Wasting disorders overlooked in older adults with cancer

Many wasting disorders remain under-recognized and undertreated among older adults with cancer, and there exists a need to properly identify and manage these conditions, suggests a study.

Investigators conducted this mixed-methods study with cross-sectional analysis and qualitative interviews. They analysed the interviews thematically using a phenomenological lens, with feedback loop analysis examining the associations between themes and synthesized findings via modified critical interpretive synthesis.

Thirty patients underwent screening for malnutrition, sarcopenia, and cachexia, and eight completed the semi-structured interviews. Of the participants, 18 (60.0 percent) were malnourished, 16 (53.3 percent) sarcopenic, and 17 (56.7 percent) cachexic. Eighty percent of patients had one or more conditions, while 30 percent had all three.

Univariate analysis revealed that Rockwood clinical frailty score (odds ratio [OR], 2.94, 95 percent confidence interval [CI], 1.26‒6.89; p=0.013) correlated with sarcopenia, reported percentage meal consumption (OR, 2.28, 95 percent CI, 1.24‒4.19; p=0.008) and visible wasting (OR, 8.43, 95 percent CI, 1.9‒37.3; p=0.005) with malnutrition, and percentage monthly weight loss (OR, 8.71, 95 percent CI, 1.87‒40.60; p=0.006) with cachexia.

Both patients and (in patients’ perceptions) clinicians “overlooked, overshadowed, and misunderstood” these nutritional and functional problems, which were often misattributed to ageing, cancer, or comorbidities. Patients also saw these conditions as “personal impossibilities, yet accepted inevitabilities.”

“Perceptions, identification, and management of these conditions need to improve, and their importance recognized by clinicians and patients so those truly ‘at risk’ are identified while conditions are more remediable to interventions,” the investigators said.