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Use of medicines by older people in a large British national survey, and their relation to vitamin status indices

Published online by Cambridge University Press:  02 January 2007

Christopher J Bates ,
Catherine M Walmsley ,
Ann Prentice  and
Steven Finch
Christopher J Bates*
Affiliation:
MRC Human Nutrition Research, Downhams Lane, Milton Road, Cambridge, CB4 1XJ, UK
Catherine M Walmsley
Affiliation:
MRC Human Nutrition Research, Downhams Lane, Milton Road, Cambridge, CB4 1XJ, UK
Ann Prentice
Affiliation:
MRC Human Nutrition Research, Downhams Lane, Milton Road, Cambridge, CB4 1XJ, UK
Steven Finch
Affiliation:
Social and Community Planning Research, 35 Northampton Square, London, EC1V 0AX, UK
*
*Corresponding author: Email Chris.Bates@mrc-hnr.cam.ac.uk
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Abstract

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Objective:

To describe the extent of use of medicines by older people living in Britain, and to explore relationships with vitamin status indices.

Design:

The National Diet and Nutrition Survey of people aged 65 years and over collected data from a British sample during 1994–95. The present study has made novel use of it, to relate medicine use with biochemical indices of vitamin status.

Setting:

Eighty postcode areas, selected randomly from mainland Britain.

Subjects:

1506 people, 65 years and over gave information about use of medication, and a 4-day weighed food record. Three-quarters gave blood for status indices.

Results:

78% of those living in the community and 93% of those in institutions were using medication. Certain vitamin status indices: plasma retinol, erythrocyte folate and riboflavin, paradoxically suggested better status in users than in non-users of antihypertensive, gastrointestinal, central nervous system, corticosteroid or diabetic drugs. There was evidence of a link with renal insufficiency, especially for plasma retinol, but neither this nor increased nutrient intake, acute phase effects or haemoconcentration could explain the paradoxical associations.

Conclusions:

Caution is needed in interpreting certain vitamin status indices, especially in older people who are extensively using medicines. New vitamin indices are needed, to avoid confounding interferences.

Keywords

Red cell folateErythrocyteglutathione reductaseactivation coefficientPlasma retinolVitamin statusMedicinesBritishElderly
Type
Research Article
Information
Public Health Nutrition , Volume 2 , Issue 1 , January 1999 , pp. 15 - 22
Copyright
Copyright © CABI Publishing 1999

References

1Bates, CJ, Vitamin analysis. Ann. Clin. Biochem. 1997; 34: 1–27.Google Scholar
2Bates, CJ, Thurnham, DI, Bingham, SA, Margetts, BM, Nelson, M. Biochemical markers of nutrient intake. In: Margetts, BM, Nelson, M, eds. Design Concepts in Nutritional Epidemiology, second edition. Oxford: Oxford University Press, 1997: 170–240.Google Scholar
3Thurnham, DI, Micronutrients: how important in old age? Eur. J. Clin. Nutr. 1992; 46 (suppl. 3): S29–S37.Google Scholar
4Thurnham, DI. Impact of disease on markers of micro-nutrient status. Proc. Nutr. Soc. 1997; 56: 521–31.CrossRefGoogle Scholar
5Smith, CH, Bidlack, WR. Dietary concerns associated with the use of medications. J. Am. Diet. Ass. 1984; 84: 901–14.CrossRefGoogle ScholarPubMed
6Chen, LH, Liu, S, Cook, Newell ME, Barnes, K. Survey of drug use by the elderly and possible impact of drugs on nutritional status. Drug–Nutrient Interactions. 1985; 3: 73–86.Google Scholar
7Roe, DA. Diet and Drug Interactions. New York: Van Nostrand Reinhold, 1988.Google Scholar
8Basu, TK. Drug–Nutrient Interactions. London: Croom Helm, 1988.CrossRefGoogle Scholar
9Tietz, NW, Finley, PR, Pruden, EL. Clinical Guide to Laboratory Tests, second edition. Philadelphia: Saunders, 1990.Google Scholar
10Finch, S, Doyle, W, Lowe, C, Bates, CJ, Prentice, A, Smithers, G, Clarke, PC. National Diet and Nutrition Survey: people aged 65 years and over, vol. 1: Report of the Diet and Nutrition Survey. London: SO, 1998.Google Scholar
11Thurnham, DI, Smith, E, Flora, PS. Concurrent liquid-chromatographic assay of retinol, α-tocopherol, ß-carotene, α-carotene, lycopene and ß-cryptoxanthin in plasma, with tocopherol as internal standard. Clin. Chem. 1988; 34: 377–81.CrossRefGoogle Scholar
12Vuilleumier, JP, Keller, HE, Keck, E. Clinical chemical methods for routine assessment of the vitamin status of populations. Part III. The apoenzyme stimulation tests for vitamins B1, B2 and B6, adapted to the Cobas Bio analyser. Int. J. Vit. Nutr. Res. 1990; 60: 126–35.Google Scholar
13Powers, HJ, Bates, CJ, Prentice, AM, Lamb, WH, Jepson, M, Bowman, H. The relative effectiveness of iron and iron with riboflavin in correcting a microcytic anaemia in men and children in rural Gambia. Hum. Nutr. Clin. Nutr. 1983; 37C: 413–25.Google Scholar
14Calvin, J, Neale, G, Fotherby, KJ, Price, CP. The relative merits of acute phase proteins in the recognition of inflammatory conditions. Ann. Clin. Biochem. 1988; 25: 60–6.Google Scholar
15Bates, CJ, Prentice, AM, Paul, AA. Seasonal variations in vitamin A, C, riboflavin and folate intakes and status of pregnant and lactating women in a rural Gambian community: some possible implications. Eur. J. Clin. Nutr. 1994; 48: 660–8.Google Scholar
16Bates, CJ, Human riboflavin requirements, and metabolic consequences of deficiency in man and animals. Wld. Rev. Nutr. Dietet. 1987; 50: 215–65.Google Scholar
17Smith, FR, Goodman, DS, The effects of diseases of the liver, thyroid and kidneys on the transport of vitamin A in human plasma. J. Clin. Invest. 1971; 50: 2426–36.Google Scholar
18Yatzides, H, Digenis, P, Fountas, P. Hypervitaminosis A accompanying advanced chronic renal failure. Br. Med. J. 1975; 3: 352–3.Google Scholar
19Yatzides, H, Digenis, P, Koutsicos, D. Hypervitaminosis A in chronic renal failure after transplantation. Br. Med. J. 1976; 2: 1075.CrossRefGoogle Scholar
20Farrington, K, Miller, P, Varghese, Z, Baillod, RA, Moorhead, JF. Vitamin A toxicity and hypercalcaemia in chronic renal failure. Br. Med. J. 1981; 282: 1999–2002.Google Scholar
21Gentile, MG, Fallin, G, Manna, GM, D'Amico, G, Testolin, G, Porrini, M, Siminotti, P. Vitamin A and retinol binding protein in chronic renal insufficiency. Int. J. Artific. Org. 1988; 11: 403–4.Google Scholar
22Vannucchi, MTI, Vannucchi, H, Humphreys, M. Serum levels of vitamin A and retinol binding protein in chronic renal patients treated by continuous ambulatorial peritoneal dialysis. Int. J. Vit. Nutr. Res. 1990; 62: 107–12.Google Scholar
23Gal, I, Parkinson, C, Craft, I. Effects of oral contraceptives on human plasma vitamin A levels. Br. Med. J. 1971; 2: 436–8.Google Scholar
24Comstock, GW, Menkes, MS, Schober, SE, Vuilleumier, JP, Helsing, KJ. Serum levels of retinol, beta-carotene and alpha-tocopherol in older adults. Am. J. Epidemiol. 1987; 127: 114–23.Google Scholar
25Nierenberg, DW, Stukel, TA, Baron, JA, Dain, BJ. Greenberg, ER, and the Skin Cancer Prevention study group. Determinants of plasma levels of beta-carotene and retinol. Am. J. Epidemiol. 1989; 130: 511–21.CrossRefGoogle ScholarPubMed
26Herbeth, B, Chavance, M, Musse, N, Mejean, L, Vernhes, G. Dietary intake and other determinants of blood vitamins in an elderly population. Eur. J. Clin. Nutr. 1989; 43: 175–86.Google Scholar
27Muggeo, M, Zenti, MG, Travia, D, Sartori, A, Trimeloni, S, Grigolini, L, Graziani, MS, Cigolini, M. Serum retinol levels throughout 2 years of cholesterol-lowering therapy. Metabolism 1995; 44: 398–403.CrossRefGoogle ScholarPubMed