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Retrospective Analysis of the Association Between Sarcopenia and Fall Risk in Older Breast Cancer Patients Using Real

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Sarcopenia significantly increases fall risk in older breast cancer survivors. While comorbidities contribute, screening for sarcopenia may improve fall prevention strategies in survivorship care.

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Area of Science:

  • Geriatric Oncology
  • Cancer Survivorship
  • Musculoskeletal Health

Background:

  • Falls are a leading cause of morbidity in older adults, posing heightened risks for breast cancer survivors due to aging, treatment effects, and comorbidities.
  • Sarcopenia, characterized by progressive loss of muscle mass and strength, is a potential contributor to fall risk but is often overlooked in cancer care.
  • Current oncology fall risk assessments rarely incorporate sarcopenia, limiting comprehensive prevention strategies for vulnerable survivors.

Purpose of the Study:

  • To investigate the association between sarcopenia and the risk of experiencing first and recurrent falls among older breast cancer patients.
  • To utilize real-world electronic health record data for evaluating sarcopenia's impact on fall incidence and frequency in this population.
  • To identify sarcopenia as a modifiable risk factor for falls within breast cancer survivorship care.

Main Methods:

  • A retrospective cohort study was performed using the TriNetX electronic health records platform.
  • The study included women aged 60-89 years diagnosed with breast cancer between 2010 and 2024, with sarcopenia identified via ICD-10 code M62.84.
  • Statistical analyses included propensity score matching and multivariable Cox regression, adjusting for key demographic, clinical, and treatment variables.

Main Results:

  • Patients with sarcopenia exhibited significantly higher rates of first falls (24% vs. 2%) and repeated falls (13% vs. <1%) compared to those without.
  • Kaplan-Meier analysis revealed an eightfold increased risk for first falls and a fourteenfold increased risk for repeated falls in sarcopenic patients.
  • Sarcopenia remained an independent predictor of first falls (HR 1.93) even after adjusting for comorbidities, with older age, hypertension, and diabetes also being significant predictors.

Conclusions:

  • Sarcopenia serves as a potent indicator of elevated fall risk in older breast cancer survivors.
  • A substantial portion of the increased fall risk associated with sarcopenia is attributable to underlying comorbidities.
  • Integrating sarcopenia screening and proactive comorbidity management into survivorship care pathways is recommended to enhance fall prevention efforts.