Review discusses mechanisms of sarcopenia and potential therapeutic targets in the aging muscle microenvironment.

This is a review article that synthesizes evidence on the pathophysiology of sarcopenia, focusing on early changes in the muscle microenvironment rather than end-stage myofiber atrophy. The authors identify key mechanisms including dysregulated immunity, cellular senescence, satellite cell dysfunction, mitochondrial dysfunction, and impaired proteostasis. The review proposes that targeting these early alterations through exercise, nutrition, anti-inflammatory strategies, senescent cell clearance, and mitochondrial support may offer more effective therapeutic approaches than interventions addressing only late-stage muscle loss.