Patients in outpatient clinics of BB were eligible to be enrolled if they had (1) clinical vertebral fractures or (2) newly identified asymtomatic radiological vertebral fractures by a routine weekly review of every plan film of thoracic or lumbar spine regardless of the reason for it.They were excluded from the service if they had life expectancy shorter than 2 years of life or not be able to complete study assessments for communication or cognitive problems.