The forecast for wearables is still bright. Studies show that one in six (15%) consumers in the United States use smartwatches or fitness bands such as Fitbit, Jawbone, Nike, Apple Watch or Microsoft Band. While around 19 million fitness devices likely to have been sold in US in 2016, the outlook for 2018 reaches 110 million.

Heart rate can now be measured with a device combined with oximeter built into a ring or a watch band; muscle activity can be tracked by an electromyographic sensor embedded into clothing; level of stress is estimated with an electrodermal sensor incorporated into a wristband, and sleep patterns via an accelerometer in a watch. All those gadgets of course are generating numerous self-tracking applications such as food monitoring MyFitnessPal or Zeo sleep analyzer.

Nevertheless, surveys signal some alarming trends. 32% of users stop wearing their tracking devices after six months, and 50% after one year. Many are bored of constantly entering and tracking multiple data with no clear evidence how the process is affecting their health. Without getting tangible functional value from wearing extravagant devices, people are unlikely to change their habitual life style.

Who is using wearable devices?

Curiosity is one of the powerful drivers stimulating people to try new things. 75% of wearables’ users described themselves as “early adopters” of innovative technologies. No wonder that 48% were younger than 35 and 29% reported to earn more than $100.000 annually. So, basically, to become a user of a modern wearable device one should be young, healthy and wealthy.  Most of Fitbit, Nike, Runtastic, etc. users are already sport fans accustomed to care about their health. Fancy gadgets are just adding more fun.

Apparently, this is not the prime target group that needs to improve its well-being. But wearables could be a solution for real problems, e.g., long-term chronic condition management or remote care. The technology has a potential to create healthy smart homes where seniors and those suffering from chronic conditions could feel themselves safe and secure. For example, a microanalysis of body movement data can be used to detect early symptoms of Parkinson disease . Such a widely popular game device as Microsoft Kinect equipped with a high resolution camera and infrared sensors is able to grab the slightest, almost invisible facial and thorax movements including tissue vibration to predict sleep apnea or a sudden cardiac arrest. All this is possible but requires a big change on behalf of the user: tolerance to adjust to the devices, diligence in monitoring vital signs.

The change is not easy. Most of those who potentially can benefit from wearables are of 50 and above age, the generation of workaholics, “company best assets” truthfully serving their employers. For years, they have been used to long overtimes, sacrificing their sleep and weekends to finish a crucial report impossible to accomplish in-between daily meetings and conference calls. Will this people be ready to withstand the demand and pressure of social obligations and sacrifice precious moments of their life that can be spent with families and friends for the sake of fitness trainings? After all, years are passing by, and there are still some things to do in this life besides reaching the goal of 5000 -10.000 steps per day.

If they will, then under one condition: wearable gadgets should add a real value to people’s life. Unfortunately, the achieved number of steps and the associated weight loss do not directly help to improve serious health issues such as hypertension, diabetes or cardio failure. On the contrary, several studies have observed that patients with type 2 diabetics who self-monitored their own blood glucose concentration did not benefit from increased glycemic control but rather found their disease more intrusive. Excessive self-quantification along with persistent inability to improve one’s health conditions provoke the feeling of helplessness that may lead to anxiety, frustration or even depression, which, in its turn, can hardly ameliorate symptoms of health disorder such as increased AD, sleep disturbances, irritability, hot flashes and other vasomotor instabilities. A number of trials show no beneficial effect of blood glucose self-monitoring among non-insulin treated patients, while others demonstrate negative outcomes, including elevated levels of depression.

Can we trust wearables?

Getting data is not enough, one should trust information it provides. The reliability and validity of data produced by wearable devices in many cases is questionable. For instance, comparisons between various types of wearables tracking physical activity showed large variations in accuracy between different devices — with error margins scaling from 10% to 24%.

It is relatively easy to count steps, but understanding the correlations between those numbers and more complex indicators such as daily energy expenditures (EE) across many devices is much more difficult. Thus, comparisons between research-graded accelerometers/multi-sensor devices (BodyMedia SenseWear, and ActiGraph GT3X+) and consumer wearables such as Fitbit One, Fitbit Zip, Jawbone UP, Misfit Shine, Nike Fuelband, Striiv Smart Pedometer and Withings Pulse demonstrated a relative consistency  in step counts, however correlations in EE were  only around 30%.

It is also important  what exactly physical parameters wearable sensors are measuring. Take for example sleep trackers. Unlike the professional polysomnography (PSG) equipment that is tracking multiple sleep pattern parameters, e.g., brain wave characteristics (EEG), blood oxygen level, heart rate and rhythm, breathing patterns (how easily or difficult you breathe, how often you stop breathing, pauses in-between inhale and exhale), eye movements, etc., the majority of self-assessing sleep monitoring wrist accelerometers are simply tracking body motions, at best in combination with pulse). But what if a person is having insomnia, but deliberately is trying to lie still? So, in a way we are sacrificing quality for the sake of usability and price.

Time is one of the most precious and vanishing values in our life, especially for those who have real health problems. If people are investing their time to change their habits, preferences and life style they want to get a meaningful return of investment. While wearables help to achieve short-term goals with diets and exercises and, possibly, temporary weight loss, a long-term impact of consumer wearable devices on complex health issues such as hypertension or diabetes is still questionable. But hope is the last one to die. Saying that I am rushing to reach my 10.000 steps goal.