Physiopathological mechanism of sarcopenia
Open accessAbstract
The aetiology of sarcopenia is multifactorial but still poorly understood while the sequelae of this phenomenon, i.e. loss of independence and metabolic complications, represent a major public health. The most evident metabolic explanation for muscle decline in elderly people is an imbalance between protein synthesis abd breakdown rates but other causes like neurodegenerative processes, reduction in anabolic hormone productions or sensitivity such as insulin, growth and sex hormones, dysregulation of cytokine secretions, modification in the response to inflammatory events, inadequate nutritional intakes and sedentary lifestyle are involved. Consequently, the age-related loss of muscle mass could be counteracted by adequate metabolic interventions including nutritional intakes or exercise training. Recent observations clearly show that changes in quantitative as well as qualitative intakes of dietary protein are able to counteract some pathophysiological processes related to muscle loss progression. Other strategies including changes in daily protein pattern, the speed of protein digestion or specific amino acids supplementation may be beneficial to improve short term muscle anabolic response in elderly people. The beneficial impact of resistance or endurance training on muscle mass and function is highlighted in many studies suggesting that the potential anabolic response to exercise still remains despite a lesser metabolic response to nutrients. Thus a multimodal approach combining nutrition, exercise, hormones, specific anabolic drugs may an innovative treatment for limiting the development of sarcopenia with aging.
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With aging, the normal balance between muscle protein synthesis and degradation is shifted toward net catabolism.
“With aging, the normal balance between muscle protein synthesis and degradation is shifted toward net catabolism, the body's anabolic response to dietary protein or amino acids is limited, 46,120,122,123 and the normal antiproteolytic response to insulin is impaired.46,124,125”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [120]
The anabolic effects of insulin and amino acids on protein synthesis are enhanced by physical activity and some nutrients (omega-3 fatty acids, vitamin D) and are impaired by sedentary lifestyle, bed rest, or immobilization.
“The anabolic effects of insulin and amino acids on protein synthesis are enhanced by physical activity and some nutrients (omega-3 fatty acids, vitamin D) and are impaired by sedentary lifestyle, bed rest, or immobilization (Figure 2).53,120,121”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [120]
With aging, the body's anabolic response to dietary protein or amino acids is limited.
“With aging, the normal balance between muscle protein synthesis and degradation is shifted toward net catabolism, the body's anabolic response to dietary protein or amino acids is limited, 46,120,122,123 and the normal antiproteolytic response to insulin is impaired.46,124,125”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [120]
Aging is associated with a progressive loss of skeletal muscle mass and strength.
“As a result, aging is associated with a progressive loss of skeletal muscle mass and strength, which leads to reduced functional capacity.120,122,127”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [120]
Age-related muscle loss can be counteracted by exercise training and by increased intake of protein or amino acids.
“Evidence shows that age-related muscle loss can be counteracted by exercise training 128 and by increased intake of protein or amino acids.5,120”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [120]
The progressive loss of skeletal muscle mass and strength leads to reduced functional capacity.
“As a result, aging is associated with a progressive loss of skeletal muscle mass and strength, which leads to reduced functional capacity.120,122,127”
From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [120]
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- Authors
- Boirie, Y.
- Venue
- The Journal of nutrition, health and aging
- Publisher
- Elsevier BV
- Published
- 2009-10
- Volume
- 13
- Issue
- 8
- Pages
- 717-723
- ISSN
- 1279-7707 (ISSN-L)
- PMC
- PMC12275616
- OpenAlex
- W2034678952
- Cited by
- 203
- References
- 14
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 11 · 2023: 13 · 2022: 8 · 2021: 9 · 2020: 11 · 2019: 17 · 2018: 12 · 2017: 9 · 2016: 6 · 2015: 20 · 2014: 13 · 2013: 9 · 2012: 21
- FWCI
- 1.72
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The journal of nutrition health & aging (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- sarcopenia, muscle mass loss, aging, insulin resistance, sex hormones, growth hormone, cytokines, inflammation, protein intake, amino acid supplementation, resistance training, endurance training, muscle function, dietary intervention, multimodal therapy
- MeSH terms
- Aged, Aging, Amino Acids, Dietary Proteins, Exercise Therapy, Humans, Muscle, Skeletal, Dietary Supplements, Muscle Strength, Resistance Training, Sarcopenia
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