The number of fractures related to osteoporosis is expected to increase in the next few decades, because of the increasing number of frail elderly patients at high risk of falls and fractures. Guidelines are available worldwide for the screening of patients at high risk of fracture, and for appropriate treatment including non pharmacological treatments for falls prevention: A number of questions will be discussed during the session. Why should we treat? Because the burden of osteoporosis is related to fractures, and their consequences on morbidity, and even on mortality for the more severe ones. When should we treat? There is an immediate increase of sustaining a new fracture in the 2–3 years following a first one; this represents a unique window of opportunity for treatment. How should we treat? Treatments are effective in prevention of fracture, and re fracture, providing that we use the more effective treatment, with the appropriate sequences. How long should we treat? The treat to target strategy must be used in patients having a low bone mineral density, and obtaining a T score above – 2 is a reachable target. A current challenge is the patients’ view on side effects of the treatments; although they are very rare, their perception is very high. A number of qualitative studies sought to assess patients’ fears and beliefs and provide wordings to clarify the fracture risk concept. The prevention of fragility fractures is now within our reach.

Disclosure of Interest None declared