Sarcopenia: An overview of emerging therapies and pathophysiological insights in age-related skeletal muscle decline.

Abstract

Sarcopenia is characterized by an age-associated decline of skeletal muscle mass and function. It has been recognized as a clinical disease by the World Health Organization since 2016. This condition is commonly linked with signs of physical frailty, functional limitations, higher frequency of falls, increased hospitalization, and a rise in mortality rates, and it is gaining recognition as a crucial geriatric syndrome considering the increasing life expectancy and the growing elderly population worldwide. A few pathological mechanisms of sarcopenia have been identified, even though its etiologies are still unclear. These mechanisms include cellular senescence, oxidative stress, and apoptosis along with "inflammaging. It also involves changes in the types of muscle fibers, satellite cells, mitochondrial function, myokines, and inflammatory cytokines in aged sarcopenic muscle as compared with young or healthy aged muscles. Ultimately, this review explores new therapeutic avenues for the management of sarcopenia. There is not a well-recognized treatment for sarcopenia clinically now. However, there are a variety of pharmacological and non-pharmacological approaches that have been used to manage sarcopenia. Among the non-pharmacological interventions, diverse exercise protocols are supplemented by potent nutritional components. Exercise mimetics, myokines and monoclonal antibodies, nicotinamide adenine dinucleotide (NAD+) stimulators, mitochondrial boosters, and compounds that regulate muscular apoptosis are all included in the pharmacological interventions. This consolidated body of knowledge is expected to enhance the formulation of more effective therapeutic strategies aimed at maintaining muscle mass in the elderly population, thus fostering the independence of senior individuals and mitigating the socioeconomic challenges related to sarcopenia.