Does ecological momentary assessment work in mid and late life and for whom?

During late adulthood, mental health symptoms fluctuate daily which may be overlooked by traditional periodic assessments. Ecological Momentary Assessment (EMA) enables frequent symptom monitoring, informing timely interventions. However, older adults may encounter challenges with EMA completion, including lower digital literacy and age-related cognitive decline, which may be exacerbated by depressive symptoms. The present study advances our understanding of EMA feasibility in late life by investigating engagement over an extended period and identifying predictors of feasibility.

Sixty-four middle-aged and older adults (31 healthy controls; 33 with major depression; Mage = 63.4 [SD = 9.6]) completed twice-daily EMAs over ~10 weeks. We compared EMA feasibility (i.e., % completion) between groups using Wilcoxon rank-sum tests and identified predictors of feasibility with linear regression models.

Overall, we found a high EMA completion rate of 76% (SD = 22.1). Healthy middle-aged and older adults demonstrated higher completion rates (M = 81%; SD = 19.3) than those with depression (M = 71%; SD = 23.8) (W = 666, p = .04). Shorter response latency (e.g., responding quickly after the prompt) predicted high EMA feasibility in both groups. Among healthy controls, greater negative mood and more rapid fluctuations in affect early on, predicted low EMA feasibility.

This study demonstrates that EMA engagement is feasible among healthy and depressed middle-aged and older adults, over extended periods. Results suggest that individuals who experience rapid affective fluctuations and more negative affect may benefit from tailored reminders and personalized mitigation strategies. Findings highlight the potential of EMA as a scalable tool for monitoring symptom dynamics to advance personalized mental health services in this vulnerable population.