With the rapid development of smart pension services in China, the privacy issues of the elderly have become increasingly prominent. Based on the empirical data of several smart elderly care pilot communities and elderly universities in Beijing, Shanghai, Guangzhou and Shenzhen, this paper systematically discusses the key factors that hinder the popularization of smart elderly care services in the elderly group from the perspective of privacy. The research focuses on the three core variables of privacy self-efficacy, privacy risk perception and privacy awareness, and uses the method of constructing a structural equation model to analyze its impact mechanism on the willingness of the elderly to use smart old-age care services. [[i]]The results show that privacy self-efficacy has a significant positive impact on the willingness to use ; privacy risk perception has a significant negative impact on the willingness to use ; privacy awareness not only positively affects privacy self-efficacy, but also negatively affects privacy risk perception. Therefore, this paper also proposes to systematically improve the sense of trust and control of the elderly from the aspects of interaction design, data transparency, authority control and privacy education, so as to provide theoretical basis and practical reference for the sustainable promotion of smart elderly care services.