You are leaving Medscape Education
Cancel Continue
Log in to save activities Your saved activities will show here so that you can easily access them whenever you're ready. Log in here CME & Education Log in to keep track of your credits.


Multivitamin, Multimineral Supplementation May Not Reduce Morbidity in Elderly

  • Authors: News Author: Laurie Barclay, MD
    CME Author:
    Désirée Lie, MD, MSEd
  • CME Released: 8/8/2005
  • Valid for credit through: 8/8/2006
Start Activity

Target Audience and Goal Statement

This article is intended for primary care physicians, geriatricians, and other specialists who care for elderly patients.

The goal of this activity is to provide the latest medical news to physicians and other healthcare professionals in order to enhance patient care.

Upon completion of this activity, participants will be able to:

  • Identify risk factors for nutritional deficiency and risk of infection among the elderly.
  • Describe the effect of multivitamin and mineral supplementation for one year on self-reported infection, use of primary care services, and quality of life in the elderly.


As an organization accredited by the ACCME, Medscape requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as "financial relationships in any amount, occurring within the past 12 months," that could create a conflict of interest.

Medscape encourages Authors to identify investigational products or off-label uses of products regulated by the U.S. Food and Drug Administration, at first mention and where appropriate in the content.


  • Laurie Barclay, MD

    Laurie Barclay is a freelance reviewer and writer for Medscape.


    Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.


  • Gary Vogin, MD

    Senior Medical Editor, Medscape


    Disclosure: Gary Vogin, MD, has disclosed no relevant financial relationships.

CME Author(s)

  • Désirée Lie, MD, MSEd

    Clinical Professor of Family Medicine; Director, Division of Faculty Development, University of California, Irvine School of Medicine, Irvine, California


    Disclosure: Désirée Lie, MD, MSEd, has disclosed no relevant financial relationships.

Accreditation Statements

    For Physicians

  • Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

    Medscape designates this educational activity for 0.25 Category 1 credit(s) toward the AMA Physician's Recognition Award. Each physician should claim only those credits that reflect the time he/she actually spent in the activity.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page.

Follow these steps to earn CME/CE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. Medscape encourages you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 5 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

*The credit that you receive is based on your user profile.


Multivitamin, Multimineral Supplementation May Not Reduce Morbidity in Elderly

Authors: News Author: Laurie Barclay, MD CME Author: Désirée Lie, MD, MSEdFaculty and Disclosures

CME Released: 8/8/2005

Valid for credit through: 8/8/2006


Aug. 8, 2005 -- Multivitamin and multimineral supplementation does not affect morbidity, according to the results of a randomized, double-blind study published in the Aug. 6 issue of the British Medical Journal.

"At least 25% of older people in the United Kingdom take nutritional supplements," write Alison Avenell, from the University of Aberdeen, United Kingdom, and colleagues from the Writing Group of the Mineral and Vitamin Intervention Study (MAVIS). "Multivitamin and multimineral supplements are widely available and most brands have similar contents. Whether such supplementation influences infections in older people, particularly those not in nursing homes, is unclear from randomized controlled trials."

In communities associated with six general practices in Grampian, Scotland, 910 men and women age 65 years or older who did not take vitamins or minerals were randomized to receive either daily multivitamin and multimineral supplementation or placebo for one year. The primary endpoints were primary care contacts for infections, self-reported days with infection, and quality of life, and secondary outcomes included antibiotic prescriptions, hospital admissions, adverse events, and compliance.

Supplementation did not significantly affect primary care contacts and days of infection per person (incidence rate ratios, 0.96 [95% confidence interval {CI}, 0.78 - 1.19] and 1.07 [95% CI, 0.90 - 1.27], respectively). The groups did not differ significantly in quality of life or in any secondary outcomes, either overall or in subgroups.

"Routine multivitamin and multimineral supplementation of older people living at home does not affect self-reported infection-related morbidity," the authors write.

Study limitations include few subjects age 85 years or older or in nursing homes, who may be at higher risk of nutritional deficiency; possibly healthier study subjects than people who did not volunteer for the study; exclusion of people already taking nutritional supplements; inability to exclude the possibility that the intakes provided in the supplement were insufficient to affect the immune system; and use of self-report to establish infections.

Health Foundation (formerly PPP Healthcare Medical Trust) funded this study. The authors report no competing interests.

In an accompanying editorial, Salah Gariballa, from the University of Sheffield, Northern General Hospital in Sheffield, United Kingdom, suggests that vitamin and mineral supplements may help prevent infections in some older people but that improved diet and physical activity are more beneficial.

She notes that this was a robust study overall but that limitations may include confounding and measurement biases, lack of data on dietary intake or physical activity, low doses of multivitamins and minerals used, and the relatively healthy study population.

"Supplements of vitamins and minerals might still benefit older people with increased risk of infections and those with evidence of vitamin deficiencies, Dr. Gariballa writes. But we will not know for sure until further robust studies have been done among high risk groups, including those with poor immunity and those living in institutional care."

Dr. Gariballa reports no financial conflicts of interest.

BMJ. 2005;331:304-305, 324-327