Multidimensional Geriatric Evaluation in Acromegaly: A Comparative Cross-Sectional Study

Abstract

Background: Improvement in acromegaly management increased disease survival and prevalence. Evidence regarding acromegaly in older adults are sparse. We aim to explore acromegaly impact on aging process quality.Methods: Multicenter case-control study conducted on 42 older adults (≥ 65 years) acromegaly patients (ACRO) compared to an age- and gender-matched control group (CTR). Each participant underwent a multidimensional geriatric evaluation.Results: Mean age in both groups was 73 ± 6 years and female gender was most represented (69%). 13 ACRO were in remission and 29 had active disease controlled by medical therapy except for one patient. ACRO showed worse physical performance and mobility skills worsening with age as compared to CTR. ACRO performed poorly in functional status assessment, and age negatively correlated with instrumental and basic daily activities execution. Cognitive evaluation was significantly impaired in ACRO vs. CTR, worsening with age. No difference was found concerning nutritional and psychological status. Musculoskeletal and bone diseases were more frequent in ACRO than in CTR (52% vs. 12%; 64% vs. 10%; P< 0.05) and independently associated with geriatric outcomes in ACRO. ACRO reported a less satisfactory quality of life concerning physical activity and pain, general health, vitality, social activities.Conclusions: Our study demonstrates increased frailty of older acromegaly patients as compared to non-acromegaly patients with a consequent negative impact on their quality of life. Therefore, it seems advisable to include physical, functional, cognitive, nutritional, and psychological status assessments in routine clinical practice. Further studies are needed to identify the most appropriate geriatric tools.

Impact of the diagnostic delay of acromegaly on bone health: data from a real life and long term follow-up experience

“…These data suggest that also the physiological process of aging may play a crucial role in the occurrence of VFs in older patients with acromegaly [42]. Moreover, in a recent case-control study, acromegaly patients aged over 65 years old showed more frequently musculoskeletal and bone diseases than no-acromegaly matched group (52% vs. 12%; 64% vs. 10%; P < 0.05) supporting that aging and acromegaly could affect both negatively bone health [43]. Osteoporosis is considered the most common metabolic disease in the elders with a prevalence of around 39% in study population in elders in 2020 in Spain and China [44].…”