The 1998 National Diet and Nutrition Survey of the Elderly identified evidence of multiple nutritional deficiencies in individuals aged 65 years and over. Other research has shown that many vitamins and minerals play key roles in immunity. Nutritional deficiencies may also contribute to decline in cognitive function in the elderly.
The MAVIS trial was a randomised controlled trial of multi-vitamin and mineral supplementation. The aim of the study was to determine whether, in persons aged 65 and over, dietary supplementation reduced infection rates and antibiotic usage, reduces general practice consultation rates, improved quality of life, reduces the number of infection related hospitalisations and improved memory.
A total of 900 people were recruited through general practices in Aberdeen and North East Scotland. Trial participants were asked to take one tablet daily for one year and were randomly allocated to receive either a multi-vitamin and mineral supplement or a placebo. Information was collected on health status, quality of life, nutritional risk and cognitive function. Participants keep a simple diary, recording any infections they contract during the trial period.
The two groups were well balanced at trial entry. Only 13% reported stopping their tablets or were lost to follow-up. There was no significant effect in the supplemented compared to the control group for contacts with primary care staff for infection (879 versus 930; odds ratio 0.96, 95% CI 0.78 to 1.19), self reported days of infection (8072 versus 7871; odds ratio 1.07, 95% CI 0.90 to 1.27). The secondary outcomes: the number of antibiotic prescriptions, total number of days that antibiotics were prescribed, the number of hospital admissions (including those for infection), the number of days in hospital with infection, and outpatient visits (in total and infection related), were also not significantly different between the two groups. We therefore found no statistically significant effect of supplementation. Our trial had few people aged over 85 years (4%) or in institutional care (3%) however and therefore cannot exclude the possibility that higher-risk populations may benefit.
- Alison Avenell; firstname.lastname@example.org
Avenell A, Campbell MK, Cook JA , Hannaford PC, Kilonzo MM, McNeill G, Milne AC, Ramsay CR, Seymour DG, Stephe AI, Vale LD (Writing Group of the MAVIS trial). Effect of multivitamin and multimineral supplements on morbidity from infections in older people (MAVIS trial): pragmatic, randomised, double blind, placebo controlled trial. BMJ, Aug 2005; 331: 324-329
Stephen A, Milne AC, Avenell A, McNeill G, for the MAVIS Group. Nutrition risk in the MAVIS Study - A comparison [Oral presentation]. Joint Nutrition Society/British Dietetic Association Meeting, Glasgow, 27-28 March 2003.
Avenell A, Milne AC, Stephen AI, for the MAVIS Trial Group. A randomised double-blind, placebo-controlled trial of the effect of vitamin and mineral supplements on morbidity from infections in men and women aged 65 years and over [Poster presentation]. BAPEN meeting, Telford 17-18 November 2004
Avenell A, Milne AC, Stephen AI, for the MAVIS Trial Group. A randomised double-blind placebo-controlled trial of the effect of vitamin and mineral supplements on morbidity from infections in men and women aged 65 years and over. [Poster presentation]. ESPEN meeting, Lisbon 11-14 September 2004.
Stephen AI, Avenell A. Vitamin and mineral supplementation to reduce infection in adults. A systematic review. [Poster presentation]. BAPEN meeting, Telford 17-18 September 2004
Milne AC, Avenell A, McNeill G for the MAVIS Group. Effects of vitamin and mineral supplementation on cognitive function in men and women aged 65 years over [Poster presentation]. Nutrition Society Meeting, Belfast, 15-17 June 2005.