Frail young adult cancer survivors experience poor health‐related quality of life

Abstract

BACKGROUND:Young adult cancer survivors experience frailty and decreased muscle mass at rates equivalent to much older noncancer populations, which indicate accelerated aging. Although frailty and low muscle mass can be identified in survivors, their implications for health-related quality of life are not well understood. METHODS: Through a cross-sectional analysis of young adult cancer survivors, frailty was assessed with the Fried frailty phenotype and skeletal muscle mass in relation to functional and quality of life outcomes measured by the Medical Outcomes Survey Short-Form 36 (SF-36). z tests compared survivors with US population means, and multivariable linear regression models estimated mean SF-36 scores by frailty and muscle mass with adjustments made for comorbidities, sex, and time from treatment. RESULTS: Sixty survivors (median age, 21 years; range, 18-29) participated in the study. Twenty-five (42%) had low muscle mass, and 25 were either frail or prefrail. Compared with US population means, survivors reported worse health and functional impairments across SF-36 domains that were more common among survivors with (pre)frailty or low muscle mass. In multivariable linear modeling, (pre)frail survivors (vs nonfrail) exhibited lower mean scores for general health (−9.1; P = .05), physical function (−14.9; P < .01), and overall physical health (−5.6; P = .02) independent of comorbid conditions. CONCLUSIONS: Measures of frailty and skeletal muscle mass identify subgroups of young adult cancer survivors with significantly impaired health, functional status, and quality of life independent of medical comorbidities. Identifying survivors with frailty or low muscle mass may provide opportunities for interventions to prevent functional and health declines or to reverse this process.

Effect of Frailty on Hospital Outcomes Among Pediatric Cancer Patients in the United States

“…[27][28][29] Interestingly, premature aging has also been found in pediatric cancer patients, suggesting that frailty in younger patients follows a similar mechanism to that in the geriatric population. 26,30,31 Though there are many studies on the mechanism of frailty among adult cancer patients, to the best of our knowledge there are no studies among pediatric cancer patients. Such studies should be done in the future to Odds ratios (ORs) were calculated using logistic regression after adjusting for age, sex, race, insurance, income, hospital size, location and teaching status, cancer type, and node positive/metastasis.…”

“…Another theory postulates that the mitochondrial bioenergetic function, which normally decreases with age, is further impaired in frail patients, which results in decreased muscle strength and endurance capacity 27–29 . Interestingly, premature aging has also been found in pediatric cancer patients, suggesting that frailty in younger patients follows a similar mechanism to that in the geriatric population 26,30,31 . Though there are many studies on the mechanism of frailty among adult cancer patients, to the best of our knowledge there are no studies among pediatric cancer patients.…”

Nicotinamide riboside intervention alleviates hematopoietic system injury of ionizing radiation‐induced premature aging mice

“…Radiotherapy is one of the most common cancer treatment methods; however, it may cause morbidity and delayed effects of acute radiation exposure (DEARE) in a variety of organ systems, including the cardiovascular, gastrointestinal, pulmonary, neurological, and hematopoietic systems, which collectively contributes to accelerated aging (Cupit‐Link et al, 2017; Tung et al, 2021). Clinical studies have shown that an increasing number of cancer survivors with DEARE, including childhood and adult patients, become frail after diagnosis and treatment, thus leading to the development of chronic diseases and geriatric syndromes prematurely (Miller et al, 2022; Pranikoff et al, 2022). These changes are referred to as accelerated or premature aging in long‐term survivors of cancer.…”

“…and treatment, thus leading to the development of chronic diseases and geriatric syndromes prematurely (Miller et al, 2022;Pranikoff et al, 2022). These changes are referred to as accelerated or premature aging in long-term survivors of cancer.…”

Accelerated epigenetic aging and myopenia in young adult cancer survivors

“…Advancements in cancer and supportive therapies have led to a growing population of young adult survivors 1,2 with more than 700,000 survivors now living in the United States 3 . The majority of young adult survivors experience significant impairments in health, quality of life, and lifespan with increased secondary cancers, cardiovascular disease, and endocrinopathies 4‐15 . The premature onset of aging‐related morbidities and functional impairment point to a process of accelerated aging in survivors, the underlying mechanism of which is not well understood 7,16,17 .…”