The Clinical Neuropsychologist · May 25, 2026

Ecological momentary assessment of cognitive functioning among older adults: The relationship between self-reported and test-based cognitive functioning

By De Block F, Kekäläinen T, Deforche B et al.

Objective: The use of ecological momentary assessment (EMA) to measure within-person fluctuations in cognitive performance has increased in recent years. However, many of the measures employed lack strong methodological foundations. This study evaluated the within-person reliability of test-based and self-reported momentary cognitive assessments and examined associations between test-based and self-reported momentary cognitive functioning, among older adults. Method: Fifty-four participants (aged 65+) completed a 10-day testing period, during which they completed three assessments daily, measuring self-reported (three items) and test-based (1-back test and spatial dot memory test) cognitive functioning on a smartphone. Within-person reliability was evaluated by examining measurement variability within and across assessments. Associations between self-reported and test-based momentary cognitive functioning were analyzed using general(ized) linear mixed models. Results: Among the momentary measures, the self-report items, 1-back test response time, and spatial dot memory test response time demonstrated adequate within-person reliability, while spatial dot memory test accuracy exhibited low reliability. Self-reported momentary cognitive functioning was only significantly associated with the spatial dot memory test span. Conclusions: Establishing within-person reliability is crucial when selecting cognitive assessments in EMA research. Furthermore, momentary measures of test-based and self-reported cognitive functioning were not consistently associated and should not be used interchangeably. Beyond the empirical findings, this study highlights key practical lessons for cognitive EMA research, including the need to consider practice effects, task difficulty, the number of trials, and the outcomes that are used.

doi.org/10.1080/13854046.2026.2668071PubMed 42186232Biomarkers