TY - JOUR
T1 - Increasing trends in elderly persons' use of nonvitamin, nonmineral dietary supplements and concurrent use of medications
AU - Wold, Rosemary S.
AU - Lopez, Susan T.
AU - Yau, C. Lillian
AU - Butler, Lisa M.
AU - Pareo-Tubbeh, Shirley L.
AU - Waters, Debra L.
AU - Garry, Philip J.
AU - Baumgartner, Richard N.
N1 - Funding Information:
There is a need to educate both the patient/consumer and dietetics professionals about the adverse effects of this trend of potential dietary supplement/medication interactions. Dietetics professionals should be aware that the potential for adverse interactions is growing, especially among the elderly population. Patients may be unaware that combining dietary supplements with OTC and prescription medications can result in interactions. Health practitioners, including dietetics professionals, could also be unaware that patients are concomitantly taking products emphasizing the importance of asking pertinent questions and documenting responses in the medical record. Dietetics professionals should inquire about supplement use, consider the potential for interactions, and be aware of the severity of these interactions, especially in the elderly. Failure to recognize and address these potential interactions could lead to interference with other medical therapies and could hold the prospect of negatively affecting the health of the patient/consumer. It is not uncommon for geriatric health practitioners to ask patients to bring in all containers of prescription medications and/or other regularly used medications to the initial clinic visit. Due to this growing trend of potential medication/dietary supplement interactions, it may also be prudent to ask patients to bring along all containers of dietary supplements. Periodic rechecks of supplement use may also be warranted because use may change and/or increase over time. Through this report, dietetics professionals can gain a better understanding of the risks of combining nonvitamin, nonmineral supplements with prescription and/or OTC medications. Armed with this knowledge, dietetics professionals can be better able to evaluate the potential for interactions and be prepared to apprise the appropriate health care provider and educate the patient/consumer. The authors wish to express their gratitude to the participants of the New Mexico Aging Process Study. Thanks are also extended to Robyn Viera for data entry, Linda Friesen for technical assistance, and Candice Wellhausen for editorial assistance. This study was supported by grants from the United States Public Health Service AG-02049 and AG-10149, and General Clinical Research Center RR00997-28. S. T. Lopez is coordinator, Biomedical Research Support, UNM Health Sciences Center Clinical Research and Data Management, University of New Mexico, Albuquerque, NM, USA; at the time of the study, she was research nutritionist, Aging and Genetic Epidemiology, University of New Mexico, Albuquerque, NM, USA. C. L. Yau is assistant professor, Department of Biostatistics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; at the time of the study, she was senior statistician, Aging and Genetic Epidemiology, University of New Mexico, Albuquerque, NM, USA. L. M. Butler is surveillance officer, Emerging Infectious Program, Institute for Public Health, University of New Mexico, Albuquerque, NM, USA; at the time of the study, she was associate scientist I, Aging and Genetic Epidemiology, University of New Mexico, Albuquerque, NM, USA. S. L. Pareo-Tubbeh is research scientist III, University of New Mexico, Center for Health Promotion, Albuquerque, NM, USA. D. L. Waters is research assistant professor, P. J. Garry is professor emeritus, and R. N. Baumgartner is professor, Aging and Genetic Epidemiology, University of New Mexico, Albuquerque, NM, USA.
PY - 2005/1
Y1 - 2005/1
N2 - Use of nonvitamin, nonmineral dietary supplements among an elderly cohort was surveyed to determine which were the most frequently used, and to report potential medication/supplement interactions observed. A retrospective review of the use of 22 supplements and prescription/over-the-counter medications was collected annually from 1994 to 1999. Supplement and medication records for an average of 359 male (36%) and female (64%) participants aged 60 to 99 years were reviewed annually. Ethnic distribution was 91% non-Hispanic white, 7% Hispanic, 1% Asian, and 1% African American. Descriptive statistics generated included mean, standard deviation, and frequency by percentage. To compare supplement user and nonsupplement user percentages across age groups, the χ2 test was used. Linear regression was performed to test for longitudinal usage trends of each individual supplement. By 1999, glucosamine emerged as the most frequently used nonvitamin, nonmineral supplement followed by ginkgo biloba, chondroitin, and garlic. For women, there was a significant linear trend (P <. 05) over time for these 12 supplements: black cohosh, borage, evening primrose, flaxseed oil, chondroitin, dehydroepiandrosterone, garlic, ginkgo biloba, glucosamine, grapeseed extract, hawthorn, and St John's wort. For men, three supplements (alpha lipoic acid, ginkgo biloba, and grape-seed extract) showed a significant linear trend (P<.05). Potential interactions between supplements and medications were seen for 10 of the 22 supplements surveyed, with a total of 142 potential interactions observed over the 6-year period. Examining nonvitamin, nonmineral supplement use in combination with prescription/over-the-counter medications in elderly persons is important to identify the potential risks of interactions.
AB - Use of nonvitamin, nonmineral dietary supplements among an elderly cohort was surveyed to determine which were the most frequently used, and to report potential medication/supplement interactions observed. A retrospective review of the use of 22 supplements and prescription/over-the-counter medications was collected annually from 1994 to 1999. Supplement and medication records for an average of 359 male (36%) and female (64%) participants aged 60 to 99 years were reviewed annually. Ethnic distribution was 91% non-Hispanic white, 7% Hispanic, 1% Asian, and 1% African American. Descriptive statistics generated included mean, standard deviation, and frequency by percentage. To compare supplement user and nonsupplement user percentages across age groups, the χ2 test was used. Linear regression was performed to test for longitudinal usage trends of each individual supplement. By 1999, glucosamine emerged as the most frequently used nonvitamin, nonmineral supplement followed by ginkgo biloba, chondroitin, and garlic. For women, there was a significant linear trend (P <. 05) over time for these 12 supplements: black cohosh, borage, evening primrose, flaxseed oil, chondroitin, dehydroepiandrosterone, garlic, ginkgo biloba, glucosamine, grapeseed extract, hawthorn, and St John's wort. For men, three supplements (alpha lipoic acid, ginkgo biloba, and grape-seed extract) showed a significant linear trend (P<.05). Potential interactions between supplements and medications were seen for 10 of the 22 supplements surveyed, with a total of 142 potential interactions observed over the 6-year period. Examining nonvitamin, nonmineral supplement use in combination with prescription/over-the-counter medications in elderly persons is important to identify the potential risks of interactions.
UR - https://www.scopus.com/pages/publications/11344250258
U2 - 10.1016/j.jada.2004.11.002
DO - 10.1016/j.jada.2004.11.002
M3 - Article
C2 - 15635346
AN - SCOPUS:11344250258
SN - 0002-8223
VL - 105
SP - 54
EP - 63
JO - Journal of the American Dietetic Association
JF - Journal of the American Dietetic Association
IS - 1
ER -