Muscoloskeletal aging, sarcopenia and cancer

doi:10.1016/j.jgo.2018.11.007

Journal of Geriatric Oncology

Volume 10, Issue 3, May 2019, Pages 504-509

https://doi.org/10.1016/j.jgo.2018.11.007 Get rights and content

Abstract

In the context of the management of the elderly patient with cancer, currently, a key topic may be expressed by sarcopenia. Sarcopenia in its various definitions and ambiguities in the older adult is always related to negative outcomes. A close correlation between sarcopenia and adverse outcomes such as treatment response or toxicity has also been shown in the patient with cancer. For these reasons, it becomes increasingly important to try to understand and therefore differentiate conditions such as the loss of muscle mass linked to normal aging, an independent pathological condition such as sarcopenia and finally a sometimes confusing pathologic condition called cachexia.

Introduction

In the scenario of the general population, aging and the increasing number of diagnosed and treated cancer in the older adult, it has become more and more important to identify, understand and assess the so-called geriatric syndromes in the elderly patient with cancer.

Among these more attention is being placed on sarcopenia. For this reason, it has become important to know the differences between sarcopenia and the loss of muscle mass related to the normal process of muscle aging, but also how to differentiate them from an overlapping pathological condition called cachexia (both cancer and no-cancer related cachexia). Cachexia has similar clinical features to sarcopenia but is deeply different in terms of pathophysiological and etiological characteristics.

Section snippets

Muscle Aging

Muscle is a major component of lean body mass (LBM) and plays a vital role in maintaining health “Fig.1”. It has been shown that there is a direct or indirect relationship between muscle and strength, energy, mobility, skeletal support, balance, wound healing, immune function, digestive function, and skin health. Furthermore, decreasing muscle strength and age-related muscle loss, are currently considered the most common changes that accompany aging [1,2].

The decrease in muscle mass and

Sarcopenia Etiological Factors and Mechanisms

The term sarcopenia was coined by Rosenberg in 1989 to describe the age-related reduction of muscle mass that occurs with advancing age [30]. However, the important changes in muscle quality [31] and structure not just mass, necessitate a functional measurement to establish the true power of muscles mass [32]. Thus currently, sarcopenia can be defined as: a pathological loss of skeletal muscle mass characterized by essential structural changes in muscle quality [31] which occurs in the older

Cancer Cachexia and no Cancer Cachexia

Cachexia is a complex metabolic syndrome associated with underlying illness which is characterized by loss of muscle muss with or without loss of fat mass that cannot be fully reversed by the conventional nutritional support and leads to progressive functional impairment. The most prominent clinical feature of cachexia is weight loss in adults or growth failure in children. Cachexia is distinct from starvation, age-related loss of muscle mass, primary depression, malabsorption and

Musculoskeletal Aging, Sarcopenia and Cachexia as Overlapping Conditions in Older Adults with Cancer

Aging is related to a decline in muscle mass and strength [15] but only when this decline becomes pathological (sarcopenia) does this process lead to adverse health outcomes [3].

In patients with cancer, many studies show how the loss of muscle mass is a prevalent condition independent of disease stage and body mass [69]. The prevalence of low muscle mass, defined using CT images, is highly variable, ranging from 5% to 89% in different groups of oncological patients [70].

Patients with cancer are

Conclusion

Muscular aging is a physiological phenomenon, but once the muscle mass decline becomes pathological, it must be taken into account in the cancer management as it has an impact on negative outcomes (longer hospitalization, overall survival or toxicity).

Sarcopenia and muscle wasting related to physical inactivity are considered treatable and reversible conditions. The most effective strategy appears to be a combination of nutritional interventions (protein/amino acid supplementation,

Disclosures and Conflict of Interest Statements

The authors have declared no conflict of interest.

Author Contributions

Conception and design: G.Colloca, B.Di Capua, A. Bellieni, R. Calvani, E. Marzetti, V.Valentini, M.Cesari.

Manuscript writing: G.Colloca, B.Di Capua, A. Bellieni.

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Citation Excerpt :
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Muscoloskeletal aging, sarcopenia and cancer

Abstract

Introduction

Section snippets

Muscle Aging

Sarcopenia Etiological Factors and Mechanisms

Cancer Cachexia and no Cancer Cachexia

Musculoskeletal Aging, Sarcopenia and Cachexia as Overlapping Conditions in Older Adults with Cancer

Conclusion

Disclosures and Conflict of Interest Statements

Author Contributions

Semin Cell Dev Biol

Clin Nutr

Am J Clin Nutr

J Am Med Dir Assoc

J Nutr Health Aging

Clin Geriatr Med

Am J Clin Nutr

J Nutr Health Aging

Int J Biochem Cell Biol

Clin Nutr

J Am Med Dir Assoc

Am J Clin Nutr

Ageing Res Rev

Clin Nutr

Lancet Oncol

J Gastrointest Surg

Am J Clin Nutr

J Nutr Health Aging

Lancet Oncol

Curr Opin Pharmacol

J Gastrointest Surg

J Gastrointest Surg

J Urol

Am J Clin Nutr

Nutrition

Arch Phys Med Rehabil

Leading on behalf of an aging society

J Am Geriatr Soc

Anticipating the “Silver Tsunami”: prevalence trajectories and comorbidity burden among older cancer survivors in the United States

Cancer Epidemiol Biomarkers Prev

Physical activity and exercise as countermeasures to physical frailty and sarcopenia

Aging Clin Exp Res

Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer

Clin Cancer Res

Prevalence and prognostic effect of sarcopenia in breast cancer survivors: the HEAL Study

J Cancer Surviv

Body composition and outcome in patients undergoing resection of colorectal liver metastases

Br J Surg

Age-related alterations in the circadian rhythms of pulsatile luteinizing hormone and testosterone secretion in healthy men

J Gerontol

The endocrinology of aging

Science

Growth hormone replacement in healthy older men improves body composition but not functional ability

Ann Intern Med

Human aging, muscle mass, and fiber type composition

J Gerontol A Biol Sci Med Sci

Aging of the human neuromuscular system

Muscle Nerve

The impact of aging on mitochondrial function and biogenesis pathways in skeletal muscle of sedentary high- and low-functioning elderly individuals

Aging Cell

Decline in skeletal muscle mitochondrial function with aging in humans

Proc Natl Acad Sci U S A

Effect of 10 days of bed rest on skeletal muscle in healthy older adults

JAMA

Exercise is medicine

JAMA

Physical inactivity is one of the strongest predictors of disability in older adults

JAMA

The association of physical activity with mortality among older adults in the longitudinal study of aging (1984–1988)

J Gerontol Med Sci

Association of sarcopenia with short- and long-term mortality in older adults admitted to acute care wards: results from the CRIME study no Title

J Gerontol A Biol Sci Med

Effects of physical activity on life expectancy with cardiovascular disease

Arch Intern Med

Association of body composition with survival and locoregional control of radiotherapy-treated head and neck squamous cell carcinoma

JAMA Oncol