Ecological Momentary Assessment to Measure Social Connectedness in Older Adults: Integrative Review

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 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: A total of 5 databases-PubMed, CINAHL, Embase, Web of Science, and PsycINFO-were searched for studies published up to March 2025. 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 multifactorial constructs of social connectedness (structural, functional, and quality) and assessed EMA protocols and compliance or adherence to EMA.

Results: Of the 18,886 studies identified, 43 were selected for final analysis. Social connectedness assessed via EMA mostly focused on the structural dimension, capturing whether an individual had social contact at a given moment (38/43, 88%). Among functional dimension (17/43, 40%), loneliness was the most measured construct, and the quality dimension (16/43, 37%) included quality of social interaction, pleasantness of encounters, and interpersonal tensions. In total, 2 studies addressed all 3 dimensions of social connectedness. In addition, to provide context for understanding social connectedness, assessments considered location at the time of assessment, type of activity, and physical (eg, pain and fatigue) and psychological states (eg, positive or negative mood). Data were mostly collected using an app on digital devices (eg, smartphone), and assessments were conducted 1-7 times per day for 5 to 25 days, achieving a compliance 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 multifactorial constructs of social connectedness and standardization of EMA protocols may increase the likelihood of capturing useful information about older adults' real-time social connectedness.