Abstract
BACKGROUND: Population aging has intensified the need for innovative approaches to support health and well-being among older adults. Interactive interfaces and wearable technologies have been proposed as promising tools for enhancing engagement in digital health management, yet evidence regarding their effectiveness and adoption remains inconsistent. OBJECTIVE: This study aimed to systematically review and synthesize current evidence on the types of interactive interfaces and wearable technologies used with older adults, their impact on health engagement and management, and the barriers affecting adoption. METHODS: This study conducted a mixed-methods systematic review to synthesize empirical evidence on interactive interfaces and wearable technologies for older adults. Two reviewers (A and B) independently screened and appraised all records, with a third reviewer (C) resolving disagreements. Database searches were conducted between January 2021 and August 2025 across PubMed, Scopus, Web of Science and CINAHL. A total of 1,474 records were identified, of which 101 full-text articles were assessed, and 48 studies met inclusion criteria. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and employed the Mixed Methods Appraisal Tool (MMAT) for quality assessment. Thematic analysis was applied to extract and integrate findings across diverse study designs. RESULTS: Five categories of technologies were identified: commercial wearable devices, custom-built systems, mobile health platforms, age-friendly interface designs, and immersive or alternative modalities. These technologies influenced health engagement through four main pathways: usability and ease of learning, self-monitoring and adherence, motivational support, and psychosocial empowerment. Nevertheless, multiple barriers constrained adoption, including usability limitations, low digital literacy, privacy and trust concerns, and financial and sustainability challenges. Quality assessment revealed considerable methodological variability, with only a subset of studies achieving high rigor. CONCLUSION: Overall, the findings demonstrate that while interactive interfaces and wearable technologies can empower older adults in managing their health, their broader impact depends on user-centered design, training and support mechanisms, transparent data practices, and equitable access models. The review provides an integrative framework that connects interface and wearable design to health management outcomes, offering practical guidance for inclusive and sustainable digital-health innovation for aging populations.