The integration of digital health technologies for elderly care has shown significant potential in enhancing quality of life, reducing social isolation, and improving healthcare efficiency. However, despite technological advancements, the widespread adoption of these innovations remains limited. The paper explores the critical role of user engagement in the design and testing phases of healthcare technologies for older adults. A key barrier lies in the mismatch between technological solutions and the actual needs, preferences, and daily realities of older users. This issue is compounded by ageism, the digital divide, and stereotypical views of older adults as a homogeneous group with limited technological capabilities. Starting from the need to better understand the relation between older adults and technology considering attitude, digital literacy and technology use we analyse the possible strategies to enhance adoption rate. The often unjustified exclusion of older adults from clinical trials, particularly in the field of digital health, creates relevant risks to undermine the validity and equity of the proposed interventions. A wider inclusion in design and testing could bridge the gap between technological innovation and user needs, fostering greater acceptance and adoption of healthcare technologies that enhance autonomy and well-being among aging populations.