The primary goal of osteoporosis treatment is to delay bone loss or increase bone mass and prevent fractures . BMD should be routinely measured in persons older than 65 years of age , or in persons aged 50-65 years with one major fracture risk factor or two or more minor risk factors. After starting treatment for osteoporosis, BMD should be measured 1-2 times a year, and in patients who do not need treatment, those at moderate risk of fracture should be reviewed once every 1-5 years; those at low risk should be followed up once every 5-10 years. The factors that cause osteoporosis and fracture are diverse, including lifestyle habits, disease, medications, and more. To reduce the risk of osteoporotic fracture, it is especially important to identify your own fracture risk factors and try to change them. It is important to maintain a balanced diet, consume the calcium, vitamin D and vitamin K2 you need, maintain your body weight at an appropriate level, exercise at least three times a week for 30 minutes or more, avoid excessive caffeine intake, and avoid smoking and excessive alcohol consumption. Therapeutic drugs: Osteoporosis treatment drugs are divided into three main categories according to their different mechanisms of action, namely drugs that promote bone mineralization, such as calcium, vitamin D3, drugs that promote bone formation such as parathyroid hormone and drugs that inhibit bone resorption such as bisphosphonates, calcitonin, estrogen, estrogen receptor modulators, etc. Timing of treatment: In general, treatment should only be initiated when the bone density loss reaches the diagnostic area of osteoporosis (refer to the table for details). Individualization of treatment: In well-defined cases of osteoporosis, treatment should be initiated taking into account the risk of fracture involved. However, during specific treatment, individualized treatment plans should be used with reference to the patient’s bone density, bone metabolism indicators, previous fractures, and nutritional status. Elderly patients with osteoporosis are prone to fractures from falls. These fracture risk cases, with or without osteoporosis, can lead to serious fractures such as femoral neck fractures. It is important to note that osteoporosis treatment medications can prevent fractures due to falls, however, they are likely to be limited to patients with osteoporosis. The choice of medication is primarily based on the prevention of fractures in patients at risk. For example, in patients with significantly low bone mineral density, a history of previous fractures, advanced age, and the presence of risk factors for falls, a bone resorption inhibitor may be chosen; in young patients with initial osteoporosis, by improving nutritional status; and in those with reduced bone mass or severe adverse reactions to other medications, vitamin D3 and calcium may be chosen. Combination of drugs: In principle, single drugs are used in the clinical treatment of osteoporosis, but there is evidence-based medical evidence that for patients with indications for combination of drugs, such as severe osteoporosis with fracture, or single drug treatment, but the disease is still progressing, or single drug treatment is not satisfactory, and the bone mineral content is difficult to recover, the combination of drugs not only has a synergistic effect, but also can reduce the adverse effects of some drugs. Adverse effects of some drugs can also be reduced. The principle of combination of drugs does not advocate the combination of too many drugs, but for the purpose of clinical treatment, the combination of two or even three drugs can be considered. Other treatments: The treatment of osteoporosis also includes surgery, Chinese medicine, and other treatments. The choice of treatment needs to be determined by a thorough assessment of the patient’s condition and fracture risk factors. In the last two years, the WHO has recommended the use of the Fracture Risk Assessment Tool (FRA X) as an alternative to BMD alone to diagnose and assess the likelihood of fracture over the next 10 years. It not only automatically calculates the risk of hip osteoporotic fracture over a 10-year period, but also provides objective threshold information for the selection of the treatment population and can be used to evaluate the treatment effect. However, this assessment tool has not yet been widely disseminated in China, and its value and significance need to be further demonstrated.