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

This feasibility study assessed perceived acceptability, adherence rates, and reasons for nonadherence to smartphone-based ecological momentary assessment (EMA). At two sites, participants (n = 103) ages 65 years or older with diagnosed 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 followed both 10-day EMA periods. 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 nonadherence included technical, logistical, physiological, and cognitive issues. 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.