Apple’s new health features bring new focus to aged care technology

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Apple’s new health features are available to anyone with an iPhone. But two of the tools announced at WWDC 2021, stable running and the ability to share health data with family members, could be especially helpful for older adults.

People who work with older adults are excited that a company like Apple is interested in technology that can be used for this group. For years, experts have been frustrated that companies don’t design products to meet the needs of that demographic. There have been a few attempts to introduce new tools, but none have gained much traction, says Richard Schulz, a social psychologist who studies aging at the University of Pittsburgh.

“I think the reason is that the big guys — companies like Apple — never got around to it,” Schulz says. The new features are a signal that the tide is starting to turn. “It’s a big deal to get Apple involved in this.”

Fear of falling

The first feature, the gait stability indicator, focuses on a major problem for older adults: falls. Waterfalls are the main cause of accidents, injuries and deaths for seniors in the US, and they are responsible for billions in health care costs each year. Researchers have been studying falls for decades and trying to find ways to prevent them, says Jacob Sosnoff, who studies mobility in the Department of Physical Therapy and Rehabilitation Sciences at the University of Kansas Medical Center.

“We can do a very good job in the lab measuring visual impairment and making predictions and recommendations, but in the real world we’re not very good,” Sosnoff says.

Apple’s new walking stability feature aims to track people as they go about their daily lives. It uses metrics such as walking speed, stride length and the time both feet are in contact with the ground to check how stable a user is. It can only be measured on the iPhone, not an Apple Watch, as some metrics need to be calculated as close to the hip as possible, Apple says — so in a pocket or bag works best.

Apple Watch already has a fall detection feature that can prompt users to call emergency services or automatically call if the user does not move for about a minute. The new iPhone feature focuses on prediction rather than reaction: it can tell people if they’re walking regularly and give an alert if it thinks they’re at increased risk of falling. Apple says the system is based on data collected during a clinical study that included more than 100,000 participants of all ages.

There are no big commercial products that track the quality of people’s movement, Sosnoff says. Until now, most movement trackers focused on how much people moved. “That’s why there’s a lot of excitement about it,” he says. “Making people aware of their fall risk is important.”

But there’s also a downside to telling people they might fall — fear of falling is linked to actually experiencing a fall. If warnings increase anxiety, people may limit their physical activity or even stop leaving the house so often, says Clara Berridge, a professor at the University of Washington who studies health technology in aging populations. “That will likely contribute to their actual fall risk, as they reduce their strength and activity,” she says.

It’s a nice balance, Sosnoff says. “We want people to be aware of the risks, but not be so overly concerned that they’re not doing anything.”

Sosnoff says he’d like to see if the gait stability feature can actually reduce falls in real-world scenarios. A challenge for the tool could be to monitor people who have difficulty walking, such as those who have a limp. Algorithms that track gait often don’t work very well in those situations, he says. If the Apple feature has that problem, it can highlight people with different gait patterns who may not really pose a fall risk.

The Apple feature may not be able to help everyone with a fall risk. Gait patterns are just one of the many reasons people fall: poor eyesight can cause people to stumble with age, certain medications can impair balance, and objects around the house (such as loose rugs) can be dangerous. The Apple Walk Stability feature is designed to allow people at risk of falling to do various stability exercises, which can be helpful in some cases. But for some people, balance may not be the biggest issue. “Being asked to exercise isn’t the only solution,” Berridge says.

To get information about a user’s walk, he must also have his phone with him regularly. Sosnoff says he’s not sure if older adults really do. Many may use their phones differently than younger people. “I know a lot of older adults who leave their phone on the counter as if it were a traditional phone,” he says.

However, there are benefits to having a player like Apple working on traps. “They’re going to have a significant amount of data to help see what’s going on,” Sosnoff says. If the iPhone could actually prevent falls, that would be a huge boon. “We bring people back together when they fall and get hurt, but we don’t really do much to stop the fall. It would be exciting if we can do that.”

Sharing data

Apple now also lets users share their health data with other people. The feature can be a great convenience to family members and caregivers of older adults, who may want or need to keep track of someone’s health statistics. Currently, they may need to collect information from multiple different sources – a heart rate app, a blood pressure monitoring system. The Apple sharing feature could give them instant access in one place.

“I could see that this is extremely appealing to adult children,” Berridge says.

It also raises privacy concerns for older adults. The Apple function is completely controlled by the user, who can decide in the app what information they want to share and with whom. In reality, older people who are uncomfortable with technology may not be able to make that decision for themselves.

“It’s very common for an adult child to buy a phone for an older adult, set the settings and take the phone out of their hand and say, ‘Let me fix it for you,'” Berridge says. “That older adult will lose the ability to remember this information for the family member.”

Some people may find it very nice to open up their Health app to family members, but there is still a power dynamic. Older adults tend to be less eager to supervise technology than their adult children, saying they want to maintain their privacy without feeling watched. But their adult children are confident they can convince parents to use monitoring technology even if they say they aren’t comfortable with it, according to Berridge’s study. has found. “They’re not necessarily inclined to bring them into the conversation, they’re just very confident that their preferences will decide in the end,” she says.

On the other hand, adult children who use this feature may be inundated with information about their older parents that they’re not sure how to interpret, says social psychologist Schulz. “Decisions have to be made about how that information is parsed and translated for the person who gets access,” he says.

In practice, Berridge isn’t sure how useful it would be to show a family member all the data from the Health app. “People can say: OK, what exactly am I supposed to do with this information? At what point does it make sense, when do I call a doctor, and so on. It can also be an alert overload situation.” she says.

Despite those concerns, there is growing interest in ways to keep older adults healthy at home. The COVID-19 pandemic has shown that healthcare facilities for the elderly can be dangerous and people generally don’t want to live in them, Berridge says. Apple’s new features mark movement in that direction. “It is becoming a major trend to move facility monitoring home,” she says.