Marine Products and Age-Related Diseases: The Path from Pre-Clinical Research to Regulatory Approval for thpe Treatment of Neurodegenerative and Musculoskeletal Diseases

Marine-derived products are emerging for their potential in mitigating aging and age-related diseases. Among them, neurodegenerative and musculoskeletal diseases represent a major health challenge, often coexisting in older adults through interconnected biological axes. This narrative review evaluates the therapeutic potential of these chemically diverse products, integrating these two pathological domains through shared mechanisms and highlighting current experimental evidence from pre-clinical in vivo models to clinical translation toward regulatory approval. Pre-clinical evidence identified several candidates with neuroprotective, anti-sarcopenic, chondroprotective or anti-osteoporotic properties, and suggests modulation of key hallmarks of aging (e.g., mitochondrial dysfunction, proteostasis/autophagy, inflammation/senescence, and gut microbiota). A candidate pleiotropic efficacy across both disease domains was suggested for fucoidan, chitosan oligosaccharides, astaxanthin, fucoxanthin and ω-3 PUFAs. However, clinical translation remains highly limited: several marine products that, in animal models, engage disease-modifying mechanisms, fail to demonstrate disease modification in humans. Out of numerous explored products, only sodium oligomannate (GV-971) has achieved disease-specific regulatory approval for Alzheimer’s disease, but only in China, and still lacks a robust international consensus. Other compounds have either failed to replicate pre-clinical efficacy in human trials or have transitioned into commercial dietary supplements without approved therapeutic claims. Finally, translational bottlenecks hindering the clinical advancement of marine compounds were discussed. Future development should prioritize standardized formulations, mechanistic insight, aged animal models and multimorbidity-oriented trials to validate cross-domain tissue protection.