Pathogenesis, Intervention, and Current Status of Drug Development for Sarcopenia: A Review

Abstract

Sarcopenia refers to the loss of muscle strength and mass in older individuals and is a major determinant of fall risk and impaired ability to perform activities of daily living, often leading to disability, loss of independence, and death. Owing to its impact on morbidity, mortality, and healthcare expenditure, sarcopenia in the elderly has become a major focus of research and public policy debates worldwide. Despite its clinical importance, sarcopenia remains under-recognized and poorly managed in routine clinical practice, partly owing to the lack of available diagnostic testing and uniform diagnostic criteria. Since the World Health Organization and the United States assigned a disease code for sarcopenia in 2016, countries worldwide have assigned their own disease codes for sarcopenia. However, there are currently no approved pharmacological agents for the treatment of sarcopenia; therefore, interventions for sarcopenia primarily focus on physical therapy for muscle strengthening and gait training as well as adequate protein intake. In this review, we aimed to examine the latest information on the epidemiology, molecular mechanisms, interventions, and possible treatments with new drugs for sarcopenia.

Ginsenoside Rc, an Active Component of Panax ginseng, Alleviates Oxidative Stress-Induced Muscle Atrophy via Improvement of Mitochondrial Biogenesis

“…In healthy adults, skeletal muscle accounts for 40–50% of the total body mass, and a decrease in skeletal muscle mass decreases the quality of life and increases morbidity and mortality. Under conditions such as wasting diseases (e.g., cancer, diabetes, and sepsis), the administration of several drugs (e.g., cancer chemotherapy, glucocorticoids, and statins), aging, and prolonged immobilization (e.g., fractures and surgical interventions), skeletal muscle loss proceeds through a multifactorial process [ 5 ]. Mitochondrial dysfunction is a common denominator of skeletal muscle loss.…”

“…Decreased muscle mass causes decreased exercise capacity, falls, osteoporosis, and fractures, which are closely related to a decreased quality of life, increased hospitalization, and increased mortality. In addition, reduced physical activity and total energy expenditure due to decreased muscle mass and function significantly increases weight gain, decreases lung function, and increases the prevalence of cardiovascular and metabolic diseases [ 3 , 4 , 5 ]. These diseases promote muscle loss through feedback mechanisms.…”

Cross-Disciplinary Approach of Adrenal Tumors: Insights into Primary Aldosteronism-Related Mineral Metabolism Status and Osteoporotic Fracture Risk

“…Another cluster involves vertebral fractures in PA. Grossly, one out of 2 to 5 adults diagnosed with PA display prevalent vertebral fractures (as shown by one study, with mostly an asymptomatic presentation) [44,48,49,51,57]; that is why screening X-rays of the thoracic-lumbar spine profile should be taken into consideration, particularly in cases with other well-known fracture risks such as older age, larger duration of menopausal period, diabetes mellitus, prior fragility fracture, and increased risk of fall due to blood pressure and glycaemia variations, and hypovitaminosis D. Moreover, a collateral hypothesis suggested a higher risk of sarcopenia in females with PA via aldosterone excess or metabolic components, a condition that is prone to fall as part of the general fracture risk panel [94][95][96].…”

Definition, diagnosis, and treatment of respiratory sarcopenia

“…Various studies continue on its pharmacological effects as a treatment for sarcopenia. Several drugs, including growth hormone, myostatin inhibitors, angiotensin II receptor antagonists, and selective androgen receptor modulators, have been tested with various scientific evidence levels to impact skeletal muscle maintenance [76,77]. However, as with whole-body sarcopenia, there are currently no effective pharmacological interventions for respiratory sarcopenia.…”