Supplementary Material for: Survey on Acceptance of Passive Technology Monitoring for Early Detection of Cognitive Impairment

Introduction: Digital biomarkers may act as a tool for early
detection of changes in cognition. It is important to under?stand public perception of technologies focused on moni?toring cognition to better guide the design of these tools
and inform patients appropriately about the associated risks
and benefits. Health care systems may also play a role in the
clinical, legal, and financial implications of such technolo?gies. Objective: To evaluate public opinion on the use of pas?sive technology for monitoring cognition. Methods: This
was a one-time, Internet-based survey conducted in English
and Spanish. Results: Within the English survey distributed
in the USA (n = 173), 58.1% of respondents would be highly
likely to agree to passive monitoring of cognition via a smart?phone application. Thirty-eight percent of those with a high?er degree of experience with technology were likely to agree
to monitoring versus 20% of those with less experience with
technology (p = 0.003). Sixty-two percent of non-health-care
professionals were likely to agree to monitoring versus 45%
of health-care workers (p = 0.012). There were significant
concerns regarding privacy (p < 0.01). We compared the surveys answered in Spanish in Costa Rica via logistic regression
(n = 43, total n = 216), adjusting for age, education level,
health-care profession, owning a smartphone, experience
with technology, and perception of cognitive decline. Costa
Rican/Spanish-speaking respondents were 7 times more
likely to select a high probability of agreeing to such a tech?nology (p < 0.01). English-speaking respondents from the
USA were 5 times more likely to be concerned about the im?pact on health insurance (p = 0.001) and life insurance (p =
0.01). Conclusions: Understanding public perception and
ethical implications should guide the design of digital bio?markers for cognition. Privacy and the health-care system in
which the participants take part are 2 major factors to be
considered. It is the responsibility of researchers to convey
the ethical and legal implications of cognition monitoring.