Clinical Reader in Ageing and Health
Pleiotropic interventions to improve health in older people
Ageing and Health
Division of Cardiovascular & Diabetes Medicine
School of Medicine
+(44) 01382 383086
Dr Witham graduated from Oxford University and worked in a number of hospitals in the south of England and Australia before moving to Scotland. He undertook his PhD in Dundee running a randomised controlled trial of exercise training for older chronic heart failure patients, before taking up post as Clinical Lecturer in Ageing and Health in 2003.
In October 2007, he commenced an NES / CSO Clinician Scientist award, with a duration of 5 years; he completed clinical training in geriatrics and general medicine in late 2009 before taking up post as Clinical Senior Lecturer in Ageing and Health, becoming Clinical Reader in Ageing and Health in July 2013.
Dr Witham works as an honorary consultant geriatrician with NHS Tayside, contributing to community geriatric medicine services, general older people’s outpatients and helps to run the Dundee Memory Clinic service. He is a member of the Health Services and Population research Committee (Chief Scientist Office, Scottish Government) and contributes to the Scottish polypharmacy guideline working group.
Pleiotropic interventions to improve the health of older people:
Multimorbidity is the norm in older people, but most interventions are tested in younger people without comorbid disease, who take few other medications. Conducting trials in typical frail older people is therefore critical if we are to build the evidence base we need to treat older people, and this forms a major focus of work in our department. Recent trials have included extensive work on the cardiovascular effects of vitamin D in different populations, the effects of exercise training in older heart failure patients, interventions for muscle weakness in older people, and a large, ongoing trial of bicarbonate for older patients with advanced CKD.
Finding interventions with multiple beneficial effects in older people (e.g. on cardiovascular disease, bone health, sarcopenia) is a key goal – such interventions could circumvent the hazard and inconvenience of polypharmacy –i.e. having to take multiple medications for each illness an older person has. By using routinely collected health, functional and social care data, we aim to find potential candidate interventions that might provide overall benefit to the health and function of older people, and use this observational data as a platform for future trials.
Witham MD, Band MM, Littleford RC, Avenell A, Soiza RL, McMurdo MET, Sumukadas D, Ogston SA, Lamb EJ, Hampson G, McNamee P. Does oral sodium bicarbonate therapy improve function and quality of life in older patients with chronic kidney disease and low-grade acidosis (the BiCARB trial)? Study protocol for a randomized controlled trial. Trials 2015;16:326. doi: 10.1186/s13063-015-0843-6
Fulton RL, McMurdo MET, Hill A, Abboud RJ, Arnold GP, Struthers AD, Khan F, Vermeer C, Knapen MHJ, Drummen NEA, Witham MD. Effect of vitamin K on vascular health and physical function in older people with vascular disease – a randomised controlled trial. J Nutr Health Ageing 2015 (in press)
Doyle EM, Sloan JM, Goodbrand JA, McMurdo MET, Donnan PT, McGilchrist MM, Frost H, Witham MD. Association between renal function, rehabilitation outcome and survival in older patients discharged from inpatient rehabilitation. Am J Kidney Dis 2015 doi: 10.1053/j.ajkd.2015.04.041. [Epub ahead of print]
Atherton I, Lynch E, Williams AJ, Witham MD. Research note – Barriers and Solutions to Linking and using Health and Social Care data in Scotland. Br J Social Work 2015 [epub ahead of print; doi:10.1093/bjsw/bcv047]
Beveridge LA, Struthers AD, Khan F, Jorde R, Scragg R, Macdonald HM, Alvarez JA, Boxer RS, Dalbeni A, Gepner AD, Isbel NM, Larsen T, Nagpal J, Petchey WG, Stricker H, Strobel F, Tangpricha V, Toxqui L, Vaquero MP, Wamberg L, Zittermann A, Witham MD; D-PRESSURE Collaboration. Effect of vitamin D supplementation on blood pressure: a systematic review and meta-analysis incorporating individual patient data. JAMA Intern Med. 2015; 175: 745-54.
Gellert P, Witham MD, Crombie IK, Donnan PT, McMurdo MET, Sniehotta FF. The role of perceived barrier and objectively measured physical activity in adults aged 65-100. Age Ageing. 2015; 44: 384-90.
Witham MD, Adams F, McSwiggan S, Kennedy G, Kabir G, Belch JJ, Khan F. Effect of intermittent vitamin D3 on vascular function and symptoms in chronic fatigue syndrome – A randomised controlled trial. Nutr Metab Cardiovasc Dis 2015; 25: 287-94.
Feng Z, Dibben C, Witham MD, Donnan PT, Vadiveloo T, Sniehotta F, Crombie IK, McMurdo MET. Dog ownership and physical activity in later life: a cross-sectional observational study. Prev Med 2014; 66: 101-6.
Witham MD, Price RJG, Struthers AD, Donnan PT, Messow M, McConnachie A, Ford I, McMurdo MET. Effect of Vitamin D supplementation on orthostatic hypotension – data from the VitDISH randomised controlled trial. J Hypertens 2014; 32: 1693-9.
Witham MD, Ireland SE, Houston JG, Gandy SJ, Waugh S, MacDonald TM, Mackenzie IS, Struthers AD. Vitamin D therapy to reduce blood pressure and left ventricular hypertrophy in resistant hypertension – a randomised controlled trial. Hypertension 2014; 63: 706-12.
Witham MD, Syddall HE, Dennison EM, Cooper C, McMurdo MET, Aihie-Sayer A. ACE inhibitors, statins and thiazides: no association with change in grip strength among community dwelling older men and women from the Hertfordshire Cohort Study. Age Ageing 2014; 43: 661-6.
Sumukadas D, Band M, Miller S, Cvoro V, Witham MD, Struthers AD, McConnachie A, Lloyd SM, McMurdo ME. Do ACE inhibitors improve the response to exercise training in functionally impaired older adults?: a randomised controlled trial. J Gerontol A Med Sci 2013; 69: 736-43.
Witham MD, Price RJG, Struthers AD, Donnan PT, Messow CM, Ford I, McMurdo MET. Cholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial. JAMA Intern Med 2013; 173: 1672-9.
Tan SC, Ramage L, McMurdo MET, Witham MD. Predicting failure to improve during rehabilitation for older patients using routinely collected clinical data. Eur Geriatr Med 2013; 4: 324-8.
Witham MD, Dove FJ, Khan F, Lang CC, Belch JJF, Struthers AD. Effect of vitamin D supplementation on markers of vascular function after myocardial infarction – a randomised controlled trial. Int J Cardiol 2013; 167: 745-9.
Burton LA, Sumukadas D, Witham MD, Struthers AD, McMurdo MET. Effect Of Spironolactone On Physical Performance In Older People With Self-Reported Physical Disability. Am J Med 2013; 126: 590-7.
Beveridge LA, Ramage L, McMurdo MET, George J, Witham MD. Allopurinol use is associated with greater functional gains in older rehabilitation patients. Age Ageing 2013; 42: 400-4.
Dr Witham is convenor for the Systems in Practice (SiP) Ageing teaching, including Ageing Week in third year, and also contributes to administering, marking and examining fourth year undergraduate geriatric medicine teaching. He contributes to the Cardiovascular BMSc course, to medical postgraduate and nursing staff teaching, and runs the Tayside StR Research training course for higher specialist medical trainee doctors – a course that he is also now leading for the Royal College of Physicians of Edinburgh. He is an associate member of the Higher Education Academy.
Roberta Fulton – Adherence to medication in older heart failure patients (CSO Doctoral fellowship, 2014-2017)
Anne Canny – Evidencing the role of social care for people with multi-morbidities – a mixed methods project to understand and successfully analyse linked health and social care data on older people (ESRC / Scottish Government PhD fellowship, 2014-2017)
Gavin Wylie - Improving physical activity levels of older people living in care homes (CSO Doctoral fellowship, 2015-2018)
Vitamin D – is it living up to the hype? (Scottish Society of Physicians, Dundee, Sept 2014)
Frailty and sarcopenia in older patients with advanced heart failure (Heart Failure Society of America, Las Vegas, Sept 2014)
Geriatric Assessment tools for the nephrologist (ERA-EDTA conference, Amsterdam, May 2014)
Vitamin D and Cardiovascular disease. (ECTS annual symposium, Stockholm, May 2012)
Vitamin D – Ray of sunshine or foggy outlook? (RCPE Moving Points in Medicine Symposium, Dundee, Feb 2012)
Broadening horizons: can we use vitamin D to treat cardiovascular disease in older people (part of Vitamin D in the elderly symposium at IAGG 2011 meeting, Bologna, Italy, April 2011)
Editorial regarding unneccessary ward moves in Age and Aging:
BBC News Scotland: 'Boarding' increases hospital stays and spreads infections, researchers say
Herald Scotland: Hospital bed shortages are jeopardising care of elderly
Mature Times: Unnecessary ward moves on increase
Mirror: Hospital ward moves are putting elderly patients 'at risk', warn experts
STV News: Study: Moving patients between wards 'increases infection risk'
The Scotsman: Hospital ward switches put elderly lives ‘at risk'
The Scotsman (editorial): Leaders: ‘Boarding’ patients unpopular & unhealthy
Sodium bicarbonate and chronic kidney disease
Dundee Evening Telegraph: Is baking soda a secret ingredient in medical breakthrough?
Drug Discovery Today: Researchers ask “Can Sodium bicarbonate improve Quality of Life in Chronic Kidney Disease?”