Real-Time Fatigue and Physical Activity of Older Adults in Assisted Living: Feasibility of Ecological Momentary Assessment.

Abstract

Background: Fatigue is associated with decreased physical activity (PA) among older adults in assisted living (AL), but the direction of the relationship is unclear and may differ with mobility status.

Objective: This study (1) assessed the feasibility and acceptability of measuring real-time fatigue and PA using ecological momentary assessment (EMA) and (2) described the temporal relationship between real-time fatigue and PA in AL residents with differing mobility levels.

Methods: Older adults in AL (N = 34; mean age 75.6) wore an activity monitor for 7 days and recorded fatigue scores 5 times/day. We reported recruitment, completion, and satisfaction metrics. We used generalized estimating equations to examine the temporal relationships between real-time fatigue and each of 6 PA time intervals (PA counts per minute averaged over 30-, 60-, and 120-minute intervals before and after fatigue scores). We examined 2 subgroups who (1) primarily ambulated or (2) primarily used a wheelchair or scooter.

Results: Eighty percent of those screened were eligible and enrolled. Participants wore the PA monitor for a mean of 7.5 (SD: 1.7) days and completed 76% of fatigue ratings. Most participants said the monitor was comfortable and had no difficulty entering fatigue scores. In the non-ambulatory subgroup, there were significant positive associations between PA (all time intervals) and subsequent fatigue (P = .002-.049).

Conclusions: This study supports the feasibility and acceptability of using EMA methods with older adults in AL and provides preliminary evidence regarding the temporal relationship between PA and fatigue in this population.