Usability Concerns and Design Solutions in Mobile Health Applications for Older Adults
DOI:
https://doi.org/10.5614/itbj.ict.res.appl.2026.19.3.3Keywords:
interface design, mobile applications, mHealth, older adults, usabilityAbstract
Mobile health applications (mHealth) are known for their potential to enhance health delivery and improve health outcomes for older adults. However, despite their broad potential, significant usability concerns persist among older adults, preventing them from gaining advantages from mHealth and hindering their adoption. This paper critically examines the key usability concerns older adults face when interacting with mHealth. This research adhered to the PRISMA guidelines in the process of retrieving and selecting articles, resulting in the review and analysis of 117 articles published between 2014 and 2024. The results highlight several prevalent usability concerns, including complex navigation, overwhelming instructions, inadequate feedback mechanisms, and limited personalization options, which overlook the diverse needs of older users. Furthermore, this study identified design solutions to address these concerns, including straightforward navigation, clear instructions, and consistent layout/design tailored to older adults. Moreover, this paper established a visual representation that maps identified usability challenges to corresponding design solutions, serving as a valuable resource for researchers, designers, and developers working on mobile health applications for older adults. Integrating these solutions into the development process can significantly improve user experience and increase engagement in health interventions.
Downloads
References
Yang C, Wang W, Li F. & Yang D., A Sustainable, Interactive Elderly Healthcare System for Nursing Homes: An Interdisciplinary Design. Sustainability, Sustainability, 14(7), pp. 1-21, Apr. 2022.
Mhd Salim, M.H., Ali N.M. & Mohd Noah, S.A., Mobile Application on Healthy Diet for Elderly based on Persuasive Design, Int J Adv Sci Eng Inf Technol, 7(1), pp. 222-227, Feb. 2017.
Paiva J.O.V., Andrade R.M.C., de Oliveira P.A.M., Duarte P, Santos I.S., Evangelista A.L.P., Theophilo R.L., de Andrade L.O.M. & Barreto I.C.H.C., Mobile Applications for Elderly Healthcare: A Systematic Mapping, PLoS One, 15(7), e0236091, Jul. 2020
PwC Malaysia, Healthcare in Digital Economy- Reimagining the Future of HealthTech in Malaysia. 2021. (https://www.pwc.com/my/ en/publications/2021/healthcare-in-a-digital-economy.html) (May 2025)
Md Fadzil N.H., Shahar S., Singh D.K.A., Rajikan R., Vanoh D., Mohamad Ali N. & Mohd Noah S.A,. Digital technology usage among older adults with cognitive frailty: A survey during COVID-19 pandemic, Digit Health, Oct. 2023.
Wildenbos G.A., Jaspers M.W.M., Schijven M.P. & Dusseljee-Peute L.W., Mobile health for older adult patients: Using an aging barriers framework to classify usability problems, Int J Med Inform, 124, pp. 68-77, Apr. 2019.
Tajudeen F.P., Bahar N., Maw Pin T. & Saedon N.I., Mobile Technologies and Healthy Ageing: A Bibliometric Analysis on Publication Trends and Knowledge Structure of mHealth Research for Older Adults, Int J Hum Compu Interact, 38, pp. 118-130, 2022.
Shackel B., Usability - Context, framework, definition, design and evaluation, Interact Comput, 21(5-6), pp. 339-346, Dec. 2009.
ISO 9241-11:2018. Ergonomics of human-system interaction ? Part 11: Usability: Definitions and concepts ISO 9241-11:2018. (https://www.iso.org/obp/ui/#iso:std:iso:9241:-11:ed-2:v1:en)
Ismail N.A., Ahmad F., Kamaruddin A. & Ibrahim R., A Review on Usability Issues in Mobile Applications, IOSR Journal of Mobile Computing & Application (IOSR-JMCA), 2016.
Dahari Z., Jun C.C., Ze P.J., Binti Mohd Zakir N.N., Bin Mohd Fauzi M.N.F., Bin Mohamad Azam M.H.S. & Hamiri, N., Development of Smart Elderly Care Mobile Application for Health Management System, 2022 IEEE International Conference on Artificial Intelligence in Engineering and Technology (IICAIET), pp. 1-6, 2022.
Jose F., Livaldo, Mahardhika M.H., Sukiman N.A., Warnars H.L.H.S., Ramadhan A. & Utomo W.H., Mobile Application for Elderly Care, 2022 Second International Conference on Artificial Intelligence and Smart Energy (ICAIS), pp. 968-974. 2022.
Wang Q., Liu J., Zhou L., Tian J., Chen X., Zhang W., Wang H., Zhou, W. & Gao, Y., Usability evaluation of mHealth apps for elderly individuals: a scoping review, BMC Med Inform Decis Mak, 22(317), pp.1-17, 2022.
Shah. e M., Chiew T.K. & Mehmood Y. A., Usability Evaluation Instrument for Pain Management Mobile Applications: An Elderly?s Perspective, Int J Hum Comput Interact, 40(9), pp. 2265-2281, 2024.
PRISMA Transparent Reporting of Systematic Reviews and Meta-Analyses. 2024. http://prisma-statement.org
Galetsi P., Katsaliaki K. & Kumar S., Exploring Benefits and Ethical Challenges in the Rise of mHealth (Mobile Healthcare) Technology for the Common Good: An Analysis of Mobile Applications for Health Specialists, Technovation, 121, Mar. 2023.
Isakovic M., Sedlar U., Volk M. & Bester J., Usability Pitfalls of Diabetes mHealth Apps for the Elderly, J Diabetes Res, 2016, 1604609, 2016.
Bateman D.R., Srinivas B., Emmett T.W., Schleyer T.K., Holden R.J., Hendrie H.C. & Callahan C.M., Categorizing Health Outcomes and Efficacy of mHealth Apps for Persons With Cognitive Impairment: A Systematic Review, J Med Internet Res, 19(8), e301, Aug 2017.
Harte R., Quinlan L.R., Glynn L., Rodriguez-Molinero A., Baker P.M., Scharf T. & aighin G., Human-Centered Design Study: Enhancing the Usability of a Mobile Phone App in an Integrated Falls Risk Detection System for Use by Older Adult Users, JMIR Mhealth Uhealth, 5(5), e71, 2017.
Loh K.P., Ramsdale E., Culakova E., Mendler J.H., Liesveld J.L., O?Dwyer K.M., McHugh C., Gilles M., Lloyd T., Goodman M., Klepin H.D., Mustian K.M., Schnall R. & Mohile S.G., Novel mHealth App to Deliver Geriatric Assessment-Driven Interventions for Older Adults with Cancer: Pilot Feasibility and Usability Study, JMIR Cancer, 4(2), e10296, 2018.
Byambasuren O., Beller E., Hoffmann T. & Glasziou P., Barriers to and Facilitators of the Prescription of mHealth Apps in Australian General Practice: Qualitative Study, JMIR Mhealth Uhealth, 8(7), Jul. 2020.
Leung R., Findlater L., McGrenere J., Graf P. & Yang J., Multi-Layered Interfaces to Improve Older Adults? Initial Learnability of Mobile Applications, ACM Trans Access Comput, 3(1), pp. 1-30, 2010.
Ramdowar H., Khedo K.K., & Chooramun N., A comprehensive review of mobile user interfaces in mHealth applications for elderly and the related ageing barriers, Univ Access Info Soc, 23, pp. 1613-1629, 2023.
Wildenbos G.A., Peute L.W., & Jaspers M.W.M., A framework for evaluating mHealth tools for Older Patients on Usability, Stud Health Technol Inform, 210, pp. 783-787, 2015.
Liao C.H., Wu Y.T., Cheng C.T., Ooyang C.H., Kang S.C., Fu C.Y., Hsu Y.P., Hsieh C.H. & Chen C.C, An Image-Based Mobile Health App for Postdrainage Monitoring: Usability Study, J Med Internet Res, 22(8), e17686, 2020.
Gomez-Hernandez M., Ferre X., Moral C., & Villalba-Mora E.. Design Guidelines of Mobile Apps for Older Adults: Systematic Review and Thematic Analysis, JMIR Mhealth Uhealth, 11, e43186 , 2023.
Cao W.J., Wang J., Wang Y.H., Hassan I.I. & Kadir A.A., mHealth App to Improve Medication Adherence Among Older Adult Stroke Survivors: Development and Usability Study, Digit Health, 10, 20552076241236291, 2024.
Choi S., Sajib M., Manzano J. & Chlebek C.J., mHealth Technology Experiences of Middle-Aged and Older Individuals With Visual Impairments: Cross-Sectional Interview Study. JMIR Form Res, 7, 2023.
Morey S.A., Stuck R.E., Chong A.W., Barg-Walkow L.H., Mitzner T.L. & Rogers W.A., Mobile Health Apps: Improving Usability for Older Adult Users, Ergonomics in Design, 27(4), pp. 4-13, 2019.
McCarthy B., Sabharwal J.K. & Chawla S., Old age or cognitive decline? Examining the Usability of a Mobile Health App for Older Australians. Inform Health Soc Care, 49(1), pp.83-97, 2024.
Lemos M., Henriques A.R., Lopes D.G., Mendon N., Victorino A., Costa A., Arriaga M., Gregio M.J., de Sousa R., Canh H. &Rodrigues A.M., Usability and Utility of a Mobile App to Deliver Health-Related Content to an Older Adult Population: Pilot Noncontrolled Quasi-Experimental Study, JMIR Form Res, 8, 2024.
Hsieh K., Fanning J., Frechette M. & Sosnoff J., Usability of a Fall Risk mHealth App for People With Multiple Sclerosis: Mixed Methods Study, JMIR Hum Factors, 8(1), 2021.
Sobrinho A.C.D., Gomes G.A.D. & Bueno C.R.J., Developing a Multiprofessional Mobile App to Enhance Health Habits in Older Adults: User-Centered Approach, JMIR Form Res, 8, 2024.
Frechette M., Fanning J., Hsieh K., Rice L. & Sosnoff J., The Usability of a Smartphone-Based Fall Risk Assessment App for Adult Wheelchair Users: Observational Study, JMIR Form Res, 6(9), 2022.
Murabito J.M., Faro J.M., Zhang Y.K., Demalia A., Hamel A., Agyapong N. & Liu H., Smartphone App Designed to Collect Health Information in Older Adults: Usability Study, JMIR Hum Factors, 11, 2024.
Choi S. & Chlebek C.J., Exploring mHealth design opportunities for blind and visually impaired older users, Mhealth, 10, pp.17?17, 2024.
Compernolle S., Cardon G., van der Ploeg H.P., Van Nassau F., De Bourdeaudhuij I., Jelsma J.J., Brondeel R. & Van Dyck D., Engagement, Acceptability, Usability, and Preliminary Efficacy of a Self-Monitoring Mobile Health Intervention to Reduce Sedentary Behavior in Belgian Older Adults: Mixed Methods Study, JMIR Mhealth Uhealth, 8(10), 2020.
Sien S.W., Kobekyaa F.K., Puts M., Currie L., Tompson M., Hedges P., McGrenere J., Mariano C. & Haase K.R., Tailored Self-Management App to Support Older Adults With Cancer and Multimorbidity: Development and Usability Testing, JMIR Aging, 7, e53163, 2024.
Maggio M.G., Luca A., CalabrR.S., Drago F., & Nicoletti A. Can Mobile Health Apps with Smartphones and Tablets be the New Frontier of Cognitive Rehabilitation in Older Individuals? A Narrative Review of a Growing Field, Neurological Sciences, 45, pp. 37-45, 2024.
Kim H., Lee S.H., Cho N.B., You H., Choi T., & Kim J., User-Dependent Usability and Feasibility of a Swallowing Training mHealth App for Older Adults: Mixed Methods Pilot Study. JMIR Mhealth Uhealth, 8, 2020.
Liu Y.C., Chen C.H., Lin Y.S., Chen H.Y., Irianti D., Jen T.N., Yeh J.Y. & Chiu S.Y.H., Design and Usability Evaluation of Mobile Voice-Added Food Reporting for Elderly People: Randomized Controlled Trial, JMIR Mhealth Uhealth, 8(9), 2020.
Carandang R.R., Ancheta Y.M., Beleno G., Gonzales A.M & Longaza N.I., ?I?m not very skilled in using gadgets:? A Qualitative Exploration of the Facilitators and Barriers to Using Telepharmacy Services among Filipino Senior Citizens. Exploratory Research in Clinical and Social Pharmacy, 15, 2024.
Portenhauser A.A., Terhorst Y., Schultchen D., Sander LB, Denkinger M.D., Stach M., Waldherr N., Dallmeier D., Baumeister H. & Messner EM. Mobile Apps for Older Adults: Systematic Search and Evaluation Within Online Stores, JMIR Aging, 4(1), e23313, 2021.
Formica C., Bonanno M., Sorbera C., Quartarone A., Giambo F.M., Marra A. & Calabr R.S., Smartphone-Based Cognitive Telerehabilitation: A Usability and Feasibility Study Focusing on Mild Cognitive Impairment, SENSORS, 24(2), 525, 2024.
Chun M., Yu H.J. & Jung H. A Deep Learning-Based Rotten Food Recognition App for Older Adults: Development and Usability Study, JMIR Form Res, 8, e55342, 2024.
Smith-Turchyn J., Gravesande J., Agarwal G., Mangin D., Javadi D,, Peter J., Parascandalo F., Dolovich L. & Richardsonet J., A healthy lifestyle app for older adults with diabetes and hypertension: usability assessment. International Journal of Healthcare Technology and Management, 16(3-4), pp.250-270, 2017.
Miller D.P., Weaver K.E., Case L.D., Babcock D., Lawler D., Denizard-Thompson N., Pignone M.P. & Spangler J.G., Usability of a Novel Mobile Health iPad App by Vulnerable Populations, JMIR Mhealth Uhealth, 5(4), e43, 2017.
Jung H., Demiris G., Tarczy-Hornoch P. & Zachry M., A Novel Food Record App for Dietary Assessments Among Older Adults With Type 2 Diabetes: Development and Usability Study, JMIR Form Res, 5(2), e14760, 2021.
Bienfait F., Petit M., Pardenaud R., Guineberteau C. & Pignon A., Applying M-Health to Palliative Care: A Systematic Review on the Use of M-Health in Monitoring Patients With Chronic Diseases and its Transposition in Palliative Care, American Journal of Hospice Palliative Medicine, 37(7), pp. 549-564, 2020.
Mena L.J., Felix V.G., Ostos R., Gonzalez A.J., Martinez-Pelaez R., Melgarejo J.D. & Maestre G.E., Mobile Personal Health Care System for Noninvasive, Pervasive, and Continuous Blood Pressure Monitoring: Development and Usability Study, JMIR Mhealth Uhealth, 8(7), e18012, 2020.
Bendig J., Spanz A., Leidig J., Frank A., Stahr M., Reichmann H., Loewenbrk K.F. & Falkenburger B.H., Measuring the Usability of eHealth Solutions for Patients With Parkinson Disease: Observational Study, JMIR Form Res, 6(10), e39954, 2022.
Wei Y., Zheng P., Deng H., Wang X., Li X. & Fu H., Design Features for Improving Mobile Health Intervention User Engagement: Systematic Review and Thematic Analysis, J Med Internet Res, 22(12), e21687, 2020.
Amouzadeh E., Dianat I., Faradmal J. & Babamiri M., Optimizing Mobile App Design for Older Adults: Systematic Review of Age-Friendly Design, Aging Clin Exp Res, 37, 248, 2025.
Fox G. & Connolly R., Mobile Health Technology Adoption Across Generations: Narrowing the Digital Divide, Information Systems Journal, 28, pp. 995-1019, 2018.
Western, M. J., Smit, E. S., Gtzow, T., Neter, E., Sniehotta, F. F., Malkowski, O. S., ? Kig, L. M., Bridging the Digital Health Divide: A Narrative Review of the Causes, Implications, And Solutions For Digital Health Inequalities, Health Psychol Behav Med, 13(1), 2493139, 2025.
Elguera Paez L. & Zapata Del R C., Elderly Users and Their Main Challenges Usability with Mobile Applications: A Systematic Review, Design, User Experience, and Usability. Design Philosophy and Theory. HCII 2019, pp. 423-438, 2019.
Khamaj A. & Ali A.M., Examining the usability and accessibility challenges in mobile health applications for older adults, Alexandria Engineering Journal, 102, pp. 179-191, 2024.
Cajita M.I., Hodgson N.A., Lam K.W., Yoo S., & Han H.R., Facilitators of and Barriers to mHealth Adoption in Older Adults With Heart Failure. CIN: Computers, Informatics, Nursing, 36(8), pp. 376-382. 2018.
Bhanvadia, S. B., Brar, M. S., Delavar, A., Tavakoli, K., Radha Saseendrakumar, B., Weinreb, R. N., Zangwill, L. M., & Baxter, S. L., Assessing Usability of Smartwatch Digital Health Devices for Home Blood Pressure Monitoring among Glaucoma Patients, Informatics, 9(4), 79, 2022.
Yeh P.C., Impact of Button Position and Touchscreen Font Size on Healthcare Device Operation by Older Adults, Heliyon, 6, e041472020.
Liu B., & Wang C., Elderly-Centric Chromatics: Unraveling the Color Preferences and Visual Needs of the Elderly in Smart APP Interfaces, Int J Hum Comput Interact, 41(5), pp.1-10, 2024.
Karmacharya, I., Ghimire, S., Bhujel, K., Shrestha Dhauvadel, A., Adhikari, S., Baral, S., & Shrestha, N., Health Services Utilization among Older Adults in Pokhara Metropolitan City, J Aging Soc Policy, 34(4), pp. 568-587, 2022.
Del Aguila Dominguez M., Ape Rs J.I., & Rada Mota L.C., Systematic Review on Mobile Application Interface Design for the Visually Impaired Community. Proceedings of the 4th LACCEI International Multiconference on Entrepreneurship, Innovation and Regional Development (LEIRD 2024): ?Creating solutions for a sustainable future: technology-based entrepreneurship,? Latin American and Caribbean Consortium of Engineering Institutions, 2024.
Sproul A., Stevens J. & Richard J., Older Adults? Use of and Interest in Technology and Applications for Health Management: A Survey Study, Canadian Journal of Hospital Pharmacy, 76(3), pp.209-215, 2023.
Jeffrey B., Bagala M., Creighton A., Leavey T., Nicholls S., Wood C., Longman J., Barker J. & Sabrina P., Mobile Phone Applications and their Use in the Self-Management of Type 2 Diabetes Mellitus: A Qualitative Study among App Users and Non-App Users, Diabetol Metab Syndr, 11, 84, 2019.
Emerson M.R., Buckland S., Lawlor M.A., Dinkel D., Johnson D.J., Mickles M.S., Fok L. & Watanabe-Gallaway S., Addressing and evaluating health literacy in mHealth: a scoping review, Mhealth, 8, 33, 2022.
Lee S., Ory M.G., Vollmer Dahlke D. & Smith M.L., Technology Use Among Older Adults and Their Caregivers: Cross-Sectional Survey Study, JMIR Aging, 7, e50759 , 2024.
