Abstract
BackgroundDaily functioning of people with cognitive disorders such as mild cognitive impairment (MCI) is usually depicted by retrospective questionnaires, which can be memory-biased and neglect fluctuations over time or contexts.ObjectiveThis study examines the feasibility and usability of applying the experience sampling method (ESM) in people with MCI to provide a detailed and dynamic picture of behavioral, emotional, and cognitive patterns in everyday life.MethodsFor 6 consecutive days, 21 people with MCI used an ESM app on their smartphones. At 8 semi-random timepoints per day, participants filled in momentary questionnaires on mood, activities, social context, and subjective cognitive complaints. Feasibility was determined through self-reports and observable human-technology interactions. Usability was demonstrated on an individual and group level.ResultsOf the 21 participants, 3 dropped out due to forgetting to carry their smartphones or forgetting the study instructions. In the remaining 18 individuals, the compliance rate was high, at 78.7%. Participants reported that momentary questions reflected their daily experiences well. Of the 18 participants, 13 (72%) experienced the increase in awareness of their own memory functions as pleasant or neutral.ConclusionsSupport was found for the general feasibility of smartphone-based experience sampling in people with MCI. However, many older adults with MCI are currently not in possession of smartphones, and study adherence seems challenging for a minority of individuals. Momentary data can increase the insights into daily patterns and may guide the person-tailored development of self-management strategies in clinical settings.
Highlights
Clinical questionnaires are commonly retrospective in nature and are potentially affected by a memory bias and thought to have low ecological validity [1]
Support was found for the general feasibility of smartphone-based experience sampling in people with mild cognitive impairment (MCI)
Many older adults with MCI are currently not in possession of smartphones, and study adherence seems challenging for a minority of individuals
Summary
Clinical questionnaires are commonly retrospective in nature and are potentially affected by a memory bias and thought to have low ecological validity [1]. As already cognitively healthy individuals over or underestimate past emotions and situations [2], this method might distort reality even more when people experience cognitive deficits. Known as the experience sampling method (ESM) [5] or ecological momentary assessment [6], may offer a solution to this problem. Individuals fill in short questionnaires about current emotions and behaviors repeatedly over several days, which results in a high ecological validity and offers detailed insight into dynamic patterns [7]. Compared to paper-pencil diaries, technology-based ESM questionnaires can be filled in faster, reducing time burden and providing more details about the exact assessment time. Functioning of people with cognitive disorders such as mild cognitive impairment (MCI) is usually depicted by retrospective questionnaires, which can be memory-biased and neglect fluctuations over time or contexts
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