Browsing by Author "MAVIS Trial Group"

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A cost-utility analysis of multivitamin and multimineral supplements in men and women aged 65 years and over
(Elsevier, 2007) Kilonzo, Mary Mueni; Vale, Luke David; Cook, Jonathan Alistair; Milne, Anne Catherine; Stephen, Audrey Isabella; Avenell, Alison; MAVIS Trial Group; University of Aberdeen, School of Medicine & Dentistry, Division of Applied Health Sciences
Background and Aims As people age there is a progressive dysregulation of the immune system that may lead to an increased risk of infections, which may precipitate hospital admission in people with chronic heart or respiratory diseases. Mineral and vitamin supplementation in older people could therefore influence infections in older people. However, the evidence from the available randomised controlled trials is mixed. The aim of the study was to assess the relative efficiency of multivitamin and multimineral supplementation compared with no supplementation. Methods Cost-utility analysis alongside a randomised controlled trial. Participants aged 65 years or over from six general practices in Grampian, Scotland were studied. They were randomised to one tablet daily of either a multivitamin and multimineral supplement or matching placebo. Exclusion criteria were: use of mineral, vitamin or fish oil supplements in the previous three months (one month for water soluble vitamins), vitamin B12 injection in the last three months. Results Nine hundred and ten participants were recruited (454 placebo and 456 supplementation). Use of health service resources and costs were similar between the two groups. The supplementation arm was more costly although this was not statistically significant (£15 per person, 95% CI -3.75 to 34.95). After adjusting for minimisation and baseline EQ-5D scores supplementation was associated with fewer QALYs per person (–0.018, 95% CI -0.04 to 0.002). It was highly unlikely that supplementation would be considered cost-effective. Conclusions The evidence from this study suggests that it is highly unlikely that supplementation could be considered cost-effective.
Effect of multivitamin and multimineral supplementation on cognitive function in men and women aged 65 years and over : a randomised controlled trial
(BMC, 2007-05-02) McNeil, Geraldine; Avenell, Alison; Campbell, Marion Kay; Cook, Jonathan Alistair; Hannaford, Philip Christopher; Kilonzo, Mary Mueni; Milne, Anne Catherine; Ramsay, Craig R; Seymour, David Gwyn; Stephen, Audrey Isabella; Vale, Luke David; MAVIS Trial Group; University of Aberdeen, School of Medicine & Dentistry, Division of Applied Health Sciences
Background: Observational studies have frequently reported an association between cognitive function and nutrition in later life but randomised trials of B vitamins and antioxidant supplements have mostly found no beneficial effect. We examined the effect of daily supplementation with 11 vitamins and 5 minerals on cognitive function in older adults to assess the possibility that this could help to prevent cognitive decline. Methods: The study was carried out as part of a randomised double blind placebo controlled trial of micronutrient supplementation based in six primary care health centres in North East Scotland. 910 men and women aged 65 years and over living in the community were recruited and randomised: 456 to active treatment and 454 to placebo. The active treatment consisted of a single tablet containing eleven vitamins and five minerals in amounts ranging from 50–210 % of the UK Reference Nutrient Intake or matching placebo tablet taken daily for 12 months. Digit span forward and verbal fluency tests, which assess immediate memory and executive functioning respectively, were conducted at the start and end of the intervention period. Risk of micronutrient deficiency at baseline was assessed by a simple risk questionnaire. Results: For digit span forward there was no evidence of an effect of supplements in all participants or in sub-groups defined by age or risk of deficiency. For verbal fluency there was no evidence of a beneficial effect in the whole study population but there was weak evidence for a beneficial effect of supplementation in the two pre-specified subgroups: in those aged 75 years and over (n 290; mean difference between supplemented and placebo groups 2.8 (95% CI -0.6, 6.2) units) and in those at increased risk of micronutrient deficiency assessed by the risk questionnaire (n 260; mean difference between supplemented and placebo groups 2.5 (95% CI -1.0, 6.1) units). Conclusion: The results provide no evidence for a beneficial effect of daily multivitamin and multimineral supplements on these domains of cognitive function in community-living people over 65 years. However, the possibility of beneficial effects in older people and those at greater risk of nutritional deficiency deserves further attention.
Factors Influencing the Participation of Older People in Clinical Trials : Data Analysis from the MAVIS Trial
(2010-01) Fearn, Paul; Avenell, Alison; McCann, Sharon Katrina; Milne, Anne Catherine; MacLennan, Graeme Stewart; MAVIS Trial Group; University of Aberdeen.Other Applied Health Sciences; University of Aberdeen.Institute of Applied Health Sciences