Work

Tolerability and the Accelerome: Open-Source Wrist Accelerometry Relates to Symptom Burden in Androgen Ablated Older Men with Prostate Cancer

Year: 2025

Type: article

Abstract: Introduction: Older men on androgen suppression for prostate cancer experience substantial symptom burden that is often missed between clinic visits. In prior work from our group, frequency-domain features ranked highly for predicting geriatric impairment, motivating a focus on interpretable spectral measures from open-source wrist accelerometry. Our overall objective was to identify accelerometry features from a pre-specified library that track weekly symptom burden in older men on ADT, and to characterize the temporal scale of the top candidates; spectral features were of particular interest. Methods: A retrospective secondary analysis of an open-source pilot was performed. Ten men ≥65 years with metastatic prostate cancer completed weekly symptom burden and self-rated health over ∼100 days. Symptom-triggered (and random) 48-h, 10-Hz wrist-accelerometry sessions were aggregated to 60-s counts-per-minute (CPM) and vector-magnitude change. From these, 98 pre-specified statistical and spectral features were extracted. Associations with a weekly Symptom Burden + Self-Rated Health Index composite (SBSI) were assessed using linear mixed-effects models (days + random intercept), Spearman correlations across five 30-day bins, penalized mixed-effects regression least absolute shrinkage and selection operator (λ = 0.5, 1), and a 500-tree random forest. Results: Nine participants provided 44 monitoring windows (14–48 h). In mixed-effects models, two CPM features were nominally associated with SBSI but did not survive false-discovery-rate adjustment. Across 30-day bins, a minute-scale restlessness pattern (CPM_top_15_freq3) rose with higher SBSI (ρ = +0.95; p = 0.012), while an overall rhythm balance measure (CPM_median_freq) tended to shift lower (ρ = −0.88; p = 0.049). Penalized models (λ = 1) retained both features, and random-forest importance ranked them highest. Within-participant plots showed restlessness increased during higher symptom weeks, while slower rhythm balance showed individual variability. Conclusion: Two interpretable CPM spectral features – restlessness (CPM_top_15_freq3) and global rhythm balance (CPM_median_freq) – were consistently associated with weekly symptom burden in this cohort. Findings are preliminary and warrant prospective validation for remote symptom monitoring.

Source: Digital Biomarkers

DOI: 10.1159/000549704

Authors: Nabiel Mir, Konstantinos Ameranis, Yan Che, Russell Z. Szmulewitz, Megan Huisingh-Scheetz

Institution: University of Chicago

Language: English

Topic: Cancer survivorship and care

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $990