World achievements in the field of science, health technologies and socio-economic development at the turn of the XX–XXI centuries have increased the life expectancy of people. It is estimated that by 2050 the number of people over 60 will reach 2 billion people. In all countries, there is an increase in life expectancy with a disproportionately large increase in the number of elderly people. To solve the problems of aging-related diseases and reduce the burden on health systems, a better understanding of age-related diseases and methods of their diagnosis is required. Some of the diseases that accompany aging are sarcopenia and osteoporosis. As the body ages, bone loss occurs, in parallel with this, muscle strength decreases significantly (dynapenia), followed by a decrease in muscle mass (sarcopenia). Thus, osteoporosis (osteopenia) and sarcopenia are combined into a geriatric syndrome called “osteosarcopenia”, which is a common multifactorial musculoskeletal syndrome. Osteosarcopenia increases the risk of falls, fractures and hospitalization, leads to a deterioration in the quality and life expectancy of patients. The biology of osteosarcopenia is best understood in the context of systemic neuroendocrine and immune/ inflammatory changes that cause decreased autophagy and cellular aging in bone and muscle. To date, specific treatment of osteosarcopenia has not been developed, however, there are a number of preventive measures. Regular exercise, consumption of protein, calcium, vitamin D and prevention of falls and fractures are necessary to maintain the musculoskeletal unit and allow you to delay the onset of this condition. The article reflects the pathogenetic aspects, primary and secondary causes of osteosarcopenia, diagnostic criteria, methods of prevention and possibilities of drug therapy.