Emerging roles of epigenetics in the pathogenesis of sarcopenia.

Sarcopenia is an age-associated degenerative disorder of skeletal muscle, characterized by the progressive decline in muscle mass and function, which increases the risk of falls, injuries, and accidental death in older adults. Deciphering its pathogenic mechanisms is crucial for advancing early detection, precision prevention, and ultimately improving the quality of life for the elderly population. Increasing evidence suggests that epigenetic regulation plays a central role in driving sarcopenia. DNA methylation, chromatin remodeling, and noncoding RNA regulation collectively accelerate the deterioration of bone and muscle by altering gene expression involved in biosynthesis and metabolism, disrupting protein homeostasis, activating inflammatory pathways, and compromising mitochondrial integrity. This review, which synthesizes the most recent progress in epigenetic research on sarcopenia, uses structured searches of PubMed and Web of Science for studies published from 2014 to the present and emphasizes how these interconnected regulatory networks drive the initiation and progression of the disease. Importantly, we emphasize their translational potential to identify novel biomarkers, enabling early risk stratification and informing the development of targeted therapeutic strategies, thereby laying the groundwork for precision clinical intervention.