With increased longevity, the elderly constitute a growing segment of the community. Bone mineral density (BMD) decreases with aging, and osteoporosis (low bone mass or density) is one of the most prevalent chronic health conditions among the elderly. Since fractures due to osteoporosis lead to considerable disability and many premature deaths, osteoporosis and osteoporotic fractures are major public health concerns. Vertebral deformities are very common among the elderly, and are associated with back pain and impairment. The incidence rates of hip fracture increase with age, and show a significant increase after ages 70. Post-fracture disability at multiple skeletal sites, especially the hip and vertebrae has been reported, and clinical vertebral fractures and hip fractures are associated with a substantial increase in mortality. The appropriate lifestyles for people of all ages, such as adequate intake of calcium, vitamin D and vitamin K should be recommended, in order to maintain bone strength (bone mass and bone quality). Physical activity increases BMD and decreases the risk of falls and fractures. In contrast, excess intake of caffeine and alcohol, as well as smoking, which is associated with low bone density and increased fracture risk, should be avoided. Although obesity is associated with higher BMD, adequate BMI (prevention of leanness) is recommended for general health. Furthermore, a simple risk assessment questionnaire helps to target high-risk women for BMD measurements. Effective drug treatment and prevention of falls are required for high-risk patients. Patients with both low BMD and susceptibility to falls should consider using a hip protector.