A 2016 study from Washington University School of Medicine in St. Louis showed that long term use of VKA’s (Warfarin), led to a 25% increase incidence of fracture. When Direct Oral Anticoagulants, DOAC’s, were developed their great benefit was that they did not inhibit vitamin K and adversely affect bone density. A study in December 2019 is the latest assessment as to whether these new blood thinners are actually lowering the risk fractures in the elderly.