Harnessing Physical Activity Monitoring and Digital Biomarkers of Frailty From Pendant Based Wearables to Predict Chemotherapy Resilience in Veterans With Cancer

Authors

Gozde Cay
Yvonne H Sada
Mohammad Dehghan Rouzi
Md Moin Uddin Atique
Naima Rodriguez
Mehrnaz Azarian
M G Finco
Sarvari Yellapragada
Bijan Najafi

Publication Date

1-31-2024

Journal

Scientific Reports

DOI

10.1038/s41598-024-53025-z

PMID

38297103

PMCID

PMC10831115

PubMedCentral® Posted Date

1-31-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Middle Aged, Aged, Frailty, Resilience, Psychological, Veterans, Exercise, Neoplasms, Wearable Electronic Devices, Biomarkers, Cancer, Predictive markers, Biomedical engineering

Abstract

This study evaluated the use of pendant-based wearables for monitoring digital biomarkers of frailty in predicting chemotherapy resilience among 27 veteran cancer patients (average age: 64.6 ± 13.4 years), undergoing bi-weekly chemotherapy. Immediately following their first day of chemotherapy cycle, participants wore a water-resistant pendant sensor for 14 days. This device tracked frailty markers like cadence (slowness), daily steps (inactivity), postural transitions (weakness), and metrics such as longest walk duration and energy expenditure (exhaustion). Participants were divided into resilient and non-resilient groups based on adverse events within 6 months post-chemotherapy, including dose reduction, treatment discontinuation, unplanned hospitalization, or death. A Chemotherapy-Resilience-Index (CRI) ranging from 0 to 1, where higher values indicate poorer resilience, was developed using regression analysis. It combined physical activity data with baseline Eastern Cooperative Oncology Group (ECOG) assessments. The protocol showed a 97% feasibility rate, with sensor metrics effectively differentiating between groups as early as day 6 post-therapy. The CRI, calculated using data up to day 6 and baseline ECOG, significantly distinguished resilient (CRI = 0.2 ± 0.27) from non-resilient (CRI = 0.7 ± 0.26) groups (p <  0.001, Cohen's d = 1.67). This confirms the potential of remote monitoring systems in tracking post-chemotherapy functional capacity changes and aiding early non-resilience detection, subject to validation in larger studies.