Mechanisms of skeletal muscle ageing; avenues for therapeutic intervention

•Age-related loss of muscle mass and function is a major contributor to frailty.•Muscles show loss of fibres, atrophy, poor regeneration and adaptive responses.•Mechanisms responsible are likely multifactoral.•Exercise is hypertrophic but the effect on loss of muscle fibres is less clear.•Interventions targeting specific pathways such as HSP/inflammation show potential.

Age-related loss of muscle mass and function, termed sarcopenia, is a catastrophic process, which impacts severely on quality of life of older people. The mechanisms underlying sarcopenia are unclear and the development of optimal therapeutic interventions remains elusive. Impaired regenerative capacity, attenuated ability to respond to stress, elevated reactive oxygen species production and low-grade systemic inflammation are all key contributors to sarcopenia. Pharmacological intervention using compounds such as 17AAG, SS-31 and Bimagrumab or naturally occurring polyphenols to target specific pathways show potential benefit to combat sarcopenia although further research is required, particularly to identify the mechanisms by which muscle fibres are completely lost with increasing age.