Vitamin E for Alzheimer's Disease

Alzheimer's Disease treated with vitamin E showed promise slowing cognitive decline as compared to placebo

(RxWiki News) As Alzheimer's disease becomes more prevalent, researchers are looking for new ways to treat the condition. A new study hints that a simple vitamin might help slow the disease.

The researchers followed Alzheimer's patients for two years as some were given a form of vitamin E.

This study showed that the patients who received vitamin E had slower cognitive decline than their counterparts who received an inactive replacement.

"Talk to a doctor if memory troubles start to interrupt daily life."

The study authors, led by Maurice W. Dysken, MD, of the Minneapolis VA (Veterans Affairs) Health Care System, in Minneapolis, Minnesota, wanted to see if vitamin E had an effect on the progression of Alzheimer's disease.

This study involved 613 patients with mild to moderate Alzheimer's disease. The patients were almost all men and had an average age of 78.8 years old. Most of the patients were also taking a type of medicine called an acetylcholinesterase inhibitor for their condition.

The study was administered at 14 different VA medical centers beginning in August 2007 and ending in September 2012. The participants were followed for an average of 2.27 years.

Patients were given either 2,000 IU (international unit) a day of alpha tocopherol (a fat-soluble form of vitamin E), 20 milligrams per day of memantine (an Alzheimer's medication with the brand name Namenda), a combination of both, or an inactive placebo. In total, 152 patients received the vitamin E, 155 received memantine, 154 received the combination treatment and 152 received the placebo.

Dr. Dysken and colleagues used the Alzheimer’s Disease Cooperative Study/Activities of Daily Living (ADCS-ADL) scale to measure the progress of the condition. They also measured the amount of time patients required a caregiver.

ADCS-ADL has a possible range of zero to 78, with a lower score representing worse cognitive function. The patients' average ADCS-ADL score at the study's beginning was 56.8.

The researchers found that over the follow-up period, the vitamin E patients had a slower cognitive decline than the placebo patients, based on the ADCS-ADL.

The vitamin E group's average ADCS-ADL score declined by 13.81 units, the memantine group's score declined by 14.98 units, the combination group's score declined by 15.20 units, and the placebo group's score declined by 16.96 units. The vitamin E group's decline was 3.15 units less than the placebo group's decline.

"The change translates into a delay in clinical progression of 19 percent per year compared with placebo (approximately 6.2 months over the follow-up period)," Dr. Dysken and colleagues reported.

The researchers also found that out of all the different treatment groups, time spent with caregivers increased least in the group who received vitamin E.

The study authors noted that no significant differences were seen between the group who received just memantine and the group who received memantine and the alpha tocopherol vitamin E.

"These findings suggest benefit of alpha tocopherol in mild to moderate AD by slowing functional decline and decreasing caregiver burden," Dr. Dysken and team wrote.

In an interview with dailyRx News, Murali Rao, MD, Chair of the Department of Psychiatry and Behavioral Neurosciences at Loyola University in Chicago, explained that vitamin E and dementia have been the subject of several studies, and will likely continue to be explored in future research.

"Vitamin C and vitamin E have been considered neural-protective because they have antioxidant properties - they have the ability to neutralize free radicals that can cause cell loss," explained Dr. Rao.

Dr. Rao said that the reduction of caregiver time seen in this fairly long study was quite significant. "Vitamin E is an inexpensive addition to existing treatment, one could add it quite comfortably to see if it helps," said Dr. Rao.

However, there is still much to be learned in terms of vitamin E and the progression of Alzheimer's disease.

Dr. Rao noted that this study was mostly males and didn't fully delve into how vitamin E and memantine might interact. Furthermore, the type of vitamin E used is a synthetic form - Dr. Rao noted that it might be interesting to look at different forms and different components of vitamin E.

This study appears January 1 in JAMA.

Several of the study's authors reported serving as board members for, receiving grants from or receiving consulting or speaking fees from a variety of organizations, including pharmaceutical companies like Trans-tech Pharma, Eli Lilly, Pfizer and Merck, and organizations like the Alzheimer's Association and the University of New England.

Review Date: 
December 29, 2013