An Evidence-Based Study of the Role of Dietary Supplements in
Helping Seniors Maintain their Independence
I. EXECUTIVE SUMMARY
By the year 2030, there will be over 70 million people aged 65+, with half over age 75. Health care for Americans over age 65 could increase to nearly $16 trillion per year. A number of age-related diseases contribute significantly to whether an older person can maintain his or her independence, including coronary heart disease (CHD), osteoporosis, and age-related macular degeneration (AMD).
AMD affects activities central to independent living, which include reading, driving, and writing, which are considerably impaired through the loss of central vision, for example. AMD is the leading cause of irreversible blindness in persons over age 65. Research studies have shown that preventive measures, such as smoking avoidance and good nutrition, that are practiced throughout one’s life can help reduce the risk of these conditions, thereby avoiding or delaying a loss of independence or the onset of functional disability. Visual impairment is one of the top four reasons for loss of independence.
Furthermore,eighteen percent of all hip fractures among seniors have been attributed to age-related vision loss. The transition to greater dependency, whether by getting more help at home or through moving to a nursing facility, places considerable financial burden on the older person, his or her family, and the health care system.
Studies have shown that there are additional medical and other costs associated with the year when an older person makes the transition to dependency at home or moves to a nursing facility. The prevention (or even delay) in the loss of independence has implications both economically and also for the individual’s quality of life.
The purpose of this evidence-based study is twofold: (1) to critically review the research literature for two dietary supplements for which an association has been shown between intake of the supplement and reduced risk of a disease that can and does lead to a loss of independence, and (2) to develop estimates of potential health care savings that could result from daily use of the supplement. Supplement/disease combinations examined in this study are (1)omega3 fatty acids and CHD and(2) lutein/zeaxanthin and AMD. Additionally, the literature was reviewed for Vitamin D as it relates to prevention of osteoporosis, but because there currently are no studies yet of Vitamin D alone (without calcium), we were not able to develop a cost model for Vitamin D without calcium.
The Lewin Group, Inc. was commissioned by the Dietary Supplement Education Alliance (DSEA) to review the existing research literature concerning the above supplements for validity (scientific validity), impact (size of the effect), and applicability (usefulness in actual practice). Lewin was asked to develop estimates of the potential health care expenditure savings that could result from daily use of these supplements. Estimates of potential savings were developed for each supplement for specific relevant outcomes. For omega3 fatty acids, estimates of potential savings associated with a reduced risk of CHD and the potentially avoided hospitalizations and physician services were developed. For lutein/zeaxanthin, estimates of potential savings associated with a reduced risk of AMD were developed through the delay or avoidance of transitioning to dependence as a result of central vision blindness. This report contains a summary of the key findings of the study, a discussion of the conceptual framework and the methodology, and a discussion of the implications of the results.