Bidirectional associations of daily mood and subjective cognition in older adults using Ecological Momentary...

Depressive symptoms and subjective cognition are linked in older adults, but traditional measures have numerous limitations that may be addressed by ecological momentary assessment (EMA). This study examined whether baseline depressive and cognitive measures correspond to daily EMA ratings and evaluated concurrent and lagged relations between mood and subjective cognition.

Fifty-five community-dwelling older adults (31% Black/African American; 44 cognitively healthy, 11 mild cognitive impairment) completed a four-week daily EMA survey assessing mood and subjective cognition. Baseline measures included a global cognitive composite and self-reported depressive symptoms, functional independence, and cognitive decline. Cumulative link mixed models examined associations between baseline and EMA measures and concurrent and lagged EMA relations.

EMA mood correlated with baseline depressive symptoms, while EMA subjective cognition was most strongly associated with functional independence rather than objective cognition or self-reported cognitive decline. EMA mood and cognition were reciprocally associated concurrently. In lagged models, worse EMA subjective cognition predicted worse next-day mood, whereas the reverse association was not statistically significant. Lagged effects were attenuated after accounting for temporal trends and prior-day EMA values.

EMA provides low-burden insights into mood and subjective cognition, supporting its utility for naturalistic assessment in older adults.