Ecological momentary assessment suggests greater sensitivity to clinical change in a compensatory strategy pilot clinical trial

Abstract Objective Ecological momentary assessment (EMA) is increasingly used in psychological clinical trials to capture outcomes. This brief report compared EMA measures of everyday functioning and cognition with traditional measures administered pre- and post-intervention in a pilot clinical trial with older adults (OAs) experiencing cognitive concerns. Method Sixty-two OAs enrolled in a remote trial; 39 met EMA compliance at baseline, and 26 both pre- and post-intervention. EMA included smartwatch-delivered Likert questions and a cognitive task collected 4x daily for 1 week; traditional measures included questionnaires and neuropsychological tests. Results EMA mean scores correlated significantly with corresponding traditional measures at baseline, supporting convergent validity. Limited associations between EMA-derived variability and standardized measures suggest EMA captures unique, dynamic aspects of functioning. EMA measures showed small-to-moderate effect sizes (Hedges’ gs 0.22) for improved mean scores and reduced variability; traditional measures did not. Conclusions EMA may offer unique insights about functional stability beyond traditional measures.