers include low digital literacy, fear of technology, perceived complexity, and anxiety from constant notifications. Socio-economic obstacles in Iran are particularly salient: high device cost, incomplete Persian-language interfaces, limited rural internet access, and cultural beliefs that “gadgets are for the young.” Ethical-legal concerns center on privacy, third-party data sharing, and the absence of national regulations protecting older adults’ health data. Consequently, 6-month adherence rates in Iran rarely exceed 35–40%, compared with 70–80% in Scandinavian and Singaporean programs.

Conclusion

For wearable technologies to realize their transformative promise in a rapidly aging Iran, they must be embedded within a culturally attuned and supportive ecosystem rather than remain isolated consumer products. This transition demands coordinated actions to enhance device affordability and full Persian-language localization, provide accessible digital literacy programs tailored to older adults, integrate activity trackers into existing community sports and neighbourhood-house initiatives, and establish robust national regulations to safeguard the health data of vulnerable older populations. Only when these contextual foundations are firmly in place can wearable technologies transcend modest increases in daily steps and become sustainable drivers of active, healthy, and dignified aging across diverse socioeconomic and geographic contexts in Iran and similar middle-income countries.

Footnotes

Ethical approval: This study was non-experimental in nature and did not involve any intervention with human or animal subjects; therefore, obtaining an ethics approval code was not required. Nevertheless, all stages of the research were conducted in accordance with ethical research principles, including academic integrity, respect for authors’ intellectual property rights, and avoidance of data fabrication or distortion.

Funding: This article has not received any grants.

Authors’ contribution: All authors contributed to the design, implementation, and writing of all parts of the present study.

Conflict of interest: The authors declare that there is no conflict.

Acknowledgment: We thank all the researchers who contributed to the writing of this article.