Cachexia: prevalence and impact in medicine

PURPOSE OF REVIEWCachexia is a progressive deterioration of body habitus associated with certain chronic diseases (e.g., cancer, chronic obstructive pulmonary disease, chronic heart failure, and chronic kidney disease). The aim of this article is to describe the prevalence and impact of cachexia (and precachexia) in such patients. RECENT FINDINGSOwing to the wide spectrum of clinical presentation and lack of an ‘all-inclusive’ definition, it is difficult to estimate the true prevalence of cachexia. Perhaps 2% of the population suffer from precachexia (characterized by weight loss in association with a chronic disease). The significant increase in obesity of the general population (which can mask significant muscle wasting) confounds such simple estimates of the true prevalence of cachexia. In contrast, a multidimensional characterization of the cachectic state (including weight loss, reduced food intake, and systemic inflammation) may be more meaningful in terms of altered clinical outcomes. Such a multidimensional view of cachexia has been shown to impact on patientsʼ survival and quality of life and therefore constitutes a major public health issue. SUMMARYThere is a high prevalence of (pre)cachexia in patients with chronic diseases. The cachexia syndrome is probably less frequent but has a significant impact in terms of morbidity and mortality.