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 (n = 10), mild cognitive impairment (MCI) (n = 7), dementia with Lewy bodies (n = 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).
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