Skeletal muscle measures and physical function in older adults with cancer: sarcopenia or myopenia?
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Grant R. Williams1,2, Allison M. Deal3, Hyman B. Muss2,3, Marc S. Weinberg2, Hanna K. Sanoff2,3, Kirsten A. Nyrop2,3, Mackenzi Pergolotti2,4, Shlomit Strulov Shachar2,5
1The University of Alabama at Birmingham, Birmingham, AL, USA
2The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
3UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
4Colorado State University, Fort Collins, CO, USA
5Division of Oncology, Rambam Health Care Campus, Haifa, Israel
Grant R. Williams, email: firstname.lastname@example.org
Keywords: sarcopenia, myopenia, skeletal muscle index, cancer, geriatric oncology
Received: December 28, 2016 Accepted: March 25, 2017 Published: April 05, 2017
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.
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