Sarcopenia, cachexia and frailty in older cats: Mechanisms, assessment and therapeutic considerations.

Early muscle condition scoring and nutritional optimization are essential for managing sarcopenia and frailty in older cats.

This review article examines sarcopenia, cachexia, and frailty in aging cats, drawing heavily from human medicine to contextualize the feline condition. Sarcopenia, the age-related loss of skeletal muscle mass, is identified as a significant contributor to frailty and reduced quality of life in older cats, with frailty also serving as a predictor of survival time. A notable subset of cats may develop sarcopenic obesity, where excess body fat is retained despite progressive muscle loss, complicating clinical assessment. The review highlights that while pathophysiological mechanisms have been extensively studied in humans, feline-specific research remains limited. Diagnostically, muscle condition scoring is recommended as an accessible early detection tool, with epaxial muscle ultrasound identified as a promising adjunctive method. Assessment of physical activity may serve as a proxy for muscle strength and function in cats, analogous to physical performance testing in humans. A validated feline frailty scoring system incorporating activity levels and other parameters is proposed as a valuable future clinical tool. From a nutritional standpoint, anabolic resistance in older cats may necessitate increased dietary protein intake, while concurrent deficiencies in fat digestion, protein absorption, cobalamin, and vitamin E should be addressed. The authors note that novel human sarcopenia therapies, often combined with resistance exercise, have not been evaluated for safety or efficacy in cats, representing a significant research gap and opportunity to advance feline geriatric medicine.

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