Ecological momentary assessment suggests greater sensitivity to clinical change in a compensatory strategy pilot clinical trial.

Abstract

Objective: Ecological momentary assessment (EMA) is increasingly used in psychological clinical trials to capture outcomes. This brief report compared EMA measures of everyday functioning and cognition with traditional measures administered pre- and post-intervention in a pilot clinical trial with older adults (OAs) experiencing cognitive concerns.

Method: Sixty-two OAs enrolled in a remote trial; 39 met EMA compliance at baseline, and 26 both pre- and post-intervention. EMA included smartwatch-delivered Likert questions and a cognitive task collected 4x daily for 1 week; traditional measures included questionnaires and neuropsychological tests.

Results: EMA mean scores correlated significantly with corresponding traditional measures at baseline, supporting convergent validity. Limited associations between EMA-derived variability and standardized measures suggest EMA captures unique, dynamic aspects of functioning. EMA measures showed small-to-moderate effect sizes (Hedges' gs > 0.22) for improved mean scores and reduced variability; traditional measures did not.

Conclusions: EMA may offer unique insights about functional stability beyond traditional measures.