Professor Josh Lewis is the head of the Disorders of Mineralisation Group within the Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth Australia. His research focuses on why as you age you get less “bone” in your bones and more in your blood vessels, and particularly in your abdominal aorta. Calcium deposits within the aortic wall or abdominal aortic calcification (AAC) are a marker of advanced blood vessel disease or cardiovascular disease. AAC is commonly seen on vertebral fracture assessment (VFA) images taken on most modern bone density machines. However, AAC is rarely reported on due to uncertainty over its prognostic importance and difficulties assessing the extent of calcification. We have shown AAC is one of the most common co-morbidities in people with low bone mineral density and is associated with a higher risk of cardiovascular disease and poorer long-term prognosis but is also surprisingly associated with high risk of injurious falls and fracture. This presentation will (i) discuss what AAC is (and is not); (ii) how it differs from subclinical cardiovascular diseases in other vascular beds, including its prognostic importance for cardiovascular events; (iii) the evidence for the relationship between AAC with musculoskeletal health measures, falls and fracture risk; and (iv) latest advances in the field using machine learning to seamlessly assess AAC using VFA images from bone density machines at the time of osteoporosis screening. Finally, this presentation will briefly discuss how the knowledge of AAC may be used to improve both bone and cardiovascular health during ageing.