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Research Project: Nutrition, Aging, Immune Function, and Inflammatory Response in Health and Disease

Location: Human Nutrition Research Center on Aging

Title: Vitamin E and Respiratory Infections among Elderly Nursing Home Residents: a Randomized Controlled Study

Authors
item Meydani, Simin - TUFTS/HNRCA
item Leka, Lynette - TUFTS/HNRCA
item Fine, Basil - MT. AUBURN HOSPITAL
item Dallal, Gerard - TUFTS/HNRCA
item Keusch, Gerald - FOGARTY INTERNATIONAL CTR
item Singh, Maria - UNIVERSITY OF LIDCOMBE
item Hamer, Davidson - TUFTS UNIVERSITY

Submitted to: Journal Of The American Medical Association
Publication Acceptance Date: July 22, 2004
Publication Date: August 18, 2004
Citation: Meydani, S.N., Leka, L.S., Fine, B.C., Dallal, G.E., Keusch, G.T., Singh, M.F., Hamer, D.H. 2004. Vitamin E And Respiratory Infections Among Elderly Nursing Home Residents: A Randomized Controlled Study. Journal Of The American Medical Association. 292(7):828-836.

Interpretive Summary: Respiratory infections are common in the elderly. These infections occur more frequently in nursing home residents than among independent-living elderly and are a major cause of morbidity and mortality. To investigate vitamin E supplementation on respiratory infections in elderly nursing home residents, a 1-year, randomized, double-blind, placebo-controlled trial was conducted from April 1998 to August 2001 at 33 long-term care facilities in the Boston, Massachusetts area. 617 subjects >/= 65 years old meeting the study's eligibility criteria were enrolled. Along with a daily vitamin E (200 IU) or placebo capsule, all subjects received ½ the Recommended Daily Allowance of essential vitamins and minerals (capsule). Incidence, number of subjects, and number of days with respiratory infections (upper and lower), and number of new antibiotic prescriptions were measured. Results were that fewer vitamin E-supplemented subjects acquired one or more respiratory infections or upper respiratory infections. Sub-group analysis on the foremost respiratory infection, the common cold, indicated that the vitamin E group had fewer common colds. Supplementation with 200 IU per day vitamin E did not have a statistically significant effect on lower respiratory infections. However, we observed a protective effect of vitamin E supplementation on upper respiratory infections, particularly the common cold. Contributing to the increased incidence of respiratory infection with age is the well-described decline in immune response. Nutritional supplementation has been shown to enhance older subjects' immune response and this research may lead to improvement of nutritional guidelines for the elderly where increased immune response is a crucial factor toward optimum health for the elderly and the prevention of infection.

Technical Abstract: Respiratory infections are prevalent in the elderly, resulting in increased morbidity, mortality, and utilization of health care services. Vitamin E supplementation has been shown to improve immune response in the elderly. To investigate the effect of 1-year vitamin E supplementation on respiratory infections in elderly nursing home residents, a randomized, double-blind, placebo-controlled trial was conducted from April 1998 to August 2001 at 33 long-term care facilities in the Boston, Massachusetts area. 617 subjects >/= 65 years old, who met the study's eligibility criteria. Along with a daily vitamin E (200 IU) or placebo capsule, all subjects received a capsule containing ½ the Recommended Daily Allowance of essential vitamins and minerals. Incidence, number of subjects, and number of days with respiratory infections (upper and lower), and number of new antibiotic prescriptions were measured. There was no statistically significant effect of vitamin E on incidence or number of days with infection for all upper or lower respiratory infections. However, fewer vitamin E-supplemented subjects acquired one or more respiratory infections or upper respiratory infections. Sub-group analysis on the foremost respiratory infection, the common cold, indicated that the vitamin E group had a lower incidence of common colds and fewer subjects in the vitamin E group acquired one or more common colds. There was no statistically significant vitamin E effect on antibiotic use. Supplementation with 200 IU per day vitamin E did not have a statistically significant effect on lower respiratory infections in elderly nursing home residents. However, we observed a protective effect of vitamin E supplementation on upper respiratory infections, particularly the common cold, that merits further investigation.

 
Project Team
Wilhelm, Kathi
Simin Meydani - Lab Chief 617-556-3312

Publications

Related National Programs
  Human Nutrition (107)

 
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