Smart Wearable Technologies for Autonomous Mental Health Monitoring in the Elderly: A Systematic Review and Design Perspectives

INTRODUCTION: The increasing prevalence of mental health issues among older adults has generated interest in smart wearable technologies as tools for emotion recognition and depression monitoring. However, their application in ageing populations remains underexplored, and there is no established set of design guidelines tailored to the needs and contexts of older users. OBJECTIVES: This paper aims to review current research on wearable technologies for mental health monitoring in older adults and to identify key design considerations to inform future development. METHODS: A systematic literature review was conducted following PRISMA 2020 guidelines. Studies from 1988 to 2025 were included if they examined the use of smart wearables for detecting emotional or depressive states in older adults, or if broader age ranges were analysed in ways that explicitly addressed ageing-related factors or design considerations. RESULTS: The review revealed notable advances in sensor-based and contactless emotion recognition. However, most systems lacked empirical validation with older users, and usability, privacy, and ethical concerns were frequently unaddressed. Few studies adopted age-specific methodologies or considered the cognitive and physical characteristics of older adults. CONCLUSION: While wearable technologies show potential for supporting autonomous mental health care in older adults, their effectiveness depends on user-centred and ethically responsible design. This paper identifies the absence of standardised guidelines and outlines preliminary principles to inform future interdisciplinary work. Given the limited number of eligible studies involving older adults, the findings should be considered exploratory and indicative rather than generalisable across broader ageing populations.