Exploring the Intricate Nexus of Sarcopenia and Cognitive Impairment

Sarcopenia, a group of skeletal muscle diseases with high prevalence in older adults, usually manifests as loss of muscle mass and strength, and/or physical performance decline. Cognitive impairment, defined as impaired function in one or more cognitive domains such as memory, language, computation, comprehension, executive, and visuospatial skills, affects the quality of life and social functioning of patients. Both sarcopenia and cognitive impairment are common geriatric syndromes, and the two disorders interact and influence each other. Declining muscle function accelerates cognitive impairment, and cognitive impairment in turn affects muscle strength. Potential common pathological mechanisms between the two include chronic inflammation, mitochondrial dysfunction and oxidative stress, and gut microbiota disorder. Additionally, neuroendocrine connections including testosterone, insulin, and growth factors have important effects on muscle and brain function. Recently, the development of applied metabolomics technologies has shown significant potential in uncovering shared biochemical pathways and exploring potential biomarkers. Exercise, nutritional, and cognitive interventions are significant as nonpharmacologic approaches in the treatment of sarcopenia and cognitive impairment. However, the specific mechanism of interaction between two diseases, biomarkers and effective therapeutic medications still has knowledge gaps that need to be further explored.