Frailty and sarcopenia: The potential role of an aged immune system
Open accessAbstract
Frailty is a common negative consequence of ageing. Sarcopenia, the syndrome of loss of muscle mass, quality and strength, is more common in older adults and has been considered a precursor syndrome or the physical manifestation of frailty. The pathophysiology of both syndromes is incompletely described with multiple causes, inter-relationships and complex pathways proposed. Age-associated changes to the immune system (both immunesenescence, the decline in immune function with ageing, and inflammageing, a state of chronic inflammation) have been suggested as contributors to sarcopenia and frailty but a direct causative role remains to be established. Frailty, sarcopenia and immunesenescence are commonly described in older adults but are not ubiquitous to ageing. There is evidence that all three conditions are reversible and all three appear to share common inflammatory drivers. It is unclear whether frailty, sarcopenia and immunesenescence are separate entities that co-occur due to coincidental or potentially confounding factors, or whether they are more intimately linked by the same underlying cellular mechanisms. This review explores these possibilities focusing on innate immunity, and in particular associations with neutrophil dysfunction, inflammation and known mechanisms described to date. Furthermore, we consider whether the age-related decline in immune cell function (such as neutrophil migration), increased inflammation and the dysregulation of the phosphoinositide 3-kinase (PI3K)-Akt pathway in neutrophils could contribute pathogenically to sarcopenia and frailty.
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Age-related mechanisms promoting the onset of sarcopenia and physical frailty include inflammation, immunosenescence, anabolic resistance and increased oxidative stress.
“The age-related mechanisms promoting the onset of sarcopenia and physical frailty include inflammation, immunosenescence, anabolic resistance and increased oxidative stress [9,10].”
From Gut Microbiota, Muscle Mass and Function in Aging: A Focus on Physical Frailty and Sarcopenia (2019) · cites this paper as [9]
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The Continuum of Aging and Age-Related Diseases: Common Mechanisms but Different Rates
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The Role of Inflammation in Age-Related Sarcopenia
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Gut Microbiota, Muscle Mass and Function in Aging: A Focus on Physical Frailty and Sarcopenia
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mTORC Inhibitors as Broad-Spectrum Therapeutics for Age-Related Diseases
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Pharmacological blockade of TNFα prevents sarcopenia and prolongs survival in aging mice
Sciorati, C., Gamberale, R., Monno, A., Citterio, L., Lanzani, C., De Lorenzo, R., Ramirez, G. A., Esposito, A., Manunta, P., Manfredi, A. A., et al. (2020) · Aging · doi:10.18632/aging.202200 · Cited by 79 · see citing works
Frailty trajectories in adult lung transplantation: a cohort study
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Nguyen, B. T. T., Lin, A. P., Yang, W.-W., Cheng, S.-J., Kuo, Y.-J., Nguyen, T. T., & Chen, Y.-P. (2024) · Aging Clinical and Experimental Research · doi:10.1007/s40520-024-02902-8 · Cited by 20 · see citing works
- Authors
- Wilson, D., Jackson, T., Sapey, E., & Lord, J. M.
- Affiliations
- Queen Elizabeth Hospital Birmingham (GB)
- Corresponding author
- Wilson, Daisy
- Venue
- Ageing Research Reviews
- Publisher
- Elsevier BV
- Published
- 2017-07
- Volume
- 36
- Pages
- 1-10
- ISSN
- 1568-1637 (ISSN-L)
- OpenAlex
- W2589489083
- Cited by
- 573
- References
- 128
- Citations by year
- 2026: 42 · 2025: 70 · 2024: 71 · 2023: 67 · 2022: 88 · 2021: 72 · 2020: 75 · 2019: 53 · 2018: 21 · 2017: 14
- FWCI
- 5.47
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Ageing Research Reviews (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
- Funders
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research
- Medical Research Council
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- frailty, sarcopenia, inflammaging, innate immunity, neutrophil dysfunction, chronic inflammation, PI3K/Akt signaling, muscle mass loss, older adults, immunosenescence
- MeSH terms
- Frailty, Aged, Aging, Animals, Humans, Immune System, Inflammation, Frail Elderly, Sarcopenia
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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