Background and Objectives There is a growing interest to involve older adults in the co-design of technology to maintain their well-being and independence. What remains unknown is whether the beneficial effects of co-designed solutions are greater than those reported for non co-designed solutions. The aim of this study was to evaluate the effects and experiences of co-designed technology that support older adults to age in place. Research Design and Methods We conducted a systematic review to (a) investigate the health and well-being outcomes of co-designed technology for older adults (≥60 years), (b) identify co-design approaches and contexts where they are applied, and (c) identify barriers and facilitators of the co-design process with older adults. Searches were conducted in MEDLINE, EMBASE, CINAHL, Science Citation Index (Web of Science), Scopus, OpenGrey, and Business Source Premiere. Results We identified 14,649 articles and included 34 projects. Four projects reported health and well-being outcomes; the effects were inconsistent. Co-design processes varied greatly and in their intensity of older adult involvement. Common facilitators of and barriers to co-design included the building of relationships between stakeholders, stakeholder knowledge of problems and solutions, and expertise in the co-design methodology. Discussion and Implications The effect of co-designed technology on health and well-being was rarely studied and it was difficult to ascertain its impact. Future co-design efforts need to address barriers unique to older adults. Evaluation of the impact of co-designed technologies is needed and standardization of the definition of co-design would be helpful to researchers and designers.

KEYWORDSco-design, user centered design, ageing in place, elderly, older adults 2 Abstract Background: Co-design in healthcare has become mainstream. Co-design with end-users can improve patient satisfaction, outcomes and reduce the cost of care. As populations age, there is a growing interest to involve the elderly in the co-design of health technology to maintain their well-being and independence. However, it is less clear if co-designed technology improves health and well-being outcomes. The aim of this study is to evaluate co-designed technology that supports elders to age in place.Methods: We conducted a systematic review to: i) investigate the health and well-being outcomes of co-designed technology for elders (≥ 60 years); ii) to identify co-design approaches and contexts where they are applied and; iii) to identify barriers and facilitators of the co-design process with elders. Searches were conducted in MEDLINE, EMBASE, CINAHL, Science Citation Index (Web of Science), Scopus, OpenGrey and Business Source Premiere databases using MeSH terms and key words. Results: We identified 14,649 articles of which 34 studies were included. Studies were from Europe (n=28), Australia (n=4), America (n=1) and Canada (n=1). Twenty of the 32 studies targeted older adults (≥ 60 years old) and 14 targeted specific medical conditions or elder-related issues. Technological solutions included robots, online applications and software, smart televisions, computer games for exercise, global positioning solutions, smart home systems and design of care pathways.Five studies reported health and well-being outcomes and were extracted. The health and well-being impact of co-designed technology was inconsistent. Co-design processes varied greatly and in their intensity of elder involvement. Common facilitators of and barriers to the co-design process included the building of relationships between stakeholders, stakeholder knowledge of problems and solutions, as well as expertise in the co-design methodology.Conclusions: The co-design approach was applied in the design of a diverse set of technologies. The effect of co-designed technology on health and well-being was rarely studied and it was difficult to ascertain its impact. Future co-design efforts need to address barriers unique to the elderly population. More evaluation of the impact of co-designed technologies' is needed and standardisation

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