Intrinsic Capacity (IC), a critical framework established by the World Health Organization, encompasses the composite of physical and mental abilities across five domains: cognition, psychological health, sensory function, vitality, and locomotion. Recent findings underscore the pivotal role of the musculoskeletal system in sustaining IC, particularly as conditions like sarcopenia, osteoporosis, and their coexistence—termed osteosarcopenia (OS)—are increasingly linked to declines in these domains. This narrative review consolidates current evidence regarding how muscles and bones modulate IC and the implications of musculoskeletal disorders on functional ability in older adults.

The review highlights that musculoskeletal tissues contribute to IC not solely through their biomechanical roles but also as secretory organs. They release various myokines and osteokines that exert endocrine, paracrine, and autocrine effects, influencing both physical and cognitive health. Key players identified include brain-derived neurotrophic factor, irisin, osteocalcin, and interleukin-6. Dysregulation of these pathways, combined with biomechanical dysfunction and systemic inflammation, has been shown to correlate with IC impairment, particularly in the context of sarcopenia, osteoporosis, and OS.

The findings present a significant shift in understanding the multifaceted interactions between musculoskeletal health and overall functional ability. This knowledge can inform future research directions, particularly in elucidating the mechanisms affecting sensory and vitality domains. Targeted interventions that enhance musculoskeletal health could be developed, potentially leading to improved outcomes in healthy aging and longevity. This underscores the necessity for a more integrated approach in both research and clinical practice to mitigate the impacts of musculoskeletal disorders on IC.

Source: academic.oup.com