This study examines digital health participation among adults aged 65–74 across European Union member states, focusing on the relationship between digital skills and multidimensional e-health use. The research addresses a key gap in the literature, as previous studies have typically analysed single dimensions of e-health use or treated older adults as a homogeneous group. Conceptually, the study builds on competence-based and digital divide frameworks, interpreting digital health use as the outcome of interactions between individual capabilities and structural conditions. Using harmonised Eurostat data, the analysis combines longitudinal trend analysis (2015–2024), a composite e-health indicator, correlation analysis, and cluster analysis. The results show a substantial increase in digital health use among older adults across the EU, particularly after 2019. A strong positive association is observed between digital skills and e-health use, especially for more advanced activities. Cluster analysis reveals persistent cross-national differences, indicating that similar skill levels may lead to different levels of e-health uptake. The findings highlight the need for combined policy approaches targeting both digital skills development and user-centred digital health services.

Digital health refers to using the internet and digital tools to manage health, such as searching for health information or accessing medical services online. These tools are increasingly important in ageing societies. People aged 65–74 form a key group, as their health needs grow but many can still use digital technologies with the right support. This study examines how digital skills relate to the use of digital health services among adults aged 65–74 across European Union countries, using publicly available Eurostat data. The findings show large differences between countries. Higher digital skills are generally linked to more frequent use of digital health services, but skills alone do not explain all differences. Accessible, easy-to-use health systems also play an important role. Supporting digital health use in this age group may improve quality of life and help reduce pressure on healthcare systems.