Gut microbiota and physical frailty through the mediation of sarcopenia

The changing physiology and lifestyle of older people affect the gut microbiota composition. In particular, the age-related diet modifications can alter the gut microbiota biodiversity and determine the relative abundance of specific microbial taxa, resulting in microbiota dysbiosis with negative consequences for the host physiology. Unhealthy microbiota may then induce an acceleration of the age-related physiological changes, consequently concurring at determining the characteristic complexity of frail older persons. One of the major clinical manifestations of frailty is represented by the individual's physical decline. Besides of a well-established clinical phenotype of frailty, the qualitative and quantitative skeletal muscle impairment (i.e., sarcopenia) is today of particular interest for potentially serving as target for (pharmacological and nonpharmacological) interventions to prevent incident disability. Evidence suggests that gut microbiota is able to influence the skeletal muscle homeostasis via microbiota-dependent metabolites, thus representing the possible biological substratum for the sarcopenia onset. In fact, the rearrangements of gut microbiota as well as the alteration of its functions contribute at increasing the anabolic resistance, releasing pro-inflammatory mediators, determining mitochondrial abnormalities with consequent oxidation, and causing insulin resistance. In this article, the link between gut microbiota and physical frailty is discussed. It is especially explained the role that sarcopenia may play in this likely bidirectional relationship.