Feasibility and Acceptability of Smartphone Assessment in Older Adults with Cognitive and Emotional Difficulties.
OBJECTIVE
Ecological momentary assessment (EMA) has several advantages in clinical research yet little is known about the feasibility of collecting EMA data with mobile technologies in older adults, particularly those with emotional or cognitive difficulties. The aim of this feasibility study was to assess perceived acceptability, adherence rates, and reasons for non-adherence to smartphone-based EMA.


METHODS
At two sites, participants (n=103) aged 65 years or older with a DSM-IV-defined anxiety or depressive disorder and cognitive concerns responded three times daily to smartphone-based EMA questions assessing clinical outcomes for two 10-day periods. Quantitative and qualitative measures assessed acceptability, adherence, and reasons for non-adherence following both 10-day EMA periods.


RESULTS
Participants were moderately satisfied with and comfortable using smartphone-based EMA. Overall, 76% of participants completed surveys on ≥10 of the 20 assessment days, and 70% of participants completed at least 30% of the total surveys. Reasons for non-adherence included technical (malfunction), logistical (competing demands), physiological (hearing difficulties), and cognitive (forgetting) issues.


CONCLUSIONS
Smartphone-based EMA is feasible in older adults with cognitive and emotional difficulties. EMA tools should be responsive to the needs and preferences of participants to ensure adequate acceptability and adherence in this population. Our findings can inform the design, development, and implementation of mobile technologies in older adults in research and clinical contexts.
Washington University in St. Louis, School of Medicine, 660 S. Euclid, St. Louis, MO 63110.
Alex T
AT
Ramsey
VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161; University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093.
Julie Loebach
JL
Wetherell
VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161; University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093.
Colin
C
Depp
Washington University in St. Louis, School of Medicine, 660 S. Euclid, St. Louis, MO 63110.
David
D
Dixon
Washington University in St. Louis, School of Medicine, 660 S. Euclid, St. Louis, MO 63110.
Eric
E
Lenze
cognitive dysfunction; digital divide; ecological momentary assessment; information and communication technology; mobile technology; mood disorder; older adults
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