Often observed with aging, the loss of skeletal muscle (sarcopenia) and bone (osteoporosis) mass, strength, and quality, is associated with reduced physical function contributing to falls and fractures. Such events can lead to a loss of independence and poorer quality of life. Physical inactivity (mechanical unloading), especially in older adults, has detrimental effects on the mass and quality of bone as well as muscle, while increases in activity (mechanical loading) have positive effects. Emerging evidence suggests that the relationship between bone and muscle is driven, at least in part, by bone–muscle crosstalk. Bone and muscle are closely linked anatomically, mechanically, and biochemically, and both have the capacity to function with paracrine and endocrine-like action. However, the exact mechanisms involved in this crosstalk remain only partially explored. Given older adults with lower bone mass are more likely to present with impaired muscle function, and vice versa, strategies capable of targeting both bone and muscle are critical. Exercise is the primary evidence-based prevention strategy capable of simultaneously improving muscle and bone health. Unfortunately, holistic treatment plans including exercise in conjunction with other allied health services to prevent or treat musculoskeletal disease remain underutilized. With a focus on sarcopenia and osteoporosis, the aim of this review is to (i) briefly describe the mechanical and biochemical interactions between bone and muscle; (ii) provide a summary of therapeutic strategies, specifically exercise, nutrition and pharmacological approaches; and (iii) highlight a holistic clinical pathway for the assessment and management of sarcopenia and osteoporosis.

通常随着年龄的增长，骨骼肌（肌肉减少症）和骨骼（骨质疏松症）质量、强度和质量的丧失与导致跌倒和骨折的身体功能下降有关。此类事件可能导致丧失独立性和生活质量下降。缺乏身体活动（机械负荷），尤其是老年人，会对骨骼和肌肉的质量和质量产生不利影响，而增加活动（机械负荷）则会产生积极影响。新的证据表明，骨骼和肌肉之间的关系至少部分是由骨骼与肌肉的串扰驱动的。骨骼和肌肉在解剖学、机械学和生化学上密切相关，并且两者都具有通过旁分泌和类内分泌作用发挥作用的能力。然而，这种串扰所涉及的确切机制仍然只有部分探索。鉴于骨量较低的老年人更有可能出现肌肉功能受损的情况，反之亦然，能够同时针对骨骼和肌肉的策略至关重要。运动是主要的循证预防策略，能够同时改善肌肉和骨骼健康。不幸的是，包括与其他联合卫生服务结合锻炼在内的整体治疗计划来预防或治疗肌肉骨骼疾病仍然没有得到充分利用。本次综述的重点是肌肉减少症和骨质疏松症，其目的是（i）简要描述骨骼和肌肉之间的机械和生化相互作用；(ii) 提供治疗策略的总结，特别是运动、营养和药理学方法；(iii) 强调评估和管理肌肉减少症和骨质疏松症的整体临床路径。