Immunity in frail elderly: a randomized controlled trial of exercise and enriched foods.

OBJECTIVE: To examine the effects of 17-wk physical exercise and enriched foods on cellular immune response (CIR) in frail elderly. METHODS: A total of 112 independently living, frail elderly men and women (mean age 79.2 +/- 5.9) received: twice weekly comprehensive, moderate intensity, progressive group exercise (group A, N = 26); daily enriched foods (group B, N = 31); both (group C, N = 29); or neither (group D, N = 26). Exercises focused on skills training. Foods were enriched with micronutrients with a high prevalence of deficiency in older people (at 25-100% the RDA). A social program and identical regular foods were offered as a control. CIR was measured by delayed-type hypersensitivity skin test response (DTH) against seven recall antigens expressed as the total number of positive responses and sum of diameters of all positive responses. RESULTS: No independent or interactive effect of enriched foods was observed. Therefore, exercise (groups A + C) was compared with no exercise (groups B + D). Nonexercising subjects showed an average decline of 0.5 responses compared with an unchanged responsiveness among exercising subjects (difference = 0.5, 95% CI: 0.04-0.89, P = 0.03 adjusted for baseline DTH, activity level, and micronutrient status). Nonexercising subjects had a larger decline in the sum of diameters of all positive responses than exercising subjects but the difference did not reach significance (adjusted difference = 2.1 mm, 95% CI:-1.0-4.8). CONCLUSION: Exercise may prevent or slow the age-related decline in immune response. Micronutrient enriched foods showed no effect. As infectious diseases can have debilitating or even fatal consequences for the elderly, prevention of the age-related decline in CIR could significantly improve their quality of life.

Effect of 50- and 100-mg vitamin E supplements on cellular immune function in noninstitutionalized elderly persons.

BACKGROUND: It has been suggested that vitamin E can counteract the age-associated decline in cellular immune responsiveness (CIR). Particularly, T helper cell type 1 (Th1) activity, ie, interferon (IFN) gamma-producing Th1 activity and, hence, delayed-type hypersensitivity (DTH) would be enhanced by vitamin E supplementation. OBJECTIVE: Our aim was to study the effects of 6 mo supplementation with 50 and 100 mg vitamin E on CIR in the elderly. DESIGN: A double-blind, placebo-controlled trial was conducted in 161 healthy elderly subjects aged 65-80 y. CIR was measured in vivo by means of DTH skin tests and in vitro by assessing the production of interleukin (IL) 2, IFN-gamma (a typical Th1 cytokine), and IL-4 (a typical Th2 cytokine) by peripheral blood mononuclear cells after stimulation with phytohemagglutinin. RESULTS: Both DTH and IL-2 production showed a trend toward increased responsiveness with increasing dose of vitamin E. However, IFN-gamma production decreased whereas IL-4 production increased in the groups receiving vitamin E. Only the change in the number of positive DTH reactions was borderline significantly larger in the 100-mg vitamin E group than in the placebo group (P = 0.06, Bonferroni adjusted). Subjects receiving 100 mg vitamin E with low baseline DTH reactivity or who were physically less active had a significantly larger increase in the cumulative diameter of the skin induration resulting from the DTH test than did the placebo group (P = 0.03), although this difference was not significant after Bonferroni correction (P = 0.07). CONCLUSION: Possible beneficial effects of 100-mg vitamin E supplementation may be more pronounced in particular subgroups of elderly subjects.

Excess seasonality of births among patients with schizophrenia and seasonal ovopathy.

In this study we examined whether the well-known winter excess of schizophrenic births exists among Dutch schizophrenia patients when statistical artifacts such as the age-incidence and age-prevalence effects are avoided and, if so, whether the seasonal preovulatory release of overripe ovum (SPrOO) hypothesis, that is, seasonally bound ovopathy, might be an explanation for this excess. We analyzed the month-of-birth distribution of 1,037 Dutch schizophrenia patients born between 1962 and 1966 and first admitted to a psychiatric hospital between 1978 and 1990 by the so-called window analysis to avoid the artifacts mentioned. The results show a winter excess of births among Dutch schizophrenia patients, even when statistical artifacts are avoided, and that the SPrOO hypothesis might be an explanation for this excess. Further research is needed to support the hypothesis that ovopathy, either seasonally bound or not, could be involved in the etiology of schizophrenia.