Evidence suggests that physical activity is fundamental to healthy ageing and is associated with prevention of chronic diseases, reduced frailty risk, and premature mortality in older adults.

To evaluate the effectiveness of interventions using activity trackers and smartphone applications for increasing physical activity (steps per day) in people aged ≥60 years with an underlying health condition.

Six databases were searched from inception to January 2025. We included randomised controlled trials of interventions that used activity trackers or smartphone applications, to promote physical activity among people aged ≥60 years with an underlying health condition, compared to minimal interventions or other active interventions.

We identified 44 trials (n = 4148). Compared with minimal intervention, the evidence is very uncertain about the effect of activity trackers on physical activity in the short term (near to intervention completion) (MD 1671 steps, 95% CI 1113 to 2229; I² = 90%, 37 trials). At 12 months, activity trackers probably increase physical activity compared with no or minimal intervention (MD 1838 steps, 95% CI 980 to 2696; I² = 64%, 6 trials; moderate certainty). At 6 months and 24 months, the effect of activity trackers on steps was uncertain. Subgroup analyses suggest activity trackers may improve physical activity across metabolic, neurological, and pulmonary conditions based on moderate to low certainty evidence.

Interventions using activity trackers may increase physical activity in the short term, although the evidence is very uncertain, and probably increase physical activity at approximately 12 months. Effects at intermediate-term and 24-month follow-up remain uncertain. Effects on mobility, quality of life and mental health were unclear or small.

CRD42024622697