Wilson Sarah, Beswick Emily, Morrell Rachel, Bhogal Sharandeep, Tolley Clare, Whitfield Tim, Wing Kieran, Mc Ardle Riona, Hassan Nehal, Walker Zuzana, Slight Sarah
School of Pharmacy, Newcastle University, King George VI Building, Queen Victoria Road, Newcastle Upon Tyne, UK.
Trinity College Dublin, Dublin, Ireland.
BMC Digit Health. 2025;3(1):55. doi: 10.1186/s44247-025-00191-3. Epub 2025 Aug 29.
The global prevalence of dementia is increasing exponentially. Early detection of dementia-causing diseases could support therapeutic intervention to decelerate disease progression. Wearable digital technologies can be used to identify early signs of such diseases and remotely monitor disease progression. However, technologies must be acceptable to users. This study explored the perspectives of participants on the acceptability of various wearable technologies for early detection.
Participants from the Cognitive Decline using Digital Devices (CODEC-II) cohort used four different wearables (smartwatch, electroencephalographic [EEG] headband, active and passive smartphone apps) for two weeks every three months over a year. A subgroup participated in semi structured interviews after two weeks to discuss their experiences and acceptance of the devices. Data was analysed using the framework analysis approach, aided by N-Vivo (v14.23.2).
Twenty-one participants were interviewed, including individuals with subjective cognitive decline ( = 10), mild cognitive impairment (MCI) ( = 7), dementia with Lewy bodies ( = 1), and three caregivers. Five key themes were identified, including ease of use, wearability, usefulness, transparency, and behavioral intention. Many participants relied on the research team to help set up the technology for them due to high levels of digital anxiety. Individuals with MCI particularly struggled with cognitive testing games in the active smartphone app, which they experienced increased awareness of their own cognitive impairments. Participants preferred wrist-worn over head-worn devices due to familiarity and impact on their appearance. While some participants enjoyed using the wearables, others questioned their accuracy for medical purposes. There was also a lack of understanding around what data were being collected from the wearables and how it was being collected, with some expressing concerns about data disclosure. Participants with professional or caregiving responsibilities described how their busy lifestyles hindered daily use of the wearables.
These findings highlight the importance of using an inclusive design approach to meet users' needs and support digital inclusivity, and an effective communication strategy to increase transparency and reduce data disclosure concerns. Future research is needed to explore the effectiveness of implementing current recommendations to support digital health equity and codesign a communication strategy with users to ensure the information is understandable.
CODEC-II was retrospectively registered as a clinical trial under the registry ClinicalTrials.gov (trial registration number: NCT07051408, date of registration: 3rd June 2025).
The online version contains supplementary material available at 10.1186/s44247-025-00191-3.
全球痴呆症患病率呈指数级增长。早期发现导致痴呆症的疾病有助于进行治疗干预，以减缓疾病进展。可穿戴数字技术可用于识别此类疾病的早期迹象，并远程监测疾病进展。然而，技术必须为用户所接受。本研究探讨了参与者对各种可穿戴技术用于早期检测的可接受性的看法。
来自使用数字设备认知衰退（CODEC-II）队列的参与者在一年时间里，每三个月使用四种不同的可穿戴设备（智能手表、脑电图[EEG]头带、主动和被动智能手机应用程序）两周。一个亚组在两周后参加了半结构化访谈，讨论他们对这些设备的体验和接受程度。数据采用框架分析方法进行分析，并借助N-Vivo（v14.23.2）软件。
采访了21名参与者，包括主观认知衰退者（n = 10）、轻度认知障碍（MCI）者（n = 7）、路易体痴呆患者（n = 1）以及三名护理人员。确定了五个关键主题，包括易用性、可穿戴性、有用性、透明度和行为意向。由于高度的数字焦虑，许多参与者依靠研究团队为他们设置技术。MCI患者在主动智能手机应用程序中的认知测试游戏中尤其困难，他们对自己的认知障碍有了更强的意识。由于熟悉且不影响外观，参与者更喜欢佩戴在手腕上而非头上的设备。虽然一些参与者喜欢使用可穿戴设备，但另一些人质疑其用于医疗目的的准确性。对于从可穿戴设备收集了哪些数据以及如何收集，也缺乏了解，一些人对数据披露表示担忧。有专业或护理职责的参与者描述了他们忙碌的生活方式如何阻碍了可穿戴设备的日常使用。
这些发现凸显了采用包容性设计方法以满足用户需求并支持数字包容性的重要性，以及采用有效的沟通策略以提高透明度并减少对数据披露的担忧的重要性。未来需要开展研究，以探索实施当前建议以支持数字健康公平性的有效性，并与用户共同设计一种沟通策略，以确保信息易于理解。
CODEC-II作为一项临床试验在ClinicalTrials.gov注册库中进行了回顾性注册（试验注册号：NCT07051408，注册日期：2025年6月3日）。
在线版本包含可在10.1186/s44247-025-00191-3获取的补充材料。
