SARCOPENIA AND COGNITIVE DECLINE IN AGING: PATHOPHYSIOLOGICAL MECHANISMS, CLINICAL IMPLICATIONS, AND STRATEGIES FOR HEALTHY AGING

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ABSTRACT Introduction: Sarcopenia and cognitive decline are highly prevalent con ditions associated with aging and are strongly linked to reduced functional capacity, loss of independence, and impaired quality of life among older adults. Due to increased life expectancy and the growing prevalence of chronic diseases, these conditions h ave become important public health concerns. Emerging evidence suggests that muscle dysfunction and cognitive impairment may share common pathophysiological mechanisms, including chronic inflammation, insulin resistance, oxidative stress, hormonal dysregulation, sedentary lifestyle, and nutritional deficiencies. Understanding the relationship between sarcopenia and cognitive decline may contribute to the development of preventive and therapeutic strategies aimed at promoting healthy aging. Objective: To ela borate a literature review analyzing the relationship between sarcopenia and cognitive decline, highlighting associated factors, pathophysiological mechanisms, and clinical repercussions in older adults. Methods: This study consists of a descriptive and exploratory literature review conducted through searches in the Scientific Electronic Library Online (SciELO), PubMed, Virtual Health Library (VHL), and Google Scholar databases. Scientific articles published between 2021 and 2026 in English were included. T he descriptors “sarcopenia,” “cognitive decline,” “elderly,” “aging,” “muscle function,” and “dementia” were combined using the Boolean operators AND and OR. Inclusion criteria comprise full -text articles addressing the association between sarcopenia and cognitive impairment in older adults. Duplicate studies, editorials, incomplete manuscripts, and studies unrelated to the proposed theme were excluded. Results: The analyzed studies demonstrated that older adults with sarcopenia have a significantly increas ed risk of cognitive impairment, particularly involving memory, attention, and processing speed. Chronic inflammation, insulin resistance, mitochondrial dysfunction, hormonal alterations, reduced physical activity, and inadequate nutritional intake were id entified as major mechanisms underlying this association. Additionally, muscle loss may contribute to mobility limitations, reduced social interaction, and greater physical dependence, factors that may further aggravate cognitive decline. The findings reinforce the existence of a bidirectional relationship between skeletal muscle health and brain function, highlighting the importance of early interventions. Conclusion: Sarcopenia and cognitive decline are interconnected conditions that negatively affect hea lth and functional autonomy in aging. Preventive and therapeutic strategies, including regular physical exercise, adequate nutritional support, and multidisciplinary monitoring, may contribute to improved clinical and functional outcomes in older adults. Further studies are needed to better elucidate the mechanisms linking muscle dysfunction and cognitive impairment.