The study used a discrete-choice experiment to explore older adults' preferences for designing age-friendly interfaces and wearable device integrations to improve medication adherence. 203 valid responses were collected and analyzed by mixed logit model and latent class analysis. Older adults preferred multimodal reminders, adaptive font and layout, one-tap confirmation, coordinated use of smartphone and smartwatch. They also positively evaluated contextually adaptive and biophilic themes of the environment through visual stimuli such as natural colors and images. Latent class analysis identified two groups: Efficiency–Context (84.2%), which preferred simple, low-load interactions, and Cue–Wearable (15.8%), which valued multimodal prompting and device coordination, but responded less to layout or environmental themes.