A large number of cross-sectional studies suggest that rates of bone loss decrease in the elderly, particularly at the spine and radius. For this reason it has been argued that bone mass measurements are unhelpful in assessing fracture risk in the elderly and that drugs affecting bone metabolism are less likely to be of benefit in reducing this risk. This paper reviews the assumptions on which these conclusions are based and argues that in many instances they are flawed. Indeed, studies examining rates of bone loss in the elderly either directly or by biochemical indices of bone turnover suggest that bone loss continues throughout life and may even accelerate after the age of 70 years. This conclusion supports the view that identification of patients at risk and subsequent treatment is of value in all age groups.