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Competing Interests: The authors declare no conflict of interest.

Introduction: Background: the population in Latin America is aging and elders face several obstacles for good health, including an elevated frequency of vitamin D deficiency. Thus, identification of patients at high risk to develop its negative consequences should be a priority. Objective: the objective of this analysis was to determine if levels of vitamin D lower than 15 ng/ml are associated with high mortality in Mexican elderly population, from the database of the Mexican Health and Aging Study (MHAS). Methods: prospective, population study in Mexico, that included Subjects of 50 years and older who were evaluated for Serum vitamin D levels during the year 2012 (third wave of the study). Serum 25(OH)D levels were categorized into four groups, based on cutoff points used in previous studies on vitamin D and frailty: < 15, 15-< 20, 20-< 30 and ≥ 30 ng/ml. Mortality was evaluated during 2015 (fourth wave of the study). Hazard ratio was calculated (for mortality) through Cox Regression Model, adjusted for covariates. Results: we included 1626 participants, and those with lower levels of vitamin D were older, more often women, required more aid for activities of daily living, reported higher number of chronic diseases, and lower scores on cognition. The relative risk of death was 5.421 (95 % CI 2.465-11.92, p < 0.001) for the participants with vitamin D levels < 15, which after adjusting for covariates, remained statistically significant. Conclusions: levels of vitamin D lower of 15, are associated with an increase in the rate of mortality in community-dwelling senior Mexicans.

Background: To determine the burden of Rheumatoid Arthritis (RA) on patients' work productivity and health related quality of life (HRQoL), and examine the influence of several exposure variables; to analyze the progression of RA over 1 year and its impact on work productivity and HRQoL., Methods: International multicenter prospective survey including patients in 18 centers in Argentina, Brazil, Colombia and Mexico with diagnosis of RA and aged between 21-55 years. The following standard questionnaires were completed at baseline and throughout a 1-year follow-up: WPAI:RA, WALS, WLQ-25, EQ-5D-3 L and SF-36. Clinical and demographic variables were also collected through interview., Results: The study enrolled 290 patients on baseline visit. Overall mean scores at baseline visit were: WPAI:RA (presenteeism) = 29.5% (SD = 28.8%); WPAI:RA (absenteeism) = 9.0% (SD = 23.2%); WPAI:RA (absenteeism and presenteeism) = 8.6% (SD = 22.6%); WALS = 9.0 (SD = 6.1); WLQ-25 = 7.0% (SD = 5.1%); SF-36 Physical Scale = 39.1 (SD = 10.3) and Mental Scale = 45.4 (SD = 11.3); EQ-5D-3 L VAS = 69.8 (SD = 20.4) and EQ-5D-3 L index = 0.67 (SD = 0.23). Higher educational levels were associated with better results in WLQ-25, while previous orthopedic surgeries reduced absenteeism results of WPAI:RA and work limitations in WLQ-25. Higher disease duration was associated with decreased HRQoL. Intensification of disease activity was associated with decreased work productivity and HRQoL, except in WLQ-25. In the longitudinal analysis, worsening in disease activity was associated with a decrease in both work productivity and HRQoL., Conclusions: RA patients are dealing with workplace disabilities and limitations and loss in HRQoL, and multiple factors seems to be associated with this. Worsening of disease activity further decreased work productivity and HRQoL, stressing the importance of disease tight control.