This study investigates the factors that influence older adults’ intentions to purchase smartwatches for health management, incorporating self-efficacy and perceived risk to examine understanding of technology adoption in the context of healthy aging. A sample of 199 older adults in Taiwan was analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) and Importance-Performance Map Analysis (IPMA). Results indicate that performance expectancy, effort expectancy, social influence, and facilitating conditions significantly impact purchase intention, whereas the hypothesized negative impact of perceived risk on purchase intention was not supported. Self-efficacy enhances perceived usability and helps mitigate perceived risk, while IPMA results identify social influence as the most important factor influencing purchase intention. These findings highlight the potential of smartwatches to promote active aging by supporting health monitoring, independence, and quality of life. Practically, marketers should enhance usability, leverage social influence, and offer accessible support to strengthen purchase intention toward smartwatches among older adults.
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