Objective Measure for Physical Symptoms in Terminal Phase: Activity Scores from Nonwearable Devices

Area of Science:

• Palliative Care
• Gerontology
• Oncology

Background:

• Continuous monitoring of terminal cancer patients using nonwearable devices presents potential advantages.
• Assessing physical symptom intensity is crucial in palliative care.
• Nonwearable monitoring offers a less intrusive method for patient assessment.

Purpose of the Study:

• To determine the association between nighttime activity scores measured by Nemuri SCAN (NSCAN) and physical symptom intensity.
• To evaluate these associations in the final days and weeks of life for advanced cancer patients.

Main Methods:

• Prospective observational study involving 1111 advanced cancer patients in a Japanese palliative care unit.
• Nighttime activity scores (NSCAN) and symptom intensity (pain, nausea, fatigue, shortness of breath) were recorded.
• Jonckheere-Terpstra test was used to analyze associations in the final days (1-3) and weeks (14, 21, 28 days) before death.

Main Results:

• Activity scores increased with worsening of the most severe symptom in the final days and weeks of life (p < 0.001).
• Significant associations were found between activity scores and pain, nausea, fatigue, and shortness of breath one day before death (p < 0.005).
• In the final weeks, activity scores were significantly associated with all symptoms except shortness of breath (p < 0.05).

Conclusions:

• Nemuri SCAN (NSCAN) activity scores show a significant association with symptom intensity in advanced cancer patients nearing end of life.
• NSCAN activity scores may serve as a supplementary tool to identify increases in symptom-related distress.
• This nonwearable monitoring can prompt timely clinical assessment and intervention in the final days of life.