Ecological momentary assessment for assessing depression in advanced dementia: a pilot study

Abstract

Up to 38% of individuals with advanced dementia experience clinical depression. Although studies demonstrate lower rates of clinical depression as dementia advances, this may be attributed to the difficulty of assessment at this stage. Clinical interviews are thorough in assessing depression, though they are time- and resource-contingent. As such, healthcare providers often turn to screening tools or scales. However, conventional tools for assessing depression have problems with validity in this population. Individuals with dementia who self-report may lack insight and have memory impairments. Recall bias may also impact proxy reports from caregivers, particularly in institutional settings. We propose sampling mood data repeatedly and in real-time to shorten the period of recall and to maximize representativeness. This approach, known as Ecological Momentary Assessment (EMA), provides data used to measure target symptoms with greater sensitivity than retrospective methods in many populations, and has shown to be a feasible method of mobile assessment. Despite this, the use of a proxy mobile EMA tool for depression in dementia has yet to be developed or evaluated. The objective of this study was to design and pilot a mobile EMA tool for assessing depression in dementia. Specific aims sought to evaluate the tool’s feasibility and reliability in assessing depressive symptoms.