Associations between the impact of menopausal symptoms and fall-related self-efficacy.

OBJECTIVE: To analyze the association between the severity of menopausal symptoms and two important fall risk factors, namely balance confidence and fear of falling, among Portuguese and Spanish postmenopausal women 65 years or older. METHODS: A cross-sectional, observational study was conducted on 363 women (66.21 ± 9.00 y) from several Portuguese and Spanish locations. The Menopause Rating Scale was used to evaluate the severity of menopausal symptoms, while the Falls Efficacy Scale-International and Activities-specific Balance Confidence Scale-16 items were used to assess balance confidence and fear of falling, respectively. Anxiety and depression (evaluated by the Hospital Anxiety and Depression Scale), age, time since the onset of menopause, body mass index, history of falls, osteoporosis, smoking habit, physical activity level, and nocturia were considered as potential confounders. Independent associations were analyzed after adjusting for potential confounding variables. Student's t test, bivariate correlations, and multivariate linear regression analysis were performed. RESULTS: A total of 363 women (66.21 ± 9.00 y) participated in the study, 192 from Portugal and 171 from Spain. Linear regression analysis indicates that more severe menopausal symptoms at a somatovegetative level (beta coefficient [ß] = -0.25; 95% confidence interval [95% CI], -2.09 to -0.81; P = <0.001), a higher body mass index (ß = -0.16; 95% CI, -1.22 to -0.22; P = 0.005), and osteoporosis (ß = 0.14; 95% CI, 1.36 to 10.08; P = 0.010) were associated with lower balance confidence values. On the other hand, a higher score in the Menopause Rating Scale somatovegetative domain (ß = 0.22; 95% CI, 0.27-0.79; P = <0.001), depression (ß = 0.36; 95% CI, 0.59-1.08; P = <0.001), and years after the menopause onset (ß = 0.15; 95% CI, 0.04-0.22; P = 0.006) were linked to increased fear of falling. CONCLUSIONS: The findings of our study show that, after taking into account possible confounders, increased severity of menopausal symptoms at a somatic level was associated with heightened fear of falling and diminished balance confidence.

Psychometric properties and validity of the Menopause Rating Scale in postmenopausal Portuguese women.

OBJECTIVE: The aim of the study is to analyze the reliability and validity of the Portuguese version of the Menopause Rating Scale (MRS) among postmenopausal Portuguese women. METHODS: A total of 184 postmenopausal women completed the Portuguese MRS. Internal consistency and test-retest reliability were studied. Construct, convergent, and concurrent validity were assessed. The 10-item Cervantes Scale and the Hospital Anxiety and Depression Scale were used to determine convergent and concurrent validity, respectively. The ability and accuracy of the Portuguese MRS to discriminate between women with and without anxiety and depression cases were evaluated, and a receiver operating characteristic curve analysis was used. RESULTS: The Portuguese MRS showed an appropriate level of internal consistency (Cronbach α, 0.84 for MRS total score) and test-retest reliability (MRS total score; intraclass correlation coefficient, 0.92; 95% confidence interval, 0.85-0.96). Factor analysis (construct validity) revealed a 3-factor structure (explained variance of 62.08%). The MRS total score and its 3 factors showed good convergent (10-item Cervantes Scale) and concurrent (Hospital Anxiety and Depression Scale anxiety and depression) validity (all P < 0.001). The Portuguese MRS total score was significantly able to discriminate between postmenopausal women with and without anxiety (P < 0.001) and depression (P = 0.001), with a cutoff point of 15.50 (80.00% sensitivity and 63.70% specificity) for detecting depression and a cutoff point of 16.50 (82.35% sensitivity and 78.57% specificity) for identifying anxiety. CONCLUSIONS: The Portuguese MRS has been shown to be a valid and reliable questionnaire for assessing the severity of menopausal symptoms and discriminating among postmenopausal women with and without anxiety and depression.