Abstract:

Internet of Things technologies are increasingly presented as a way to extend healthcare into the homes of older adults, to support independent living, and to reduce avoidable errors in geriatric care. Yet the people who stand to gain most from connected care are often the least connected. This narrative review draws on a screened corpus of empirical and review literature to examine how digital divides and structural barriers shape who can actually reach IoT-enabled care models, and what those patterns mean for public health. The evidence describes three connected layers of disadvantage: unequal physical access and connectivity, unequal digital and health literacy, and unequal health outcomes that follow from both. Reported uptake of internet-based and remote health services among older adults remains low across very different national settings, and digital literacy declines steeply with age. Acceptance studies add a further set of barriers around trust, privacy, cost, infrastructure, and the availability of human support. Taken together, the literature suggests that IoT-enabled care will widen rather than narrow inequalities unless access, literacy, and structural support are treated as design and policy problems from the outset rather than as afterthoughts.