JMIR Publications

ABSTRACT

Background:

The importance of social connectedness as a determinant of health and well-being in older adults is well established. Ecological momentary assessment (EMA) shows promise for real-time measurement of social interactions, making it worthwhile to investigate its feasibility and the challenges of applying it to older adults.

Objective:

This integrative review aimed to (1) summarize and integrate the implementation of ecological momentary assessment (EMA) in assessing older adults' social connectedness, and (2) discuss the EMA method and its use to assess the concept of social connectedness in order to guide future research.

Methods:

Five databases—PubMed, Embase, Web of Science, CINAHL, and PsycINFO—were searched for studies published up to the year 2023. Of the 2,208 studies identified, 21 were selected for final analysis. We included studies that (1) targeted adults aged 60 years or older, (2) used EMA to assess social connectedness, and (3) were published in a peer-reviewed journal. Studies using third-party reports to obtain EMA data and studies focusing on marital dyads were excluded. The analysis identified multi-factorial constructs of social connectedness (structural, functional, and quality) and assessed EMA protocols and adherence to EMA.

Results:

Social connectedness assessed via EMA mostly focused on structural aspects, capturing whether an individual had social contact at a given moment or the number of people they interacted with (18/21; 85.7%). Among functional aspects (9/21; 42.9%), loneliness was the most measured, and quality aspects (6/21; 28.6%) included quality of social interaction, pleasantness of encounters, and interpersonal tensions. Only one study addressed all three aspects of social connectedness. Additionally, to provide context for understanding social connectedness, assessments considered location at the time of assessment, type of activity, and physical (e.g., pain, fatigue) and psychological states (e.g., positive or negative mood). Data were mostly collected using an app on digital devices (e.g., smartphone), and assessments were conducted 3-6 times per day for 5 to 21 days, achieving an adherence rate of over 70%.

Conclusions:

The findings of this study highlight the current state of science in measuring social connectedness in older adults through EMA and demonstrate its feasibility in real-world settings. Further research is suggested to address the conceptual and methodological challenges of EMA, as measurement of multi-factorial constructs of social connectedness and standardization of EMA protocols may increase the likelihood of capturing useful information about older adults' real-time social connectedness.