Fractures are a major source of reduced quality of life, chronic illness, and death in people over the age of fifty. A number of factors are associated with fracture risk, including bone density. It is common to assess bone density using biennial DXA scans. Patients with low bone density often receive recommendations to take medications that increase bone density. Such medications are controversial, however, as they have not been shown to reduce the incidence of fractures, they have potential serious adverse effects, and they are poorly tolerated, with fewer than half of people taking them for more than a year.
Although bone density scanning with DXA is the best method we have currently of predicting fracture risk, it has significant limitations. It is primarily based on assessing mineral content of bones, and fracture risk also depends on the ability of bones to bend when stressed; this results from the collagen-based architecture that the mineral is embedded. As a consequence, rather than focusing solely on bone density, prevention should be focused on factors that have been shown to reduce fractures, including Vitamin D3, Vitamin K2 MK4, calcium, weight-bearing and exercise, falls prevention, and dietary protein intake. For more on this see here.