Influencing factors of digital health technology anxiety in the elderly: a systematic review and meta-analysis.

Background: With the acceleration of global population aging, the widespread application of digital health technologies provides new opportunities for health management of older adults. However, many older adults generally face "digital health technology anxiety," which is characterized by irrational fear and resistance to emerging technologies, resulting in significantly lower rates of technology adoption than younger adults and increased health inequalities. The factors influencing digital health technology anxiety in the elderly were comprehensively evaluated through meta-analysis to provide an evidence-based foundation for developing targeted intervention measures. Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, the systematic search of Chinese and English databases (as of February 2025) included cross-sectional OR cohort studies of older adults ≥60 years old, and the outcome measures were factors influencing technology anxiety (reported as odds ratios [OR] with and corresponding 95% confidence intervals [CI]). Statistical analyses were performed using RevMan 5.3 software, combining effect sizes by fixed or random effects models. Heterogeneity was tested using the I 2 test. In addition, sensitivity analyses and publication bias assessment were performed. Results: Following the screening process, 11 studies were included in the analysis. The meta-analysis showed that the following factors significantly associated with technology anxiety: age (OR = 1.09, 95%CI 1.03-1.14), digital health literacy (OR = 0.67, 95%CI 0.49-0.92), monthly income (OR = 0.73, 95%CI 0.62-0.87), household registration (OR = 0.19, 95%CI 0.08-0.45), family support (OR = 0.85, 95%CI 0.81-0.90), social network (OR = 0.60, 95%CI 0.54-0.66), information application ability (OR = 0.46, 95%CI 0.28-0.74), and self-efficacy (OR = 0.96, 95%CI 0.92-0.99). Sensitivity analyses showed consistent overall results, although there was some variation in the size of the age group. Discussion: Digital health technology anxiety among the elderly is influenced by multiple factors, including individual characteristics, technological capabilities, and social support. Designing for the elderly, low-income, and rural populations is essential to improve digital literacy, optimize age-appropriate designs, and strengthen family-community support, ultimately alleviating anxiety. Future studies need to expand the sample size and include longitudinal data to validate the causal association. Systematic review registration: The protocol for this systematic review has been registered in PROSPERO (CRD42025649793, available at: https://www.crd.york.ac.uk/PROSPERO/search).