Skeletal muscle measures and physical function in older adults with cancer: Sarcopenia or myopenia?

Grant R. Williams*, Allison M. Deal, Hyman B. Muss, Marc S. Weinberg, Hanna K. Sanoff, Kirsten A. Nyrop, Mackenzi Pergolotti, Shlomit Strulov Shachar

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

93 Scopus citations

Abstract

Background: Skeletal muscle loss, commonly known as sarcopenia, is highly prevalent in older adults and linked with adverse outcomes in cancer, yet the definition and role of sarcopenia remains uncertain. The aim of this study was to examine the association of Computerized Tomography (CT) assessed skeletal muscle measures with physical function in older adults with cancer. Results: CTs for 185 patients were available. Median age 73 (IQR 68-76) and 56.5% female. After controlling for sex and BMI, we found no evidence that SMI was associated with physical function impairments. Both SMD and SMG were associated physical function impairments and higher values were associated with decreased limitations in instrumental activities of daily living (RR 0.84 [CI 0.73-0.96] and 0.94 [CI 0.89-0.99], respectively), climbing stairs (RR 0.84 [CI 0.76-0.94] and 0.91 [CI 0.87-0.96]), walking 1 block (RR 0.77 [CI 0.67-0.90] and 0.91 [CI 0.85-0.97]), and prolonged Timed Up and Go (RR 0.83 [CI 0.75-0.92] and 0.92 [CI 0.88-0.96]). Materials and Methods: Using the Carolina Senior Registry, we identified patients with CT imaging performed within 60 days +/- of baseline geriatric assessment (GA). Skeletal muscle area and density (SMD) were analyzed from L3 lumbar segments. Muscle area and height (m2) were used to calculate skeletal muscle index (SMI). Skeletal Muscle Gauge (SMG) was created by multiplying SMI x SMD. Conclusions: Skeletal muscle mass as assessed from CT imaging was not associated with physical function impairments. Skeletal muscle radiodensity was more associated with physical function and may aid in identifying older adults at risk for functional impairments.

Original languageEnglish
Pages (from-to)33658-33665
Number of pages8
JournalOncotarget
Volume8
Issue number20
DOIs
StatePublished - 2017
Externally publishedYes

Funding

FundersFunder number
UNC Oncology Clinical Translational Research Training Program
UNC Radiology
University CancerResearch Fund
National Institutes of Health1UL1TR001111
National Cancer InstituteK12CA120780
Breast Cancer Research Foundation
National Center for Advancing Translational Sciences
University of North Carolina

    Keywords

    • Cancer
    • Geriatric oncology
    • Myopenia
    • Sarcopenia
    • Skeletal muscle index

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