Variables influencing digital health literacy in older adults: a systematic review and meta-analysis

This study aimed to synthesize existing evidence on digital health literacy (DHL) among older adults and to estimate the associations between related influencing factors through a systematic literature review and meta-analysis.

A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Literature searches were performed across PubMed, EMBASE, Cochrane Library, CINAHL, RISS, and DBPIA. The search and screening process was conducted from December 24, 2023, to March 31, 2025. Effect sizes (ESr) using correlation coefficient for each variable were calculated, and meta-analyses were performed using Microsoft Excel and R version 4.3.1.

Forty-seven variables were identified, including two demographic, six physical, six behavioral, 23 psychosocial, and 10 cognitive factors. Meta-analysis results showed that physical, behavioral, psychosocial, and cognitive factors had significant effects on DHL. Among these, digital information level (ESr=.62; 95% confidence interval [CI], 0.55 to 0.69) within the cognitive domain and technophobia (ESr=-.55; 95% CI, -0.47 to -0.40) within the psychosocial domain demonstrated the largest ESr.

Among factors influencing DHL, digital information level and technophobia showed the strongest associations. These findings suggest that improving DHL in older adults requires a dual approach targeting both cognitive and psychosocial dimensions-enhancing digital information skills while reducing technophobia-to effectively support digital engagement and health empowerment in this population (PROSPERO registration number: CRD42023487486).