# A Systematic Review of the Usability of Telemedicine Interface Design for Older Adults
## 3 Results
### Factors Affecting the Usability of Interface Design
#### 3.2.2 Interaction Logic  
For the elderly, both motor control precision and manual dexterity are impacted by aging [65; 66]. Accidental touches are the most common issue hindering effective operation [67]. Navigation challenges are a primary concern [68; 69], where seniors often struggle to navigate through app features, leading to a disconnect between perceived usability and actual usability [69]. Researchers and designers must recognize the physical limitations of the elderly, allowing users to transfer data to other devices and input information retroactively [20]. System navigation and feedback are essential components of the application's interactive logic.  
Feedback should include both visual and auditory cues, as elderly users often seek confirmation of task completion to enhance their confidence in using applications [66]. The accuracy and sensitivity of voice interaction systems can significantly improve the user experience in mobile health applications [18]. Feedback should integrate visual changes with sound cues, allowing users to adjust the volume, enable vibration, and access audio-visual instructions [54; 70]. Utilizing family members' voices for reminders can add a personal touch [54]. An Arabic-based health app employs a tagging and notification system for progress and providing positive feedback [12; 19]. Personalized information and timely notifications can enhance telemedicine usage [71], while the app should support multiple languages and avoid technical jargon [13; 58; 72]. While positive feedback and clear training messages can motivate users [72], excessive reminders should be avoided [70].  
Given that older adults often struggle to process large amounts of information, app navigation should be consistent, concise, and clear. A step-by-step approach with minimal steps and straightforward interaction instructions is essential [13; 66; 73]. An intuitive user interface, along with a clear background and easy-to-navigate design, enhances readability [60; 73]. \"Breadcrumb\" navigation can assist users with poor short-term memory by minimizing steps and confirmation messages, avoiding complex gestures, and ensuring quick response times [13]. The interface should display only task-related information, avoiding parallel tasks, pop-ups, and dialog boxes [65], while providing spacious click areas and clearly visible buttons for improved accessibility [70]. Considering older adults' health knowledge, the app should feature intuitive navigation, visual feedback, a simple registration process, interactive tutorials, and multiple access methods such as a table of contents, link lists, and search functions [18; 66; 70]. Clear buttons for returning to the home screen, proceeding, canceling, or completing tasks should guide users effectively [58; 74]. Additionally, users should be able to recall steps using photos or illustrations. Voice recognition can assist with voice-to-text conversion for easier information retrieval, navigation, emergency requests, and updates [13].  
To address input method challenges for older users, developers should implement larger touch targets and identify touch-sensitive areas [70]. Utilizing gesture-based controlsand incorporating predictive text input can reduce effort and minimize error [69], allowing the system to anticipate input content in advance [75].