Proposed framework: sarcopenia as systemic energetic failure with ageing
A Personal View proposes understanding sarcopenia as a manifestation of systemic energetic failure with ageing, not mainly a disorder intrinsic to skeletal muscle. The authors call this a physiological hypothesis. [1]
Automatic summary · not editorially reviewed
The key findings
The authors say sarcopenia is still mainly conceptualised as a disorder intrinsic to skeletal muscle, which contributes to underdiagnosis and undertreatment. [1]
The proposed framework links muscle function to coordination of energetic demand, oxygen and substrate delivery, mitochondrial ATP production and utilisation. [1]
The authors describe the framework as a physiological hypothesis that integrates current evidence and generates testable predictions. [1]
The source at a glance
- Study type / format
- Personal View (abstract only)
- Population / context
- People with age-related impairment of muscle function (sarcopenia), discussed conceptually
- Summary based on
- Study abstract
- Original publication
- September 28, 2026
Why muscle-only framing is questioned
The authors note that sarcopenia remains underdiagnosed and undertreated, partly because it is still mainly conceptualised as a disorder intrinsic to skeletal muscle. Current definitions include muscle strength and physical performance, but the authors say these are not intended to explain the integrated physiological processes behind age-related impairment of muscle function.
Supporting source [1]
Proposed mismatch of demand and energy
In the proposed framework, muscle function is an emergent property of integrated physiology. Ageing is said to disrupt coordination among energetic demand set by neural activation, delivery of oxygen and metabolic substrates, their mitochondrial transformation into ATP, and efficient utilisation. The resulting mismatch between demand and available energy is proposed to show clinically as reduced strength in physical performances, increased fatigability, impaired recovery and mobility disability.
Supporting source [1]
Cited evidence lines and hypothesis status
The authors cite three independent lines of evidence: epidemiological data linking muscle strength more closely than muscle mass to disability and mortality; interventional studies in which increasing muscle mass did not reliably improve function; and emerging findings that mitochondrial performance is constrained by upstream processes regulating oxygen and substrate delivery. They present this as a physiological hypothesis that integrates current evidence and generates testable predictions.
Supporting source [1]
How to interpret this
This is an abstract of a Personal View; the full text was not reviewed. The framework is presented as a physiological hypothesis, not a validated model, and the cited evidence lines are summarised only.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Ferrucci L, Donega S, Picca A, Calvo-Rubio Barrera M, Rolland Y, Clark BC, Gomez-Cabrera MC. · europepmc.org · September 28, 2026