Section of Endocrinology, Geriatrics & Internal Medicine, Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara 64/B, 44121, Ferrara, Italy.
Department of Translational Medicine and Surgery, UOC Endocrinology and Diabetology, Fondazione A Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy.
BMC Geriatr. 2021 Oct 26;21(1):598. doi: 10.1186/s12877-021-02549-4.
Improvement in acromegaly management increased disease survival and prevalence. Evidence regarding acromegaly in older adults are sparse. We aim to explore acromegaly impact on aging process quality.
Multicenter case-control study conducted on 42 older adults (≥ 65 years) acromegaly patients (ACRO) compared to an age- and gender-matched control group (CTR). Each participant underwent a multidimensional geriatric evaluation.
Mean age in both groups was 73 ± 6 years and female gender was most represented (69%). All comorbidities were more frequent in ACRO than CTR. Thirteen ACRO were in remission and 29 had active disease controlled by medical therapy except for one patient. ACRO showed worse physical performance and mobility skills worsening with age as compared to CTR. ACRO performed poorly in functional status assessment, and age negatively correlated with instrumental and basic daily activities execution. Cognitive evaluation scores were significantly lower in ACRO vs. CTR, worsening with age. No difference was found concerning nutritional and psychological status. Musculoskeletal and bone diseases were more frequent in ACRO than in CTR (52% vs. 12%; 64% vs. 10%; P < 0.05) and independently associated with geriatric outcomes in ACRO. ACRO reported a less satisfactory quality of life concerning physical activity and pain, general health, vitality, social activities.
Our study demonstrates increased frailty of older acromegaly patients as compared to non-acromegaly patients with a consequent negative impact on their quality of life. Therefore, it seems advisable to include physical, functional, cognitive, nutritional, and psychological status assessments in routine clinical practice. Further studies are needed to identify the most appropriate geriatric tools.
肢端肥大症管理水平的提高增加了疾病的存活率和患病率。关于老年人肢端肥大症的证据很少。我们旨在探讨肢端肥大症对衰老过程质量的影响。
对 42 名年龄≥ 65 岁的肢端肥大症患者（ACRO）进行了多中心病例对照研究，并与年龄和性别匹配的对照组（CTR）进行了比较。每位参与者都接受了多维老年评估。
两组的平均年龄均为 73 ± 6 岁，女性比例最高（69%）。ACRO 的所有合并症均比 CTR 更为常见。13 名 ACRO 处于缓解期，29 名处于活跃疾病状态，尽管有一名患者除外，所有患者均通过药物治疗得到控制。与 CTR 相比，ACRO 的身体表现和移动技能更差，且随着年龄的增长而恶化。ACRO 的功能状态评估表现不佳，年龄与执行工具性和基本日常活动呈负相关。ACRO 的认知评估得分明显低于 CTR，且随年龄增长而恶化。在营养和心理状态方面没有差异。与 CTR 相比，ACRO 的肌肉骨骼和骨骼疾病更为常见（52%比 12%；64%比 10%；P<0.05），且与 ACRO 的老年结局独立相关。ACRO 报告称，在身体活动和疼痛、一般健康、活力、社会活动方面的生活质量较差。
与非肢端肥大症患者相比，我们的研究表明，老年肢端肥大症患者的虚弱程度更高，这对他们的生活质量产生了负面影响。因此，在常规临床实践中似乎有必要评估身体、功能、认知、营养和心理状况。需要进一步研究以确定最合适的老年评估工具。
