Introduction A rapidly aging global population is placing increasing strain on healthcare systems. Digital health (mHealth) applications may support older adults in managing chronic conditions and adhering to medication, yet this population is often underrepresented in research. This study aimed to investigate engagement, retention, and adherence among adults aged ≥65 years using the Perx Health mobile app. Methods We conducted a retrospective observational analysis using real-world data from Perx users in Australia and the United States. Medication adherence, app engagement, and retention patterns were analyzed among participants aged 65 years and older. Results A total of 250 participants were included (mean age 70.1 ± 4.7 years; 61.8% female; 61.6% Australia-based). Median medication adherence was 95.0% (IQR 85.3–98.3). Participants were retained in the app for a median of 595.5 days (IQR 206.3–1,182.8). Older adults demonstrated higher engagement with gamified and social features than the overall Perx user population, with 62.5% engaging with leaderboards and 26.5% using streak tracking. Discussion/conclusion Older adults demonstrated high engagement, adherence, and retention with the Perx app. These findings suggest that mHealth solutions incorporating social and gamified elements can effectively support self-management in this population. The results provide a foundation for future research on app design features that optimize uptake and sustained use among older adults.
Wiecek et al. (2026) studied this question.