New horizons in the pathogenesis, diagnosis and management of sarcopenia

Abstract

Sarcopenia is the age-related loss of skeletal muscle mass and function. It is now recognised as a major clinical problem for older people and research in the area is expanding exponentially. One of the most important recent developments has been convergence in the operational definition of sarcopenia combining measures of muscle mass and strength or physical performance. This has been accompanied by considerable progress in understanding of pathogenesis from animal models of sarcopenia. Well-described risk factors include age, gender and levels of physical activity and this knowledge is now being translated into effective management strategies including resistance exercise with recent interest in the additional role of nutritional intervention. Sarcopenia is currently a major focus for drug discovery and development although there remains debate about the best primary outcome measure for trials, and various promising avenues to date have proved unsatisfactory. The concept of ‘new tricks for old drugs’ is, however, promising, for example, there is some evidence that the angiotensin-converting enzyme inhibitors may improve physical performance. Future directions will include a deeper understanding of the molecular and cellular mechanisms of sarcopenia and the application of a lifecourse approach to understanding aetiology as well as to informing the optimal timing of interventions.

Incidence and Risk Factors for Frailty in the Community-Dwelling Elderly Population. A Two-Year Follow-Up Cohort Study

“…Some authors [8] consider frailty to derive from an accumulation of unrelated diseases, dysfunctions and disabilities, while others [9] consider frailty to be a unique pathophysiological process involving the breakdown of homeostatic mechanisms, with muscle wasting as the major component of the frailty phenotype. Loss of muscle mass and strength has been associated with low physical activity, malnutrition, chronic inflammatory processes and falling anabolic hormone levels [10,11]. However, the contribution and relevance of each of these components in the genesis of sarcopenia and frailty is not well established.…”

Screening with a Novel Cell-Based Assay for TAZ Activators Identifies a Compound That Enhances Myogenesis in C2C12 Cells and Facilitates Muscle Repair in a Muscle Injury Model

“…Sarcopenia is a skeletal muscle atrophy associated with ageing (42). Sarcopenia deprives elderly populations of the ability to live independently and will be a major health concern in industrialized countries.…”

Mitochondrial respiratory chain deficiency in older men and its relationship with muscle mass and performance

“…However, much remains to be understood in terms of the cellular and molecular processes underlying the development of sarcopenia. A range of areas have been investigated including mitochondrial dysfunction, anabolic resistance, motor unit remodelling and oxidative stress [7].…”