## 3 Results
### Reported Challenges and Facilitating Conditions around Older Persons' ICT Access and Use
#### 3.3.1 Personal Factors  
Among the factors affecting ICT access and use among older persons in the Arab region, that are mainly intrinsic to the person, our review identified these factors:  
Attitudes towards technology: Two studies found that personal attitudes toward the technology, its perceived usefulness, and its perceived ease of use accurately predicted technology utilization rates [32; 33]. For example, when the technology aligned with participants' values and beliefs, that fostered a more positive attitude toward the technology and a greater willingness to accept it [32].  
Online privacy and trust: The included studies report that older persons might choose not to use AAL in their daily living due to (a) concerns about personal data, (b) household safety and security limitations on the adoption of AAL technologies, (c) usability of technology, and (d) older persons' refusal to be monitored through a surveillance camera and to be monitored remotely as this may attack their privacy [5; 6; 34]. [PERSON] and [PERSON] [34] surveyed 194 older persons living in Saudi Arabia, in which 94.3% of the sample were Saudi citizens, on barriers and challenges affecting their use of AAL and revealed that concerns around privacy and security of personal data were a limiting factor. The lack of trust surrounding application operation was also identified as a problem for ICT access and use by older persons in the region [6]. One example was the reoccurring need to confirm that an operation step, such as clicking a button, will subsequently lead to an action from the application [6].  
Functional limitations: Four studies reported a range of physical, cognitive, and psychological limitations that impact ICT access and use by older persons [2; 5; 6; 34]. [PERSON] and [PERSON] [5], who developed and tested a smartwatch application that helps memory recall by taking photos, stated that during the testing phase some participants could not remember to tap the watch screen or were physically unable to point the smartwatch in the correct direction [5]. Additionally, physical challenges experienced by older persons when using technology were slow movement and shaky hands for persons living with dementia [6]. Another common limitation experienced by older persons was psycho-motor-related challenges, including functional limitations such as visual and hearing impairments; this tended to result in an inability to operate the technology comfortably and correctly [2; 6; 34].  
Further, a study which surveyed 45 senior citizen in Saudi Arabia on the use of and attitude towards a smartphone application showed that declining visual and auditory abilities result in low self-esteem when dealing with new technologies [2]. Several studies reported older persons' experiences of low self-efficacy and confidence around new technology, some of which were due to limited personal experience with the technology [2; 32]. Some study participants experienced stress, boredom, and confusion from mobile application navigation [6]. Conversely, an existing and familiar technology, or a well-designed technology, increased confidence and had a higher usage rate [4; 9; 32]. For example, [PERSON] and [PERSON]'s field study [9] showed that WhatsApp was reported to be easy to use, with flexible functionalities utilized by participants regularly.