Pathological changes and therapeutic strategies for sarcopenia

Sarcopenia is becoming a major public health concern for older adults. The incidence rate in people over 70 years of age is 30-50%. Patients with sarcopenia not only have difficulty moving and are prone to falls and fractures, but in severe cases, they may also experience heart and lung failure and even death. Early diagnosis and prevention in high-risk populations can effectively prevent the deterioration of muscle atrophy. In this review, we describe the physiological mechanism of muscle contraction and reveal common pathological changes in sarcopenic patients, including oxidative stress, inflammation, insulin resistance, hypoxia, and disturbance of the gut microbiota. These pathological changes synergistically inhibit the mass and strength of skeletal muscles. We also discuss nonpharmacological therapeutic methods for sarcopenia, such as nutrient supplementation and exercise, especially resistance training. On the basis of a thorough analysis of the pathogenesis of sarcopenia in high-risk populations, we believe that tissue synthesis and energy supply are the foundation for maintaining the normal physiological functions of muscles. Mitochondria are potential targets for the optimization of intervention methods. Targeted delivery of functional mitochondria to skeletal muscle cells contributes to improving biological oxidation, redox balance, and tissue remodeling. Additionally, stem cell transplantation with the stimulation of growth factors may also be an available method for the further treatment of sarcopenia.