This is a position paper from the National Bone Health Alliance Working Group, a public-private partnership of 56 partners from the government, nonprofit, and for-profit sectors collectively promoting bone health and disease prevention, improved diagnosis, treatment and enhanced research. They recommend that postmenopausal women and men aged 50 years should be diagnosed with osteoporosis if they have a demonstrable elevated risk for future fractures based on specific bone density measurements, called T-scores, or have already sustained specific types of fractures. This conflicts with the recommendations of the U.S. Preventive Services Task Force, which recommends screening for women at age 65, or younger if there are known risk factors.