By Megan Rauscher
NEW YORK (Reuters Health) – Nutritional supplements are probably worthwhile for helping prevent infections in the elderly, Dr. Kevin P. High concludes in the journal Clinical Infectious Diseases for December 1st.
Dr. High, of Wake Forest University School of Medicine in Winston-Salem, North Carolina, conducted an extensive review of nutritional interventions that have been examined in clinical trials involving older adults.
Current data suggest that adults over the age of 65 "are likely to benefit from a daily multivitamin/mineral supplement, with additional zinc to equal a total dose of 20 mg/day, selenium to equal 100 µg/day, and vitamin E to achieve a daily intake of 200 mg/day," Dr. High told Reuters Health.
"Available evidence suggests these supplements are likely to enhance immune function and may boost vaccine responses in healthy older adults and reduce the risk of infectious illness in both healthy and frail elders," he said.
Published data also suggest that elderly people with recurrent urinary tract infections are likely to benefit from drinking cranberry juice daily. "This strategy may be particularly beneficial in long-term care facilities as a means of reducing unnecessary antibiotic use in older adults," the researcher writes.
He emphasized, however, that there are "many" questions yet to be answered such as whether there are nutrients in a multivitamin/mineral supplement that are more important than others or whether some forms of specific vitamins are better than others. "For example, there are many forms of vitamin E, but only a few have been examined in clinical studies, and they may not all be equivalent," Dr. High said.
The "right dose" of many nutrients is also largely undetermined. "Some vitamins may be helpful at modest doses, but harmful at high doses," Dr. High noted. "For example, vitamin A supplementation in two different large trials of smokers increased the risk of cancer when the presumption of the studies was it would decrease the risk," Dr. High said.
Future studies are needed to pinpoint subgroups of elderly that would benefit most from nutritional supplementation, such as the extremely frail elderly or those with underlying lung disease or diabetes.
Dr. High also encourages healthcare providers to be aware of drug-nutrient interactions, which occur commonly in the elderly.
Clin Infect Dis 2001;33:1892-1900.
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