Daily life functioning of community‐dwelling elderly couples: an investigation of the feasibility and validity of Ecological Momentary Assessment

Abstract

Although ambulatory data collection techniques have been used in elderly populations, their feasibility and validity amongst elderly individuals with cognitive impairment and amongst couples remains unexplored. The main objective of this study is to examine the validity of Ecological Momentary Assessment (EMA) in elderly persons with or without cognitive impairment and their spouses. The sample included 58 retired farmers (mean 77.3 years, standard deviation [SD] 5.5) with or without cognitive impairment, recruited within a French cohort and 60 spouses (mean 73.4 years, SD 6.9). The presence of cognitive impairment determining by a panel of specialized neurologists permitted to define two groups: "The Cognitive Impairment Group" and "The Control Group". EMA procedures consisted of repeated telephone interviews five times per day during four days for each spouse. Our results demonstrate the validity of EMA procedures through a 92.1% level of compliance, the absence of fatigue effects, and the lack of evidence for major reactivity to the methods. However, the specificity of our sample may explain the acceptance (42%) and response (75%) rates and may reduce the generalizability of the results to the general population of elderly individuals. Finally, the validation of such techniques may contribute to future research examining community-dwelling elderly individuals and their spouses.

Feasibility and Acceptability of Smartphone Assessment in Older Adults with Cognitive and Emotional Difficulties

“…Although participants only approached 50% adherence for all surveys, 76% of participants completed surveys on at least 10 different days, and 70% completed at least 30% of the total surveys—an EMA adherence rate deemed acceptable in prior research (Rullier et al, 2014). Thus, the majority of participants contributed sufficient observations to allow for adequate analysis and improve on retrospective self-report data collection methods.…”

“…For the qualitative responses informing EMA non-adherence (i.e., missed surveys), we used a directed content analysis approach and assigned thematic codings to each response using Atlas.ti Qualitative Data Analysis and Research software. We also tracked EMA adherence objectively through device-generated data reports, and used the standard set by Rullier et al (2014) of 30% of total surveys completed as an indication of acceptable EMA adherence. For comparisons of EMA adherence rates between Time 1 and Time 2, p-value was set to 0.05 to remain consistent with the standard level of statistical significance in scientific research (Bross, 1971).…”

“…Given the diminished reliance on retrospective memory, EMA could be especially useful for enhancing the accuracy of assessment in older adults, who are more likely than younger adults to experience cognitive impairments (Rullier et al, 2014). Although older adults may be less likely to own and be proficient with mobile devices (Smith, 2014), this “digital divide” is rapidly shrinking, and evidence suggests that older adults may actually prefer electronic data collection platforms over more traditional paper-based diaries (Shiffman et al, 2008).…”

“…Although older adults may be less likely to own and be proficient with mobile devices (Smith, 2014), this “digital divide” is rapidly shrinking, and evidence suggests that older adults may actually prefer electronic data collection platforms over more traditional paper-based diaries (Shiffman et al, 2008). Previous studies have examined the acceptability and feasibility of EMA (Wenze & Miller, 2010), but few studies have addressed these issues in older adults, particularly those with clinical disorders or cognitive difficulties (Cain, Depp, & Jeste, 2009; Rullier et al, 2014). The use of EMA in this unique population is novel, and additional research is needed to better understand and maximize EMA acceptability and adherence in older adults with cognitive and emotional difficulties.…”

Perception of Older Adults Toward Smartwatch Technology for Assessing Pain and Related Patient-Reported Outcomes: Pilot Study (Preprint)

“…These approaches can provide finer-resolution and possibly more valid assessments, while also providing the ability to examine the fluctuations and variation of pain over time. The use of digital EMA tools can be especially important for enhancing the accuracy of assessments in older adults, who are more likely than younger adults to experience memory lapses (14).…”