Optimizing mHealth Apps for Older Adults: 8 Strategies
Older adults are increasing in number and increasing in the frequency they use mobile apps, especially to manage their healthcare. Today, older adults – aged 65 and older – make up 13% of the U.S. population, and this population is expected to grow to 19% by 2030. Mobile technology use among this population is growing with 27% of older adults owning a tablet, an e-book reader, or both, and 18% owning a smartphone. As UX designers, we can influence the adoption of mobile technology by designing user interfaces that overcome typical usage barriers for older adults.
At PointClear, we frequently work on mobile app design and development where the target user group is age 65+. We’ve done our research and compiled a set of strategies for designing usable mobile interfaces for this audience.
What’s Different About Older Adults?
As people age, they experience a decline in motor, sensory and cognitive abilities. For example, visual acuity, visual search capabilities, fine-motor skills, hand dexterity and touch sensitivity all decline with age . These changes can make interacting with mobile applications more difficult.
These natural changes don’t mean we have to “dumb down” our apps for the older audience, but rather that we are careful and thoughtful in our design choices so that older adults can access all of the same functionality and content as their younger counterparts, but can do so without frustration.
Strategy 1: Limit Gestures to Tap and Swipe
Tap and Swipe gestures are best understood by older adults.
Most older adults don’t use advanced gestures such as double-tap, flick, tap and hold, pinch or spread. Strive to limit your gestures to tap and swipe.
If your app needs to include these advanced gestures, make sure the actions that are activated are also available through menus or UI buttons that can be accessed by tapping or swiping.[2, 3]
Strategy 2: Demonstrate Gestures
Consider providing videos or animated gifs to show how to make the correct gesture. A tutorial is a good way to accomplish this, but it also helps to have the demonstrations available to users at any time, through a Help feature. Show users where certain gestures can be made and demonstrate the physical performance of these gestures.
Strategy 3: Make Touch Targets Larger
Increasing the size of touch targets, such as buttons, improve accuracy and speed at which older adults interact with them. Targets for all gestures should be larger than standard to support older adults.
The table below shows dimensions for Best Performing Size and Minimum Size for touch targets. The most critical targets for best performing size are those that are used frequently or result in a permanent action. When screen real estate is a limitation, a smaller sized target can be used, but errors may increase. The minimum sizes are the point at which speed and accuracy rates fall below satisfactory levels. [2, 3]
Strategy 4: Place Targets in Easy-To-Reach Places
Most older adults use their index fingers, as opposed to their thumbs, for interacting with smartphone displays. Some areas on the screen are more easily reachable with the index finger, and therefore allow for faster and more accurate selections.[3, 5]
Targets placed in more problematic regions of the screen can be sized larger to improve performance.
Strategy 5: Allow Adequate Space Between Targets
The spacing between adjacent targets has less influence on performance than target sizes, however older adults have longer reaction times with larger spacing between tap targets.[2, 3]
Strategy 6: Provide Feedback When Interacting with Targets
Performance for older adults can be improved by adding a visual magnification effect of an icon when tapping on the icon. Other effects that may help when tapping include a color change or a small displacement of the icon.
Audio feedback can be used, however tone detection of different frequencies decreases as people age. Use sounds with lower frequencies, between 500 and 1000 Hz, which can be detected better than high-pitched sounds. For videos, a man’s voice is suggested over a woman’s voice due to the lower frequency. 
A combination of audio-tactile feedback may increase performance, satisfaction and usability, however, use tactile feedback cautiously as it can be distracting and affects a stable hand grip on handheld devices.
Strategy 7: Limit Text Entry Where Possible
Entering text using a touchscreen device’s soft keyboard is more difficult for older adults. Error rates increase as the number of options displayed on the screen at one time increase, especially for users with tremor. Limit the amount of text entry necessary, if possible. Display the appropriate keypads for the type of text entry needed. For example, display a numeric keypad when only numbers are necessary. Performance can be improved by supporting word prediction, keyboard swiping and automatic correction. Also consider using a voice-based user interface, such as Apple’s Siri.
Strategy 8: Use a Legible Font and Appropriate Font Size
Due to declining vision, many older adults require large text, including text in form fields and other controls. Use sans-serif fonts with a size no smaller than between 12 and 14 point.
As you can see, designing for older adults doesn’t have to constrain your creative muscle. With just a few adjustments to interface elements, mobile application interfaces can be optimized for the older audience, preventing frustration on their part and improving adoption.
- The New Era of Connected Aging: A Framework for Understanding Technologies that Support Older Adults in Aging in Place
Center for Technology and Aging, 2014.
- Target and Spacing Sizes for Smartphone User Interfaces for Older Adults: Design Patterns Based on an Evaluation with Users
Roxanne Leitão, Paula Alexandra Silva, 2012.
- Design Patterns for Mobile User Interfaces Targeted at Older Adults
Roxanne Leitão, 2012. Retrieved May 15, 2014.
- Interaction techniques for older adults using touchscreen devices: a literature review
Lilian Genaro Motit, Nadine Vigouroux, Philippe Gorce. IHM ’13 Proceedings of the 25ième conférence francophone on l’Interaction Homme-Machine, 2013-11-12.
- Elderly text-entry performance on touchscreens
Hugo Nicolau, Joaquim Jorge. ETS ’12 Proceedings of the 14th international ACM SIGACCESS conference on Computers and accessibility, 2012-1-22.
- Older Adults and Technology Use
PEW Research Center, 2014. Retrieved May 15, 2014.
- Is a Big Button Interface Enough for Elderly Users? Towards User Interface Guidelines for Elderly Users
Tanid Phiriyapokanon. Masters’ Thesis submitted at Mälardalen University, 2011.
- The Next Four Decades: The Older Population in the United States: 2010 to 2050
U.S. Census Bureau, 2010.
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