Presentation
From Early Warning to Life-Saving Intervention: Case Study Evidence of Persuasive Wearable Health Monitoring in Older Adults and Older Adults With MCI
DescriptionIntroduction
Wearable technologies have become increasingly available in the consumer marketplace (Wright & Keith, 2014). One type of wearable is known as a persuasive wearable (PW). These are commercially available devices that utilize sensors to collect biometric data, tracking the wearer’s activity and sleep patterns. These data are then displayed on the device itself or on an accompanying mobile device, such as a tablet or phone. Furthermore, these devices can incorporate gamified features to enhance user motivation and interactivity, such as daily scores, progress rings, and social communities (Mercer et al., 2016). While PWs may not be as accurate as lab-grade equipment (Bellicha et al., 2017; Shin et al., 2018), these wearables enable the collection of near-constant data in a more natural environment.
Researchers have predicted that PWs have the potential to play an essential role in chronic disease management as they become more integrated into daily life (Lu et al., 2020; Mattison et al., 2022). The literature suggests that older adults are a specific population that can benefit from adopting and using persuasive wearables. For example, normative age-related changes, such as loss of muscle function, are common in this population and are one of the primary predictors for loss of independence among older adults (dos Santos et al., 2017). PWs have proven to be a successful intervention in this area, with one study finding that older adults who utilized the device increased their lower limb function by 10.5% compared to the control group (p < 0.05) (Wu & Manga, 2025). Multiple systematic reviews have identified other areas where older adults may benefit from these devices, with benefits ranging from fall detection and medication reminders to continuous health monitoring over time (Canali et al., 2024; Lyons et al., 2014).
Much of the existing literature on older adults’ use of these technologies has emphasized broad categories of benefits or has focused on the theoretical motivation behind the adoption of these emerging technologies. Less is known about the lived experiences of older adults who utilize PWs in their daily lives. Understanding these experiences offers a complementary perspective on the utility of PWs. This paper presents narrative case studies describing the experiences of older adults and those with mild cognitive impairment (MCI) who used a commercially available PW device in daily life. By situating these experiences within the broader context of the adoption of these devices, this study contributes to a deeper understanding of how older adults and those with MCI utilized PWs and acted upon the information provided.
Methods
This case study was part of a larger mixed-methods investigation into the adoption and use of a commercially available PW by older adults with MCI and their spousal care partners who did not have a diagnosis of MCI. This work draws upon qualitative case narratives to examine how participants’ lived experiences impacted their attitudes towards their devices.
Participants
The larger study included 44 older adults (25 males, 19 females) aged 55-86 (M = 74.25, SD = 7.43). Over half of the participants had received a clinical diagnosis of MCI (n = 29). Participants wore the PW for an average of 444 days (Range = 42-797).
Procedure
Each month, researchers contacted the participants by phone to conduct a monthly interview. Interviews were conducted individually or jointly, with the MCI-diagnosed older adult and their spousal care partner present together. Participants were asked, “What has been your experience with [specific PW] over the past month?”
Analysis
Interviews were transcribed verbatim by the researchers. Interview transcripts were reviewed to identify instances where participants reported that PW feedback prompted them to seek medical care. Reports were further examined to determine whether participants had detected an issue that might have otherwise resulted in hospitalization. Identifying information was removed from participant responses, and quotations presented in this manuscript were lightly edited for grammar and clarity without altering meaning.
Results:
Two categories of preventive instances were identified: routine medical visits and serious interventions. A total of 12 (27.27%) participants reported discussing the data collected by the PW with their doctor. Of those, six participants discussed the data with their doctor after recognizing that a trend in their data had changed, and one indicated intention to discuss the data with their doctor at their upcoming appointment.
Case 1 (Male with MCI): “We also discovered that my husband has a very low deep sleep. Deep sleep is when you flush out toxins, so we want to talk to the doctor about a sleep study. The doctor suggested that it was a good idea.”
Case 2: (Female Care Partner). “I made an appointment with my doctor about it because it [the PW] said my body was stressed. They [my doctor] called me back and said to come. I am going tomorrow morning.”
In addition to the PW prompting routine visits, there were three described instances that we categorized as serious interventions. There was a total of three instances among two participants. In these cases, participants attributed their decision to seek care to the data provided by the PW, thus helping the participants to avoid hospitalization or adverse health outcomes.
Case 3A: (Female Care Partner). “I wasn't feeling well about 3 weeks ago. [PW] confirmed that my heart rate was high. It turned out that I had a serious UTI. It was almost like an early warning system that I needed to do something.”
Case 3B: (Female Care Partner). “My overnight heart rate was very important, and when it was at 109 last Saturday, we got a blood pressure monitor. That's when we called the ambulance. Knowing that I should check my blood pressure was a cue that we needed help. The SPO2 data on [PW] was so important during this time because it gave me comfort. This gave me a better sense that I had started to recover from a serious illness. The [PW] gave me a sense of control, allowing me to manage what I needed to do, and prompted me to understand what I was feeling and when to call for emergency help. My current feeling is that I would never go without a smart device on my person. Especially at this age and the vulnerability.”
In the previous narrative, the participant emphasized the role of the PW in taking urgent action to call the ambulance and the importance of the psychological reassurance that the PW provided.
Ultimately, these cases illustrate the impact of PW from routine check-ups to serious interventions. For older adults and older adults with MCI, the presence of accessible, objective data provided both confidence and a sense of urgency to act when something was wrong.
Discussion:
These case narratives demonstrate that, beyond supporting daily wellness routines, PWs can help older adults monitor their health and act on changes to their trending health information. These cases also provide evidence for the utility of health monitoring features and potentially additional ways for the monitoring to foster the detection of atypical patterns. Among older adults, these patterns may serve as a cue to act and engage in preventive health behaviors. Future research should examine the prevalence of these experiences among older adults. Case studies offer unique insights into the lived experiences of a small number of participants; however, due to the small sample size, these accounts may not be widely generalizable. A better understanding of the prevalence of these instances among older adults who adopt PWs can help researchers and clinicians explore solutions and find new ways to integrate wearable data into preventive care routines more effectively.
Wearable technologies have become increasingly available in the consumer marketplace (Wright & Keith, 2014). One type of wearable is known as a persuasive wearable (PW). These are commercially available devices that utilize sensors to collect biometric data, tracking the wearer’s activity and sleep patterns. These data are then displayed on the device itself or on an accompanying mobile device, such as a tablet or phone. Furthermore, these devices can incorporate gamified features to enhance user motivation and interactivity, such as daily scores, progress rings, and social communities (Mercer et al., 2016). While PWs may not be as accurate as lab-grade equipment (Bellicha et al., 2017; Shin et al., 2018), these wearables enable the collection of near-constant data in a more natural environment.
Researchers have predicted that PWs have the potential to play an essential role in chronic disease management as they become more integrated into daily life (Lu et al., 2020; Mattison et al., 2022). The literature suggests that older adults are a specific population that can benefit from adopting and using persuasive wearables. For example, normative age-related changes, such as loss of muscle function, are common in this population and are one of the primary predictors for loss of independence among older adults (dos Santos et al., 2017). PWs have proven to be a successful intervention in this area, with one study finding that older adults who utilized the device increased their lower limb function by 10.5% compared to the control group (p < 0.05) (Wu & Manga, 2025). Multiple systematic reviews have identified other areas where older adults may benefit from these devices, with benefits ranging from fall detection and medication reminders to continuous health monitoring over time (Canali et al., 2024; Lyons et al., 2014).
Much of the existing literature on older adults’ use of these technologies has emphasized broad categories of benefits or has focused on the theoretical motivation behind the adoption of these emerging technologies. Less is known about the lived experiences of older adults who utilize PWs in their daily lives. Understanding these experiences offers a complementary perspective on the utility of PWs. This paper presents narrative case studies describing the experiences of older adults and those with mild cognitive impairment (MCI) who used a commercially available PW device in daily life. By situating these experiences within the broader context of the adoption of these devices, this study contributes to a deeper understanding of how older adults and those with MCI utilized PWs and acted upon the information provided.
Methods
This case study was part of a larger mixed-methods investigation into the adoption and use of a commercially available PW by older adults with MCI and their spousal care partners who did not have a diagnosis of MCI. This work draws upon qualitative case narratives to examine how participants’ lived experiences impacted their attitudes towards their devices.
Participants
The larger study included 44 older adults (25 males, 19 females) aged 55-86 (M = 74.25, SD = 7.43). Over half of the participants had received a clinical diagnosis of MCI (n = 29). Participants wore the PW for an average of 444 days (Range = 42-797).
Procedure
Each month, researchers contacted the participants by phone to conduct a monthly interview. Interviews were conducted individually or jointly, with the MCI-diagnosed older adult and their spousal care partner present together. Participants were asked, “What has been your experience with [specific PW] over the past month?”
Analysis
Interviews were transcribed verbatim by the researchers. Interview transcripts were reviewed to identify instances where participants reported that PW feedback prompted them to seek medical care. Reports were further examined to determine whether participants had detected an issue that might have otherwise resulted in hospitalization. Identifying information was removed from participant responses, and quotations presented in this manuscript were lightly edited for grammar and clarity without altering meaning.
Results:
Two categories of preventive instances were identified: routine medical visits and serious interventions. A total of 12 (27.27%) participants reported discussing the data collected by the PW with their doctor. Of those, six participants discussed the data with their doctor after recognizing that a trend in their data had changed, and one indicated intention to discuss the data with their doctor at their upcoming appointment.
Case 1 (Male with MCI): “We also discovered that my husband has a very low deep sleep. Deep sleep is when you flush out toxins, so we want to talk to the doctor about a sleep study. The doctor suggested that it was a good idea.”
Case 2: (Female Care Partner). “I made an appointment with my doctor about it because it [the PW] said my body was stressed. They [my doctor] called me back and said to come. I am going tomorrow morning.”
In addition to the PW prompting routine visits, there were three described instances that we categorized as serious interventions. There was a total of three instances among two participants. In these cases, participants attributed their decision to seek care to the data provided by the PW, thus helping the participants to avoid hospitalization or adverse health outcomes.
Case 3A: (Female Care Partner). “I wasn't feeling well about 3 weeks ago. [PW] confirmed that my heart rate was high. It turned out that I had a serious UTI. It was almost like an early warning system that I needed to do something.”
Case 3B: (Female Care Partner). “My overnight heart rate was very important, and when it was at 109 last Saturday, we got a blood pressure monitor. That's when we called the ambulance. Knowing that I should check my blood pressure was a cue that we needed help. The SPO2 data on [PW] was so important during this time because it gave me comfort. This gave me a better sense that I had started to recover from a serious illness. The [PW] gave me a sense of control, allowing me to manage what I needed to do, and prompted me to understand what I was feeling and when to call for emergency help. My current feeling is that I would never go without a smart device on my person. Especially at this age and the vulnerability.”
In the previous narrative, the participant emphasized the role of the PW in taking urgent action to call the ambulance and the importance of the psychological reassurance that the PW provided.
Ultimately, these cases illustrate the impact of PW from routine check-ups to serious interventions. For older adults and older adults with MCI, the presence of accessible, objective data provided both confidence and a sense of urgency to act when something was wrong.
Discussion:
These case narratives demonstrate that, beyond supporting daily wellness routines, PWs can help older adults monitor their health and act on changes to their trending health information. These cases also provide evidence for the utility of health monitoring features and potentially additional ways for the monitoring to foster the detection of atypical patterns. Among older adults, these patterns may serve as a cue to act and engage in preventive health behaviors. Future research should examine the prevalence of these experiences among older adults. Case studies offer unique insights into the lived experiences of a small number of participants; however, due to the small sample size, these accounts may not be widely generalizable. A better understanding of the prevalence of these instances among older adults who adopt PWs can help researchers and clinicians explore solutions and find new ways to integrate wearable data into preventive care routines more effectively.
Event Type
Oral Presentations
TimeTuesday, March 2411:00am - 11:30am EDT
LocationNassau
Digital Health