The influence of sarcopenia on health-related quality of life among older patients with gastrointestinal cancer: an assessment using the SarQoL® questionnaire

Abstract

Introduction: Sarcopenia, characterized by a progressive loss of skeletal muscle mass and function, significantly affects older adults, particularly those with cancer. Although sarcopenia’s negative influence on quality of life (QoL) is acknowledged, data on its specific impact among older hospitalized oncology patients remain limited. The aim of the present study was to assess the health-related quality of life in older patients (≥ 65 years) diagnosed with gastrointestinal cancer using the SarQoL® questionnaire and to analyze the association between weight loss and functioning across individual quality of life domains. Methods: This cross-sectional study included 97 consecutive patients (≥ 65 years) diagnosed with gastrointestinal cancer, hospitalized at the University Hospital in Krakow between June and September 2023. Participants completed the SarQoL® questionnaire, assessing QoL across seven domains: physical and mental health, locomotion, body composition, functionality, activities of daily living, leisure activities, and fears. Nutritional status was evaluated using Nutritional Risk Screening 2002 (NRS-2002). Results: Patients had moderate impairment in overall QoL (mean SarQoL® score: 61.7 ± 15.4/100). Lowest scores were observed in leisure activities (55 points), while highest scores occurred in fears (83 points). A significant but weak inverse correlation was observed between body weight and functionality (r = -0.225 ; p < 0.05) and fears domains (r = -0.255 ; p < 0.05), indicating higher QoL scores with lower body weight. Notably, patients with higher NRS scores paradoxically reported better functionality (r = 0.213 ; p < 0.05). Additionally, subjective physical weakness strongly correlated with mobility limitations and fatigue during walking (p < 0.001). Conclusions: Sarcopenia substantially impairs QoL in older oncology patients, especially regarding leisure and functionality domains. The SarQoL® questionnaire is effective in identifying nuanced impacts of sarcopenia on QoL. Early nutritional and rehabilitative interventions tailored to these insights could significantly enhance patient care and QoL outcomes.