Sarcopenia as a predictor of all-cause mortality among older nursing home residents: a systematic review and meta-analysis

Zhang, Xiaoming; Wang, Conghua; Dou, Qingli; Zhang, Wenwu; Yong-hua, Yang; Xie, Xiaohua

doi:10.1136/bmjopen-2017-021252

Cited by 85 publications

(68 citation statements)

References 48 publications

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“…The association between sarcopenia and mortality has been explored in many different populations, ranging from community-dwelling older adults [23] to nursing home residents [24]. Recently, a number of studies have found that sarcopenia can increase the risk of mortality among patients with certain types of cancer, such as lung cancer [25], gastric cancer [26], and colorectal cancer [27], indicating that sarcopenia can be a predictive factor in cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

et al. 2020

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Background: Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death in women worldwide. Recently, studies have been published with inconsistent findings regarding whether sarcopenia is a risk factor for mortality in breast cancer patients. Therefore, the aim of this systematic review and meta-analysis was to systematically assess and quantify sarcopenia as a risk factor for mortality in breast cancer patients. Methods: In a systematic literature review of PubMed, EMBASE, and the Cochrane CENTRAL Library, we searched for observational studies written in English (from database inception until April 30, 2019) that reported an association between sarcopenia and breast cancer in women who were 18 years or older. Results: A total of six studies (5497 participants) were included in this meta-analysis. Breast cancer patients with sarcopenia were associated with a significantly higher risk of mortality, compared to breast cancer patients without sarcopenia (pooled HR-hazard ratio = 1.71, 95% CI: 1.25-2.33, I 2 = 59.1%). In addition, the results of age subgroup analysis showed that participants younger than 55 years with sarcopenia had a lower risk of mortality than participants aged 55 years and older with sarcopenia (pooled HR = 1.46, 95% CI: 1.24-1.72 versus pooled HR = 1.99, 95% CI: 1.05-3.78), whereas both have an increased risk of mortality compared to non-sarcopenic patients. Subgroup analyses regarding stage at diagnosis revealed an increased risk of mortality in non-metastatic patients compared to participants without sarcopenia (pooled HR = 1.91, 95% CI: 1.32-2.78), whereas the association was not significant in metastatic breast cancer patients. Other subgroup analyses were performed using different follow-up periods (> 5 years versus ≤5 years) and the results were different (pooled HR = 1.81, 95% CI: 1.23-2.65 versus pooled HR = 1.70, 95% CI: 0.80-3.62). Conclusions: The present study found that sarcopenia is a risk factor for mortality among female early breast cancer patients. It is imperative that more research into specific interventions aimed at treating sarcopenia be conducted in the near future in order to provide evidence which could lead to decreased mortality rates in breast cancer patients.

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Section: Discussionmentioning

confidence: 99%

Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

et al. 2020

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“…Moreover, our primary outcome is not overall survival, but cancer-specific survival and survival data were collected by an experienced colorectal surgeon using medical records, and not exclusively from registries, which can be misleading [59]. This is particularly important when studying sarcopenia since it is a risk factor for all-cause mortality [60,61], postoperative complications [62,63], and CRC patients with sarcopenia are at a higher risk of cardiovascular events [64]. Furthermore, clinical data for all patients were verified by a gastrointestinal pathologist specialized in CRC, regarding tumor stage and site, and date of surgery and diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Body composition measured by computed tomography is associated with colorectal cancer survival, also in early-stage disease

et al. 2020

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Background: Cachexia and sarcopenia are associated with poor survival after colorectal cancer (CRC) diagnosis. Computed tomography (CT) can be used to measure aspects of cachexia including sarcopenia, myosteatosis and the amount of subcutaneous and visceral adipose tissue. The aim of this study was to relate CT-based body composition variables with survival outcomes in CRC. Material and methods: In this population-based, retrospective cohort study, CT scans of 974 patients with pathological stages I-IV CRCs, collected at or very near diagnosis (years 2000-2016), were used to measure cross-sectional fat and muscle tissue areas. Body composition variables based on these measurements were assessed in relation to tumor stage and site and cancer-specific survival in stages I-III CRC (n ¼ 728) using Cox proportional hazards models and Kaplan-Meier estimators. Results: Sarcopenia was associated with decreased cancer-specific survival, especially in patients with stages I-II tumors. The hazard ratio (HR) for the lowest versus highest tertile of skeletal muscle index (SMI) was 1.67; 95% confidence interval (CI), 1.08-2.58 for all stages, and HR 2.22; 95% CI 1.06-4.68, for stages I-II. Myosteatosis was also associated with decreased cancer-specific survival [(HR 2.03; 95% CI 1.20-3.34 for the lowest versus the highest tertile of skeletal muscle radiodensity (SMR)]. SMI and SMR were lower in patients with right-sided CRC, independent of age and sex. No adipose tissue measurement was significantly associated with cancer-specific survival. Conclusion: In concordance with previous studies, sarcopenia and myosteatosis were associated with decreased cancer-specific survival. The strong association between sarcopenia and poor cancer-specific survival in early-stage disease could have clinical implications for personalizing therapy decisions, including nutritional support.

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“…sarcopenia are associated with increased risk of CVD (26)(27)(28)(29)(30) . It is well documented that sarcopenia is a significant predictor of death in older adults, including those who are community-dwelling, care home residents or hospitalised patients (31)(32)(33) . A recent meta-analysis of six prospective cohort studies examined the association between sarcopenia and mortality, including 7367 community-dwelling older adults (31) .…”

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confidence: 99%

“…A recent meta-analysis of six prospective cohort studies examined the association between sarcopenia and mortality, including 7367 community-dwelling older adults (31) . The (32) . Despite it being the case that body composition can greatly change with age, the fact that visceral fat tends to increase and muscle mass tends to decrease means that there may be no significant change to an individual's overall body weight or BMI (6,11) .…”

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Sarcopenic obesity in ageing: cardiovascular outcomes and mortality

Atkins¹,

Wannamathee

2020

Br J Nutr

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Obesity is a major public health issue with prevalence increasing worldwide. Obesity is a well-established risk factor for CVD and mortality in adult populations. However, the impact of being overweight or obese in the elderly on CVD and mortality is controversial. Some studies even suggest that overweight and obesity, measured by BMI, are apparently associated with a decreased mortality risk (known as the obesity paradox). Ageing is associated with an increase in visceral fat and a progressive loss of muscle mass. Fat mass is positively associated and lean mass is negatively associated with risk of mortality. Therefore, in older adults BMI is not a good indicator of obesity. Sarcopenia has been defined as the degenerative loss of muscle mass, quality and strength with age and is of major concern in ageing populations. Sarcopenia has previously been associated with increased risks of metabolic impairment, cardiovascular risk factors, physical disability and mortality. It is possible for sarcopenia to co-exist with obesity, and sarcopenic obesity is a new class of obesity in older adults who have high adiposity levels together with low muscle mass, quality or strength. Therefore, sarcopenia with obesity may act together to increase their effect on metabolic disorders, CVD and mortality. This review will discuss the available evidence for the health implications of sarcopenic obesity on CVD and mortality in older adults.

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Sarcopenia as a predictor of all-cause mortality among older nursing home residents: a systematic review and meta-analysis

Cited by 85 publications

References 48 publications

Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review

Body composition measured by computed tomography is associated with colorectal cancer survival, also in early-stage disease

Sarcopenic obesity in ageing: cardiovascular outcomes and mortality

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