Bijetri Biswas

Background: Sleep disturbance is a common symptom of and potential risk factor for neurodegeneration and dementia. Remote monitoring technologies and increasing digital literacy offer promise for monitoring symptoms and treatment responses via sleep and cognitive assessments from patients’ homes. However, the acceptability of remote sleep and circadian research in older adults with and without cognitive impairment is not known. Objective: This study aimed to explore and describe the barriers, facilitators, and user experience of older adults participating in longitudinal sleep and dementia research using remote monitoring technologies. Methods: Older adults with mild cognitive impairment (MCI) or dementia due to probable Alzheimer disease or Lewy body disease and age-matched controls participated in an 8-week remote study involving multimodal assessments of sleep and cognition, including actigraphy, wireless electroencephalography, web-based cognitive tasks, and serial saliva samples. Participants were asked for feedback via questionnaires during the study at 2 time points and purposively invited to complete end-of-study interviews about their experiences. The Capability, Opportunity, Motivation–Behavior model of behavior change, and the extended Unified Theory of Acceptance and Use of Technology, were used to guide questionnaire and interview topic guide development. Inductive reflexive thematic analysis was undertaken, with components from the models used as sensitizing concepts. Results: A total of 14 participants (9 with MCI or dementia, 5 controls) completed end-of-study interviews, and 28 participants (9 with MCI or dementia, 19 controls) completed questionnaires. Six key themes were identified: (1) “Perceived value as motivation,” (2) “Trust and simplicity as cornerstones in user experience,” (3) “Adjusting to study participation over time,” (4) “Adherence, accuracy, and getting it right,” (5) “Social support as a facilitator and a barrier,” and (6) “Reflections, realities, and uncertainties around sleep.” Conclusions: Older adults with and without cognitive impairment were motivated to engage in longitudinal remote sleep research and provide good quality data. Acceptability was related to burden, usability, and reliability of devices, having sufficient support, and ability to build study tasks into a routine. In repeated cognitive tasks, varying task content and difficulty, and allowing flexibility in timing may avoid fatigue and frustration. Future studies should aim to identify effective strategies for recruiting diverse populations, particularly those with limited technology experience or from underserved communities, to ensure equitable participation and representation in research. Providing education on the importance of sleep for brain health and technology use may be beneficial.

Background: Soft robotics holds promise in healthcare, enhancing rehabilitation and daily support for physical and mental well‐being. Despite this potential, their role in caring for older adults with neurodegenerative disorders (NDD) remains underexplored, even though the World Health Organization identifies NDD as a major global health challenge. User acceptance is critical but shaped by complex factors that designers often struggle to access and apply effectively. Method: This study explores perceptions of soft robotics for NDD care, focusing on usability, safety, emotional comfort, and design preferences. Data were gathered from focus groups, interviews, and co‐design sessions with patients, caregivers, and clinicians. Discussions were facilitated using a virtual think‐space and structured co‐design workshops. Result: Participants expressed a strong preference for large‐scale soft robotics, viewing them as engaging, comforting, and immersive. They emphasised the need for multi‐functional designs integrating physical assistance, sensory stimulation, and emotional engagement. Larger robots were seen as fostering a sense of security, encouraging social interactions, and strengthening relationships between patients and caregivers. Concerns about safety, durability, and ease of maintenance were raised, highlighting the need for soft yet robust materials. Biomorphic designs inspired by nature were favoured for their emotional and aesthetic appeal. Clinicians also stressed the importance of modularity, allowing for customisable features to meet individual needs. Conclusion: Findings emphasise the importance of large‐scale, interactive, and adaptable soft robotics. By addressing user‐centred concerns, designers can enhance technology acceptance, foster empathy and ethical awareness, and create more engaging, supportive robotic solutions for both patients and caregivers.

Background: Sleep disturbance is a common symptom of and potential risk factor for neurodegeneration. Remote sleep and cognitive assessments offer promise for monitoring symptoms and treatment response from patients’ homes, but the acceptability of remote sleep and circadian technology in older adults with and without cognitive impairment is not known. Objective: This qualitative study was designed to explore and describe the barriers, facilitators, and user experience of older adults with mild cognitive impairment and dementia and cognitively unimpaired older adults who participated in a longitudinal sleep and memory study designed around remote monitoring technologies. Methods: Patients with mild cognitive impairment or dementia due to probable Alzheimer’s disease or Lewy body disease and age-matched controls participated in a longitudinal remote study involving multimodal assessments of sleep and cognition including actigraphy, wireless electroencephalography, a smartphone app, web-based cognitive tasks, and serial saliva samples. Participants were asked for feedback via questionnaires during the study and invited to complete end-of-study interviews about their experiences. Questions were informed and thematic analysis was guided by the Capability, Opportunity, Motivation – Behaviour model of behaviour change and the extended Unified Theory of Acceptance and Use of Technology and focused on perceived barriers and facilitators. Results: The study identified six key themes. The first theme, ‘motivations to participate’, highlighted how participants felt the research could be helpful to themselves and others. The second theme, ‘navigating the user experience of devices’, identified comfort, security, privacy, ease of use, and reliability as fundamental in determining acceptability. ‘Adjusting over time to study participation’, the third theme, covered changing perceptions with increased exposure and familiarity, and the importance of convenience, flexibility, and developing a routine. The fourth theme explored ‘social support as a facilitator and barrier to research participation’, looking at the influence of both the research team and relatives supporting at home. A fifth theme of ‘adherence, accuracy, and getting it right’ was also identified, as participants were motivated to provide good quality data for the study. Finally, we identified a sixth theme surrounding participants’ ‘reflections, realities, and uncertainties around sleep’, which focused on sleep hygiene and common sleeping problems in older adults, such as snoring and nocturnal awakenings. Conclusions: Older adults with and without cognitive impairment were motivated to engage in longitudinal remote sleep research, follow remote research protocols, and produce good quality data. Acceptability was related to burden and convenience, usability, and emotional responses to study tasks. When study tasks are repeated over time, care should be taken to introduce variety where possible to avoid fatigue and frustration. Study partners offer essential support for some participants, but requiring a study partner may also be an unnecessary barrier to research participation for others. Future studies should aim to identify effective strategies for recruiting diverse populations, particularly those with limited technology experience or from underserved communities, to ensure equitable participation and representation in research. Providing education on the importance of sleep for brain health and technology use may be beneficial.

Background: Sleep holds promise as a modifiable risk factor for neurodegenerative diseases and dementia. Clinical trials to modify sleep in people at risk of or in the early stages of dementia are needed. Monitoring natural sleep from home could support pragmatic and decentralized large-scale clinical trials. However, whether longitudinal sleep research can be successfully delivered remotely in this population has not been established yet. Objective: We investigated the feasibility of remote longitudinal research using wearable devices, web-based cognitive tasks, and a smartphone app to record sleep and cognition in older adults with mild cognitive impairment (MCI) or dementia. Methods: Older adults with MCI or dementia due to Alzheimer disease or Lewy body disease and cognitively healthy participants completed at-home sleep and circadian monitoring (digital sleep diaries, actigraphy, wearable sleep electroencephalography, and saliva samples) and digital cognitive assessments for 8 weeks. Feasibility outcomes included recruitment, retention, and data completeness. Results: In total, 41 participants consented (n=10, 24% participants with Alzheimer disease; n=11, 27% participants with Lewy body disease; and n=20, 49% controls). There were predominantly male and White British participants, with a mean age of 70.9 (SD 5.9) years. Retention was very high, with 40 (98%) participants completing 8 weeks of remote monitoring. Data completeness for sleep electroencephalography was 91% and ranged from 79% to 97% for all remote tasks and was overall high across all participant subgroups. In total, 30% (12/40) of participants reported receiving external support with completing study tasks. Conclusions: High rates of retention, data completeness, and data quality suggested that longitudinal multimodal sleep and cognitive profiling using novel and remote monitoring technology is feasible in older adults with MCI and dementia and healthy older adults, even without study partner support. Remote monitoring should be considered for mechanistic and interventional trials. Careful consideration should be given to how to ensure remote monitoring technologies reduce burden and enhance inclusivity, particularly in communities traditionally underserved by research and those with lower digital literacy. International Registered Report Identifier (IRRID): RR2-10.2196/52652

STRUCTURED INTRODUCTION: We investigated the feasibility of remote longitudinal research using wearable devices and smartphone applications to record sleep and cognition in older adults with mild cognitive impairment (MCI) or dementia. METHODS: Older adults with MCI or dementia due to Alzheimer’s disease (AD) or Lewy body disease (LBD) and cognitively healthy participants completed at-home sleep and circadian monitoring (digital sleep diaries, actigraphy, wearable sleep electroencephalography (EEG), saliva samples) and digital cognitive assessments for 8 weeks. Feasibility outcomes included recruitment, retention, and data completeness. RESULTS: 41 participants consented (10 AD, 11 LBD, and 20 controls) and 40 completed the 8-week study. Data completeness for sleep EEG was 91% and ranged from 79% to 97% for all remote tasks. 12/40 (30%) participants reported receiving external support with completing study tasks. DISCUSSION: Longitudinal multimodal sleep and cognitive profiling using novel technology is feasible in older adults with MCI and dementia and healthy older adults.

BACKGROUND Sleep holds promise as a modifiable risk factor for neurodegenerative diseases and dementia. Clinical trials to modify sleep in people at risk of or in the early stages of dementia are needed. Monitoring natural sleep from home could support pragmatic and decentralized large-scale clinical trials. However, whether longitudinal sleep research can be successfully delivered remotely in this population has not been established yet. OBJECTIVE We investigated the feasibility of remote longitudinal research using wearable devices, web-based cognitive tasks, and a smartphone app to record sleep and cognition in older adults with mild cognitive impairment (MCI) or dementia. METHODS Older adults with MCI or dementia due to Alzheimer disease or Lewy body disease and cognitively healthy participants completed at-home sleep and circadian monitoring (digital sleep diaries, actigraphy, wearable sleep electroencephalography, and saliva samples) and digital cognitive assessments for 8 weeks. Feasibility outcomes included recruitment, retention, and data completeness. RESULTS In total, 41 participants consented (n=10, 24% participants with Alzheimer disease; n=11, 27% participants with Lewy body disease; and n=20, 49% controls). There were predominantly male and White British participants, with a mean age of 70.9 (SD 5.9) years. Retention was very high, with 40 (98%) participants completing 8 weeks of remote monitoring. Data completeness for sleep electroencephalography was 91% and ranged from 79% to 97% for all remote tasks and was overall high across all participant subgroups. In total, 30% (12/40) of participants reported receiving external support with completing study tasks. CONCLUSIONS High rates of retention, data completeness, and data quality suggested that longitudinal multimodal sleep and cognitive profiling using novel and remote monitoring technology is feasible in older adults with MCI and dementia and healthy older adults, even without study partner support. Remote monitoring should be considered for mechanistic and interventional trials. Careful consideration should be given to how to ensure remote monitoring technologies reduce burden and enhance inclusivity, particularly in communities traditionally underserved by research and those with lower digital literacy. INTERNATIONAL REGISTERED REPORT RR2-10.2196/52652

Background: We investigate perceptions of soft robotics in individuals with neurodegenerative diseases (NDD) from diverse communities. Soft robotics is made from soft, flexible materials to make it safer for users. It is a fast‐emerging medical field with applications ranging from diagnosis to rehabilitation practices. However, this area is underinvestigated in the older population with neurological disorders.Method: We recruited individuals with NDD, e.g. dementia, Parkinson’s and mild cognitive impairment, via Bristol Brain Centre, charities, personal contacts, and social media advertisements. We aim to understand better user requirements and their views on such innovative technologies. In this ongoing study, we interviewed individuals with NDD, careers and clinicians to find the gap in designing soft robotics and conducted co‐design sessions with each group. To conclude the study, we will collect all the designs, create a prototype and gather iterative feedback.Result: Preliminary results from the semi‐structured interviews have shown that interaction with soft robotics technologies, such as smart pillows, prosthetics, and others, needs further exploration but is challenging. Therefore, individuals found it difficult to think or acknowledge what could help them improve their quality of life. It also highlights the importance of technologies that can help carers facilitate patients' needs. Interviews with clinicians also emphasised carers' needs and technology that can promote independence and improve well‐being. Another interesting finding from the study is that previously, individuals were unaware of creating technologies personalised to them. Furthermore, co‐designing with this population showed that involving them in the ideation and designing process is critical for empowerment.Conclusion: Do‐it‐yourself (DIY) practice offers a higher engagement in developing complex technologies, and the user‐centric design process using the Arduino prototyping platform improves the engagement rate. Cultural and ethnic diversity in the study population was another challenge, as it was challenging to get a clear view of their needs due to the language barrier. However, they overcame this by expressing their ideas by drawing. We aim to understand user requirements better and their views on such innovative technologies, present developments in soft robotics technology, and research challenges associated with our population to highlight research directions to understand this emerging field better.

Soft robotics offers significant promise for enhancing healthcare, providing benefits such as improved rehabilitation and daily assistance for both physical and mental health. Despite these advantages, its application in caring for older adults with neurodegenerative disorders (NDD) remains largely unexplored, even though the World Health Organization (WHO) identifies NDD as a major global health burden. This study investigates the perceptions of soft robotics among individuals with neurodegenerative diseases. Through focus groups, individual interviews, and co-design sessions with patients, clinicians, and caregivers, we explored usability, safety, concerns, emotional comfort, and design ideas for soft robotics. Our findings highlight the necessity for user-centered design to address these concerns, emphasizing the importance of creating multi-purpose technologies that can be used by both patients and caregivers to support each other and build relationships. This approach aims to enhance the acceptance and effectiveness of soft robotic technologies for this vulnerable population.

Soft robotics is used in real-world clinical situations, including surgery, rehabilitation, and diagnosis. However, several challenges remain to make soft robots more viable, especially for clinical interventions such as improving sleep quality, which impacts physiological and mental health. This paper presents an autoethnographic account of the experience of sleeping with a companion robot (Somnox), which mimics breathing to promote better sleep. The study is motivated by the key author’s experience with insomnia and a desire to better understand how Somnox is used in different social contexts. Data were collected through diary entries for 16 weeks (8 weeks without, 8 weeks with) and analysed thematically. The findings indicate improved sleep and observations about the relationship developed with the companion robot, including emotional connection and empathy for the technology. Furthermore, Somnox is a multidimensional family companion robot that can ease stomach discomfort and stress, reduce anxiety, and provide holistic care.