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

Mir N, Ameranis K, Che Y, Szmulewitz RZ, Huisingh-Scheetz M

Digital biomarkers, 2026

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…

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