Effect of multivitamin and multimineral supplementation on cognitive function in men and women aged 65 years and over : a randomised controlled trial

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.Peer reviewedPublisher PD

Cosmic evolution of submillimeter galaxies and their contribution to stellar mass assembly

The nature of galaxies selected at submillimeter wavelengths (SMGs, S_850 > 3 mJy), some of the bolometrically most luminous objects at high redshifts, is still elusive. In particular their star formation histories and source of emission are not accurately constrained. In this paper we introduce a new approach to analyse the SMG data. Namely, we present the first self-consistent UV-to-radio spectral energy distribution fits of 76 SMGs with spectroscopic redshifts using all photometric datapoints from ultraviolet to radio simultaneously. We find that they are highly star-forming (median star formation rate 713 MSun yr^-1 for SMGs at z>0.5), moderately dust-obscured (median A_V~2 mag), hosting significant stellar populations (median stellar mass 3.7x10^11 MSun) of which only a minor part has been formed in the ongoing starburst episode. This implies that in the past, SMGs experienced either another starburst episode or merger with several galaxies. The properties of SMGs suggest that they are progenitors of present-day elliptical galaxies. We find that these bright SMGs contribute significantly to the cosmic star formation rate density (~20%) and stellar mass density (~30-50%) at redshifts 2-4. Using number counts at low fluxes we find that as much as 80% of the cosmic star formation at these redshifts took place in SMGs brighter than 0.1 mJy. We find evidence that a linear infrared-radio correlation holds for SMGs in an unchanged form up to redshift of 3.6, though its normalization is offset from the local relation by a factor of ~2.1 towards higher radio luminosities. We present a compilation of photometry data of SMGs and determinations of cosmic SFR and stellar mass densities.Comment: Accepted to A&A. 14 pages (+23 pages as appendix), 7 figures, 6 tables. Table A1-A5 can be found in the source file in the machine-readable form. For SED templates, see http://archive.dark-cosmology.dk/ or the source file. v3: major improvements: 1) the incompleteness correction applied; 2) the (higher) local q-value correctly assigned; 3) estimates of A_V adde

The Spitzer Mid-infrared Active Galactic Nucleus Survey. I. Optical and Near-infrared Spectroscopy of Obscured Candidates and Normal Active Galactic Nuclei Selected in the Mid-infrared

We present the results of a program of optical and near-infrared spectroscopic follow-up of candidate active galactic nuclei (AGNs) selected in the mid-infrared. This survey selects both normal and obscured AGNs closely matched in luminosity across a wide range, from Seyfert galaxies with bolometric luminosities L_(bol) ~ 10^(10) L_☉ to highly luminous quasars (L_(bol) ~ 10^(14) L_☉), all with redshifts ranging from 0 to 4.3. Samples of candidate AGNs were selected with mid-infrared color cuts at several different 24 μm flux density limits to ensure a range of luminosities at a given redshift. The survey consists of 786 candidate AGNs and quasars, of which 672 have spectroscopic redshifts and classifications. Of these, 137 (20%) are type 1 AGNs with blue continua, 294 (44%) are type 2 objects with extinctions A_V ≳5 toward their AGNs, 96 (14%) are AGNs with lower extinctions (A_V ~ 1), and 145 (22%) have redshifts, but no clear signs of AGN activity in their spectra. Of the survey objects 50% have L_(bol) > 10^(12) L_☉, in the quasar regime. We present composite spectra for type 2 quasars and objects with no signs of AGN activity in their spectra. We also discuss the mid-infrared—emission-line luminosity correlation and present the results of cross correlations with serendipitous X-ray and radio sources. The results show that: (1) obscured objects dominate the overall AGN population, (2) mid-infrared selected AGN candidates exist which lack AGN signatures in their optical spectra but have AGN-like X-ray or radio counterparts, and (3) X-ray and optical classifications of obscured and unobscured AGNs often differ

A systematic literature review of factors affecting outcome in older medical patients admitted to hospital

The ACMEplus project aims to devise a standardised system for measuring case-mix and outcome in older patients admitted to hospitals in different parts of Europe for primarily 'medical' (i.e. not surgical or psychiatric) reasons. As a first step in this project, a systematic review was carried out to identify factors which had a significant influence on outcome in such patients

Effect of multivitamin and multimineral supplements on morbidity from infections in older people (MAVIS trial): pragmatic, randomised, double blind, placebo controlled trial

Objective To examine whether supplementation with multivitamins and multiminerals influences self reported days of infection, use of health services, and quality of life in people aged 65 or over. Design Randomised, placebo controlled trial, with blinding of participants, outcome assessors, and investigators. Setting Communities associated with six general practices in Grampian, Scotland. Participants 910 men and women aged 65 or over who did not take vitamins or minerals. Interventions Daily multivitamin and multimineral supplementation or placebo for one year. Main outcome measures Primary outcomes were contacts with primary care for infections, self reported days of infection, and quality of life. Secondary outcomes included antibiotic prescriptions, hospital admissions, adverse events, and compliance. Results Supplementation did not significantly affect contacts with primary care and days of infection per person (incidence rate ratio 0.96, 95% confidence interval 0.78 to 1.19 and 1.07, 0.90 to 1.27). Quality of life was not affected by supplementation. No statistically significant findings were found for secondary outcomes or subgroups. Conclusion Routine multivitamin and multimineral supplementation of older people living at home does not affect self reported infection related morbidity. Trial registration ISRCTN: 66376460

A multi-centre European study of factors affecting the discharge destination of older people admitted to hospital:analysis of in-hospital data from the ACMEplus project

to examine the relationship between seven predictor variables (recorded on Day 3 of hospital admission) and discharge destination in non-elective medical patients aged 65+ years