Is vitamin-D supplementation not useful in patients at risk of fractures and falls?

To evaluate numerous publications that question the bone and extraosseous benefits of vitamin D diet supplementation based on results, which often transcend to public opinion, but are not well interpreted. This may have negative consequences on compliance of patients under vitamin D supplementation. Critical appraisal of several articles on vitamin D supplementation and its relationship with fractures, falls, cardiovascular diseases, and cancer incidence. Such publications have certain limitations (i.e. patients excluded because of a diagnosis of osteoporosis, or at a higher risk for fractures and falls, or because they have a vitamin D deficiency, etc.), and conclusions and/or subsequent recommendations should be approached with caution. Our research shows that patients with osteoporosis, vitamin D deficiency, and at high risk of fractures and falls should not discontinue vitamin D supplementation (often associated with calcium). It is becoming increasingly evident that patients with hypovitaminosis D are those that gain a maximal benefit from vitamin D supplementation.

EMAS position statement: The ten point guide to the integral management of menopausal health.

With increased longevity and more women becoming centenarians, management of the menopause and postreproductive health is of growing importance as it has the potential to help promote health over several decades. Women have individual needs and the approach needs to be personalised. The position statement provides a short integral guide for all those involved in menopausal health. It covers diagnosis, screening for diseases in later life, treatment and follow-up.

Structural validity of a 16-item abridged version of the Cervantes Health-Related Quality of Life scale for menopause: the Cervantes Short-Form Scale.

OBJECTIVE: The Cervantes Scale is a specific health-related quality of life questionnaire that was originally developed in Spanish to be used in Spain for women through and beyond menopause. It contains 31 items and is time-consuming. The aim of this study was to produce an abridged version with the same dimensional structure and with similar psychometric properties. METHODS: A representative sample of 516 postmenopausal women (mean [SD] age, 57 [4.31] y) seen in outpatient gynecology clinics and extracted from an observational cross-sectional study was used. Item analysis, internal consistency reliability, item-total and item-dimension correlations, and item correlation with the 12-item Medical Outcomes Study Short Form Health Survey Version 2.0 were studied. Dimensional and full-model confirmatory factor analyses were used to check structure stability. A threefold cross-validation method was used to obtain stable estimates by means of multigroup analysis. RESULTS: The scale was reduced to a 16-item version, the Cervantes Short-Form Scale, containing four main dimensions (Menopause and Health, Psychological, Sexuality, and Couple Relations), with the first dimension composed of three subdimensions (Vasomotor Symptoms, Health, and Aging). Goodness-of-fit statistics were better than those of the extended version (χ(2)/df = 2.493; adjusted goodness-of-fit index, 0.802; parsimony comparative fit index, 0.749; root mean standard error of approximation, 0.054). Internal consistency was good (Cronbach's α = 0.880). Correlations between the extended and the reduced dimensions were high and significant in all cases (P < 0.001; r values ranged from 0.90 for Sexuality to 0.969 for Vasomotor Symptoms). CONCLUSIONS: The Cervantes Scale can be reduced to a 16-item abridged version (Cervantes Short-Form Scale) that maintains the original dimensional structure and psychometric properties. At 51% of the original length, this version can be administered faster, making it especially suitable for routine medical practice.