## 3 Systematic Review Results
### Barriers and Facilitators to Adoption
Privacy concerns remain a significant factor, but participants also weigh them against the need for support in scenarios like fall detection. This study underscores the importance of considering individual support requirements and the persistent desire for independent living among older adults. The study by [65] highlights the impact of cultural and generational factors on wearable device adoption in Taiwan. The gifting of wearables by younger generations and the influence of their internet expertise are noteworthy findings. This research emphasises the importance of human interaction, user-friendly design, and a focus on healthcare functionalities to promote wearable device adoption among older adults. Technology adoption among older adults is a dynamic interplay of personal experience, design features, and social influences. Understanding this complexity is vital for designing technologies that are both inclusive and empowering. Differences in technological proficiency call for differentiated learning strategies, while motivators like perceived usefulness, ease of use, and optimism about technology's potential must be embedded in design choices. Equally important is the social context, support networks, cultural norms, and privacy concerns all shape technology perceptions and behaviours. The surveyed literature reveals several critical shortcomings in current understanding of technology acceptance amongst older adults. Whilst foundational models such as the Technology Acceptance Model (TAM) provide essential theoretical frameworks, they suffer from excessive generality and a fundamental inability to generate actionable design insights, explaining a small percentage of variance in user intentions to adopt information technology. A concerning disconnect exists between theoretical design guidelines and practical implementation, evidenced a fraction of the analysed mobile applications were genuinely accessible to older adults despite existing recommendations. Furthermore,traditional acceptance models inadequately address psychological and social factors, particularly internalised ageism, stigma, and emotional responses to assistive technologies, which constitute significant barriers to adoption. The literature consistently challenges assumptions of a homogeneous older adult population, showing that factors like social influence and perceived usefulness differ widely depending on personal and contextual characteristics--a diversity that existing frameworks struggle to capture effectively. Additionally, current research provides an insufficient understanding of the dynamic nature of technology acceptance over time, particularly in relation to how attitudes and behaviours evolve throughout the adoption process for older adults experiencing cognitive or physical changes. Finally, many studies superficially address the multifaceted nature of barriers beyond basic access issues, overlooking the complex interplay of usage proficiency, emotional comfort, social support, and cultural considerations that comprise the digital divide, thereby necessitating more nuanced, culturally sensitive, and psychologically informed approaches that effectively translate theoretical insights into practical design solutions. For those experiencing frailty or cognitive decline, early-stage interventions and pragmatic, easy-to-use technologies tailored to specific functional needs are particularly impactful. In designing our co-design workshop, we were influenced by this understanding and deliberately incorporated commercial off-the-shelf products (COTS) as assistive devices, recognising their familiarity, accessibility, and potential for rapid adoption. Furthermore, addressing privacy concerns, combating ageist design assumptions, and raising awareness about technology's real-life benefits are essential to foster trust and long-term engagement.