Abstract: Sarcopenia is a prevalent progressive skeletal muscle disease associated with aging population, which characterized by reduced muscle mass, decreased strength, and impaired physical function, significantly increasing the risk of falls, disability, and mortality in the elderly. The pathogenesis of sarcopenia is complex and involves multiple pathophysiological processes such as mitochondrial dysfunction, chronic inflammation, protein homeostasis imbalance, and neuromuscular junction degeneration. Currently, there are no approved specific therapeutic agents in clinical practice, and the treatment primarily relies on resistance training combined with nutritional support. However, due to the compliance and individual variability of patients, the efficacy is often difficult to ensure with certainty. This article provides a systematic review of the major pathological mechanisms and current therapeutic approaches for sarcopenia, with a focus on cutting-edge treatment targets of research value, including modulation of iron metabolism to promote skeletal muscle regeneration, targeted inhibition of the myostatin (Myostatin/ActRⅡB) signaling pathway, application of selective androgen receptor modulators (SARMs), and other molecular intervention strategies. This article aims to provide theoretical basis and scientific reference for the development of precise and effective therapeutic drugs and comprehensive intervention strategies for sarcopenia by reviewing the latest research progress.

Key words: sarcopenia, aged, drug target, signal pathway