Systematic review describes skeletal muscle aging as loss of tissue resilience with exercise as clinical foundation.

This systematic review examined molecular mechanisms of skeletal muscle aging, emphasizing that age-related muscle dysfunction results from more than just mass loss, involving changes across myofibers, stem cells, immune, vascular, and metabolic systems. The authors reviewed therapeutic evidence and identified exercise and nutritional optimization as established clinical approaches, while mitochondrial, anabolic, senescence-directed, and regenerative strategies are presented as emerging interventions. The review synthesized evidence from single-cell, multi-omics, and translational studies to propose a framework of muscle aging centered on impaired proteostasis, mitochondrial dysfunction, chronic inflammation, and cellular senescence.