| Publication Abstract Display | | Type: Published Abstract | | Title: Ecological momentary assessment of daily functioning among older adults living with HIV. | | Authors: Moore R, Rooney A, Depp CA, Eyler L, Granholm E, Heaton RK, Woods SP, Gouaux B, Letendre SL, Marquine M, Moore DJ | | Year: 2015 | | Publication: HIV & Aging Conference | | Volume: Issue: Pages: | | Abstract:Introduction: Older HIV-infected adults experience substantial impairment in everyday functioning, and there is a significant public health need to better understand how best to assess and enhance functioning among those aging with HIV. The predominant approach to assess participation in functionally relevant behaviors is via global self-report measures, which are often subject to retrospective biases. As such, there is a need to identify novel assessment approaches for daily functioning among older HIV-infected adults. The goal of this pilot study was to test the feasibility and acceptability of ecological momentary assessment (EMA) delivered via smartphones. EMA is an ambulatory data collection technique that allows for real-time, in vivo assessment of time spent engaged in various daily life activities (e.g., self-care, cognitively stimulating activities, passive leisure activities), social interactions, and affective symptoms. A second goal of this study was to examine the relationship between EMA-measured daily functioning and neuropsychological performance.
Material & Methods: Twenty older (≥50 years) HIV-infected adults (mean age=59, range=51-67 years) completed a laboratory-based assessment of neuropsychological functioning: the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), as well as at-home EMA assessments five times per day for one week. EMA adherence was calculated by dividing number of surveys completed by total possible number of surveys, and rates and variability of participation in active and passive functional behaviors were aggregated within individuals.
Results: Results demonstrated feasibility and acceptability of EMA among older HIV+ adults, with an excellent adherence rate of 86% and low perceived burden. Aggregated across the week, participants spent 74% of their time at home, 63% of their time alone, and 31% of their time engaged in passive leisure activities (e.g., watching TV). Cognitive performance (RBANS score) was inversely related to time spent engaged in passive leisure activities (r=-0.57, p=0.01), but was unrelated to time spent engaged in self-care or cognitively stimulating activities. We also found that greater depressed mood was associated with greater variability in cognitively stimulating daily life activities (Wald Chi2=4.7, p=0.03).
Conclusions: These findings suggest EMA is a feasible and acceptable tool to assess functional activities among older HIV-infected adults. The study revealed that participants spent a remarkable amount of time at home, alone, and engaged in passive activities. Findings additionally suggest that neurocognitive impairment is related to passivity, and depressed mood contributed to fluctuations in cognitively stimulating activity participation. It may be useful to leverage EMA technology to deliver interventions aimed at reducing social isolation and depressed mood and enhancing cognitive stimulation in an effort to diminish disability in this population. |
return to publications listing
|