Evaluation of the Relationship Between Sarcopenia, Nutritional Status, and Frailty in Older Patients with Cancer

Sarcopenia, malnutrition, and frailty frequently coexist in older adults with cancer, adversely affecting treatment tolerance, functional independence, and survival. While comprehensive geriatric assessment (CGA) is the gold standard for frailty evaluation, its resource-intensive nature limits routine use, and simple tools are needed. This cross-sectional study included 291 patients aged ≥70 years with histologically confirmed cancer, evaluated at a oncology outpatient clinic between January and November 2024. Sarcopenia was defined according to EWGSOP2 criteria: handgrip strength (HGS) and skeletal muscle index (SMI) by bioelectrical impedance analysis (BIA). Nutritional status was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF), and frailty was defined as G8 ≤ 14. Additional measures included SARC-F, Mini-Mental State Examination (MMSE), and Geriatric Depression Scale. The median age was 74 years, and 53% were male. Possible sarcopenia was identified in 39.5%, confirmed sarcopenia in 33.7%, severe sarcopenia in 26.8%. Nutritional risk was observed in 66.7%, and frailty in 44.7%. Frailty correlated strongly with nutritional status and moderately with muscle strength and mass. In multivariable analysis, low HGS, low SMI, nutritional risk, and depression independently predicted frailty. ROC analysis showed, G8 with HGS and nutritional assessment improved predictive accuracy. These findings highlight that simple measures enhance frailty detection and may support personalized care.