Osteoporosis and sarcopenia are age-associated diseases of the musculoskeletal system. Osteosarcopenia, the presence of osteopenia/osteoporosis and sarcopenia. The prevalence of osteosarcopenia in older adults with failing was 37% and associated with higher rate of death. Diagnosis of osteosarcopenia consists of describing medical history of fractures, providing x-ray of the spine (if it is needed) and bone densitometry, calculation of Fracture Risk Assessment Tool (FRAX), evaluating muscle strength, mass, function. The most common exam which is used to measure bone mineral density (BMD) is dual-energy x-ray absorptiometry (DXA or DEXA). Screening using the FRAX is recommended in all postmenopausal women and mеn over 50 in order to identify individuals with high probability of fractures. It is recommended to diagnose osteoporosis in patients with fragility fracture of large bones of the skeleton. Diagnosis of sarcopenia is consist of measures for three parameters: muscle strength, muscle quantity/quality and physical performance as an indicator of severity. Muscle strength can be measured with carpal dynamometry. Muscle mass can be evaluated dual-energy X-ray absorptiometry (program «Whole body»). Muscle function can be evaluated with short physical performance battery (SPPB) tests. In this article described algorithm of diagnosis of osteosarcopenia.

Locomotive syndrome is a geriatric syndrome that corresponds to the model of autonomy loss and the emergence of addictions due to pathology of the musculoskeletal system with a heavy medical and social burden. Combination of musculoskeletal system diseases, including osteoarthritis, osteoporosis, dorsopathy, sarcopenia, neuropathy, together with impaired physical functioning are the clinical characteristics of locomotive syndrome. Only comprehensive programs, including pain treatment, the risk of osteoporetic fractures, prevention of falls, correction of sarcopenia, physical training, psychotherapeutic methods, etc., can increase the mobility of patients with locomotive syndrome and help reduce addictions in older age.

Objective: to assess the structure and influence of chronic pain (CP) on the functional status of patients with geriatric syndromes.Patients and methods. The study included 370 geriatric patients who were divided into two groups. Group A included 300 patients (mean age 75.1±8.25 years) with CP, and group B – 70 subjects of comparable age (75.1±7.75 years) without CP. All study participants were found to have polymorbidity: the Charlson index was 5.55±1.59 points in group A and 5.56±1.64 points in group B (p=0.963). All patients underwent a comprehensive geriatric assessment (CGE) to determine the functional status and diagnose geriatric syndromes.Results and discussion. According to the CGE data, senile asthenia syndrome was detected in 127 (42.3%) patients with CP and in 20 (28.6%) patients without CP (p=0.035). The average number of geriatric syndromes in group A was 7.06±2.68, in group B – 5.2±1.8 (p<0.001).Group A patients differed from those without CP in a significantly higher degree of dependence in daily life (Bartel index) and a lower score on the Physical Performance Battery.Conclusion. Patients with CP have poorer physical functioning and a greater degree of dependence on others in their daily life. When planning the most effective complex strategies for the treatment and prevention of CP exacerbations, it is necessary to take into account the functional status of elderly patients.