Abstract
OBJECTIVE: This study investigates the associations between sarcopenia and quality of life in elderly cancer patients, with nutritional status and physical function as potential mediators. It also explores the interactions among sarcopenia, nutritional status, and physical function. METHODS: A cross-sectional study was conducted among 275 elderly cancer patients. Sarcopenia was assessed using the criteria of the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Nutritional status was evaluated using the Nutritional Risk Screening 2002 (NRS-2002) tool, along with serum albumin, prealbumin levels, and body mass index (BMI). Physical function was assessed using the 6-minute walk distance (6MWD), gait speed, and Timed Up and Go (TUG) test. All functional indicators were standardized into z-scores. Quality of life (QOL) was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Structural equation modeling (SEM) was used to analyze the relationships among sarcopenia, nutritional status, physical function, and QOL. RESULTS: Multivariate analysis indicated that sarcopenia, nutritional status, and physical function together explained 54% of the variance in quality of life. Path analysis showed significant associations through the following pathways: (1) Sarcopenia → Nutritional status → quality of life (22.0%); (2) Sarcopenia → Physical function → quality of life (17.07%); (3) Sarcopenia → Nutritional status → Physical function → quality of life (6.09%). CONCLUSION: Sarcopenia, nutritional status, and physical function are significantly associated with quality of life in elderly cancer patients. Physical function mediates the associations between both sarcopenia and nutritional status. Early detection and comprehensive interventions targeting sarcopenia, nutrition, and physical function are essential for improving patient outcomes. Future strategies should be individualized to address the complex needs of this population. CLINICAL TRIAL NUMBER: Not applicable.