This systematic review examined interactive interfaces and wearable technologies to improve health management in older adults. Searches of the PubMed, Scopus, Web of Science and CINAHL databases between January 2021 and August 2025 identified 1474 records, of which 48 studies met the inclusion criteria after review of 101 full-text articles. Two reviewers independently assessed records according to PRISMA and MMAT, with a third resolving disagreements. Five technology categories were identified: commercial wearables, custom systems, mobile health platforms, human-friendly interface designs, and immersive modalities. These technologies increase health engagement through four pathways: usability and ease of learning, self-monitoring and adherence, motivational support, and psychosocial empowerment. Adoption is hindered by barriers such as limited usability, low digital literacy, privacy and trust concerns, financial issues and sustainability. The studies showed methodological variability, with only a portion achieving high quality. The findings highlight the need for user-centered design, training, transparent data practices and equitable access for broader impact.