Objective
This study aimed to examine the feasibility, acceptability, and initial validity of
using smartphone-based ecological momentary assessment (EMA) to assess daily functioning
and other behavioral factors among older HIV+ adults.
Methods
Twenty older HIV+ adults (mean age: 59 years) completed laboratory-based neurobehavioral
and functional assessments then completed EMA surveys via smartphones five times per
day for one week.
Results
Excellent EMA adherence (86.4%) was found, and participants rated their experience
with EMA methods positively. Time-use data indicated participants were spending 74%
of their waking-sampled time at home, 63% of their time alone, and 32% of their time
engaged in passive leisure activities (e.g., watching TV). Better neurocognitive and
functional capacity abilities were correlated with less time spent in passive leisure
activities. Lastly, mood and cognitive symptom data collected via EMA were significantly
associated with scores from laboratory-based assessments of these same constructs.
Conclusions
EMA via smartphones is a feasible and acceptable data collection method among older
HIV+ adults and appears to be a promising mobile tool to assess daily functioning
behaviors in HIV. These preliminary findings indicate older HIV+ adults are spending
a considerable amount of time at home, alone, and engaged in passive leisure activities,
primarily watching TV. EMA may contribute to future research examining functional
disability among the growing population of older HIV+ adults.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of Geriatric PsychiatryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Synergistic effects of HIV infection and older age on daily functioning.J Acquir Immune Defic Syndr. 2012; 61: 341-348
- The impact of neuropsychological performance on everyday functioning between older and younger adults with and without HIV.JANAC. 2013; 24: 112-125
- Diagnoses of HIV infection among adults aged 50 years and older in the United States and dependent areas, 2007–2010.(HIV Surveillance Supplemental Report; 18(No. 3))http://www.cdc.gov/hiv/topics/surveillance/resources/reports/#supplemental. Published February 2013(Accessed December 29, 2016)Date: 2013
- HIV and aging: state of knowledge and areas of critical need for research. A report to the NIH office of AIDS research by the HIV and aging working group.J Acquir Immune Defic Syndr. 2012; 60: S1-S18
- Older Americans: the changing face of HIV/AIDS in America.(Washington, DC, U.S. Government Publishing Office)2013
- Aging with HIV: a cross-sectional study of comorbidity prevalence and clinical characteristics across decades of life.JANAC. 2011; 22: 17-25
- Aging hearing: HIV over fifty, exploring the new threat.(Washington, DC, U.S. Government Publishing Office)2006
- Depression, cognition, and self-appraisal of functional abilities in HIV: an examination of subjective appraisal versus objective performance.Clin Neurospychol. 2011; 25: 224-243
- HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER Study.Neurology. 2010; 75: 2087-2096
- Neuropsychologic impairment in early HIV infection. A risk factor for work disability.Arch Neurol. 1995; 52: 525-530
- Medication adherence among HIV+ adults: effects of cognitive dysfunction and regimen complexity.Neurology. 2002; 59: 1944-1950
- The impact of HIV-associated neuropsychological impairment on everyday functioning.JINS. 2004; 10: 317-331
- The ecological validity of tests of executive function.JINS. 1998; 4: 547-558
- Diagnosing symptomatic HIV-associated neurocognitive disorders: self-report versus performance-based assessment of everyday functioning.JINS. 2012; 18: 79-88
- Self-predictions of prospective memory in HIV-associated neurocognitive disorders: evidence of a metamemory deficit.Arch Clin Neuropsychol. 2014; 29: 818-827
- Self-reports: how the questions shape the answers.Am Psychol. 1999; 54: 93-105
- A review of performance-based measures of functional living skills.J Psychiatr Res. 2007; 41: 97-118
- Ecological momentary assessment in aging research: a critical review.J Psychiatr Res. 2009; 43: 987-996
- For vast majority of seniors who own one, a smartphone equals “freedom”.(Pew Research Center; Available from:)
- Older adults and technology use.(Pew Research Center; Available from:)
- A new brief instrument for assessing decisional capacity for clinical research.Arch Gen Psychiatry. 2007; 64: 966-974
- Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults 1993.MMWR Recomm Rep. 1992; 41: 1-19
- Updated research nosology for HIV-associated neurocognitive disorders.Neurology. 2007; 69: 1789-1799
- Defining neurocognitive impairment in HIV: deficit scores versus clinical ratings.Clin Neurospychol. 2012; 26: 894-908
- Computerized reaction time battery versus a traditional neuropsychological battery: detecting HIV-related impairments.JINS. 2003; 9: 64-71
- Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse.AIDS. 2004; 18: S19-S25
- The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): preliminary clinical validity.J Clin Exp Neuropsychol. 1998; 20: 310-319
- Relationship of the Brief UCSD Performance-based Skills Assessment (UPSA-B) to multiple indicators of functioning in people with schizophrenia and bipolar disorder.Bipolar Disord. 2010; 12: 45-55
- A neuropsychological investigation of multitasking in HIV infection: implications for everyday functioning.Neuropsychology. 2011; 25: 511-519
- Manual for the Beck Depression Inventory-II.Psychological Corp., San Antonio, TX1996
- Profile of Mood States.Educational and Industrial Testing Service, San Diego, CA1981
- Assessment of older people: self-maintaining and instrumental activities of daily living.Gerontologist. 1969; 9: 179-186
- Ecological momentary assessment of social functioning in schizophrenia: impact of performance appraisals and affect on social interactions.Schizophrenia Res. 2013; 145: 120-124
- Computerized ambulatory monitoring in psychiatry: a multi-site collaborative study of acceptability, compliance, and reactivity.Int J Methods Psychiatr Res. 2009; 18: 48-57
- SPSS Statistics Base 23.0.IBM Corporation, Chicago, IL2010
- American Time Use Survey.(Available from:)www.bls.gov/TUS/CHARTS/OLDER.HTMDate: 2015
- Augmenting psychoeducation with a mobile intervention for bipolar disorder: a randomized controlled trial.J Affect Disord. 2015; 174: 23-30
- Feasibility and validity of computerized ecological momentary assessment in schizophrenia.Schizophrenia Bull. 2008; 34: 507-514
- Cognition in older women: the importance of daytime movement.J Am Geriatr Soc. 2008; 56: 1658-1664
- Physical activity and risk of cognitive impairment among oldest-old women.Am J Geriatr Psychiatry. 2014; 22: 1149-1157
- Cross-sectional and longitudinal associations of different sedentary behaviors with cognitive performance in older adults.PLoS ONE. 2012; 7 (e47831)
- Leisure activity and risk of cognitive impairment: the Chongqing aging study.Neurology. 2006; 66: 911-913
- The relationships between television viewing in midlife and the development of Alzheimer's disease in a case-control study.Brain Cogn. 2005; 58: 157-165
- Engaging in cognitive activities, aging, and mild cognitive impairment: a population-based study.J Neuropsychiatry Clin Neurosci. 2011; 23: 149-154
- Effect of early adult patterns of physical activity and television viewing on midlife cognitive function.JAMA Psychiatry. 2016; 73: 73-79
- The health indicators associated with screen-based sedentary behavior among adolescent girls: a systematic review.J Adolesc Health. 2013; 52: 382-392
- Sedentary behavior and depression among adults: a review.Int J Behav Med. 2010; 17: 246-254
- Television-viewing time and dietary quality among U.S. children and adults.Am J Prev Med. 2012; 43: 196-200
- Mobile technologies in the early detection of cognitive decline.PLoS ONE. 2014; 9: e112197
- The role of employment on neurocognitive reserve in adults with HIV: a review of the literature.JANAC. 2015; 26: 316-329
Article info
Publication history
Published online: December 02, 2016
Accepted:
November 23,
2016
Received in revised form:
November 17,
2016
Received:
May 15,
2016
Identification
Copyright
Published by Elsevier Inc. on behalf of American Association for Geriatric Psychiatry.
