Remote monitoring in older adults with cancer, opportunities and challenges: a narrative review

Background

The ageing population has led to more cancer cases among older adults, who face higher risks of treatment-related adverse events, functional decline, and unplanned healthcare use. Traditional assessments like Eastern Cooperative Oncology Group and Karnofsky Performance Status lack sensitivity for this group, highlighting the need for new methods to monitor symptoms and functional changes in cancer care. This review examines remote monitoring technologies for older adults with cancer, focusing on their potential and challenges.

Main body

E-health tools such as electronic patient-reported outcomes (ePROs) and wearable devices enable continuous monitoring of symptoms, treatment toxicity, functional status, and adherence. Although benefits like fewer hospitalisations and better survival are shown in younger populations, evidence for older adults is limited. Early studies indicate these technologies are feasible and well-received by older patients but face barriers including digital literacy, cognitive and physical impairments, and healthcare system readiness. Devices like activity trackers and smartphones may detect functional decline and fall risk, though optimal intervention criteria remain unclear. Incorporating e-health into geriatric assessment and survivorship care could foster personalized, proactive management.

Conclusion

Remote monitoring technologies hold promise for enhancing symptom and functional assessment in older adults with cancer, supporting age-appropriate care. However, robust geriatric-specific evidence is lacking. Future research should address technological challenges, validate clinical thresholds, and assess long-term outcomes. Integrating these tools within multidisciplinary frameworks can improve care delivery throughout the cancer journey.