Are You Counting? Effectiveness of Interventions Using Activity Trackers and Smartphone Applications for Increasing Physical Activity in Older People Living in the Community: A Systematic Review With Meta-Analysis

OBJECTIVE: To evaluate the effectiveness of interventions using activity trackers and smartphone applications (apps) for increasing physical activity (steps per day) in people aged ≥ 60 years. DESIGN: Intervention systematic review with meta-analysis LITERATURE SEARCH: We searched six electronic databases (including EMBASE and MEDLINE) from inception to January 2025. SELECTION CRITERIA: We included randomised controlled trials that used activity trackers or smartphone apps to promote physical activity in people aged ≥ 60. DATA SYNTHESIS: Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Meta-analyses were conducted using a random-effects model, and certainty of the evidence was rated using the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework. RESULTS: We included 29 trials with 3005 participants. In the short-term (data point closest to the end of the intervention), activity trackers and apps may increase physical activity by about 1113 steps per day compared to minimal intervention (95% CI: 669 to 1557, 20 trials, low certainty evidence). When compared to other active interventions, activity trackers and apps may increase physical activity by 912 steps per day (95% CI: 412 to 1413, 8 trials, very low certainty evidence). Single trials reported intermediate (6 months) and long-term (12 and 24 months) effects, and suggested no sustained benefits. CONCLUSION: Activity tracker and app-based interventions may cause short-term increases in physical activity among older adults, but effects were not sustained.