# Performance Fatigability is Associated with Differential Gene Expression Patterns in Human Skeletal Muscle

**Authors:** Emma Gay, Paul Coen, Rebecca Deek, Brenda Diergaarde, Samaneh Farsijani, Michael Jurczak, Yujia Qiao, Nancy Glynn

PMC · DOI: 10.1093/geroni/igaf122.3637 · 2025-12-31

## TL;DR

This study finds that performance fatigability in older adults is linked to specific gene expression patterns in skeletal muscle, which could help develop interventions to reduce fatigue and improve mobility.

## Contribution

The study identifies novel gene expression patterns and biological pathways associated with performance fatigability in older adults.

## Key findings

- 1,935 differentially expressed genes were found in individuals with performance fatigability.
- Four key pathways related to muscle aging were up-regulated in those with performance fatigability.
- Upregulated pathways are linked to muscle strength loss and mobility decline in aging.

## Abstract

Performance fatigability, the degree one is limited by fatigue during a physical task, is a common trait among older adults and is associated with physical and cognitive function. Knowledge of the biological mechanisms underlying performance fatigability is limited; the skeletal muscle transcriptome may reveal important pathways to prevent or mitigate performance fatigability and promote longer healthspan. The accelerometry-based Pittsburgh Performance Fatigability Index (PPFI) quantified percentage of cadence decline (i.e., slowing down) during the usual-paced 400m walk (range 0-100%). We used available cross-sectional skeletal muscle RNAseq data from the Study of Muscle, Mobility and Aging (n = 724, 55.5% Women, 86.9% White) to identify differentially expressed genes in participants with performance fatigability (PPFI>0%, n = 455, 62.8%) and those without performance fatigability (PPFI=0%, n = 269, 37.2%). A total of 1,935 differentially expressed genes were identified (DESeq2; adjusted for age, sex, and batch, false discovery rate adjusted p-value < 0.05). Of these genes, 594 were down-regulated and 1,341 were up-regulated in participants with performance fatigability vs. those without. Gene set enrichment analysis identified up-regulation in those with performance fatigability in four key muscle-related pathways: collagen organization/processing, immune system activation/response, extracellular organization and muscle cell development/function pathways; no pathways were significantly enriched in the under-expressed genes. Upregulation of these four pathways is known to be associated with phenotypic changes in aging muscle that leads to loss of strength and function, all important for maintaining mobility in older age. Pharmaceutical or therapeutic interventions that improve muscle quality may also concomitantly reduce performance fatigability, its sequelae, and extend healthspan.

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Source: https://tomesphere.com/paper/PMC12762803