We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Malnutrition, sarcopenia and cachexia: exploring prevalence, overlap, and perceptions in older adults with cancer.
- Authors
Bullock, Alex F.; Patterson, Michael J.; Paton, Lewis W.; Currow, David C.; Johnson, Miriam J.
- Abstract
Background: Older adults with cancer are a growing population requiring tailored care to achieve optimum treatment outcomes. Their care is complicated by under-recognised and under-treated wasting disorders: malnutrition, sarcopenia, and cachexia. We aimed to investigate the prevalence, overlap, and patients' views and experiences of malnutrition, sarcopenia, and cachexia, in older adults with cancer. Methods: Mixed-methods study with cross-sectional study and qualitative interviews. Interviews were thematically analysed through a phenomenological lens, with feedback loop analysis investigating relationships between themes and findings synthesised using modified critical interpretative synthesis. Findings: n = 30 were screened for malnutrition, sarcopenia, and cachexia, n = 8 completed semi-structured interviews. Eighteen (60.0%) were malnourished, 16 (53.3%) sarcopenic, and 17 (56.7%) cachexic. One or more condition was seen in 80%, and all three in 30%. In univariate analysis, Rockwood clinical frailty score (OR 2.94 [95% CI: 1.26–6.89, p = 0.013]) was associated with sarcopenia, reported percentage meal consumption (OR 2.28 [95% CI: 1.24–4.19, p = 0.008]), and visible wasting (OR 8.43 [95% CI: 1.9–37.3] p = 0.005) with malnutrition, and percentage monthly weight loss (OR 8.71 [95% CI: 1.87–40.60] p = 0.006) with cachexia. Screening tools identified established conditions rather than 'risk'. Nutritional and functional problems were often overlooked, overshadowed, and misunderstood by both patients and (in patients' perceptions) by clinicians; misattributed to ageing, cancer, or comorbidities. Patients viewed these conditions as both personal impossibilities, yet accepted inevitabilities. Conclusion: Perceptions, identification, and management of these conditions needs to improve, and their importance recognised by clinicians and patients so those truly 'at risk' are identified whilst conditions are more remediable to interventions.
- Subjects
ENGLAND; MALNUTRITION diagnosis; CROSS-sectional method; WEIGHT loss; RISK assessment; MALNUTRITION; ATTITUDES toward illness; FOOD consumption; WASTING syndrome; RESEARCH funding; INTERVIEWING; FRAIL elderly; DESCRIPTIVE statistics; DISEASE prevalence; CANCER patients; THEMATIC analysis; ODDS ratio; MUSCLE weakness; RESEARCH methodology; STATISTICS; AGING; GERIATRIC assessment; CACHEXIA; TUMORS; MEDICAL screening; COMPARATIVE studies; CONFIDENCE intervals; EARLY diagnosis; SARCOPENIA; PATIENTS' attitudes; COMORBIDITY; DISEASE complications; OLD age
- Publication
European Journal of Clinical Nutrition, 2024, Vol 78, Issue 6, p486
- ISSN
0954-3007
- Publication type
Article
- DOI
10.1038/s41430-024-01433-9