Vitamin E May Slow Alzheimer's Decline

The results of a recent study indicate that Alzheimer’s disease patients who took vitamin E had significantly slower disease progression than those who took placebo.

Vitamin E has been shown to help slow disease progression in patients with moderately severe Alzheimer’s disease, and a new study suggests that high doses of the supplement may also benefit patients with less severe forms of the disease.

The double-blind study, published in the January 1, 2014, issue of JAMA, assessed the efficacy of alpha tocopherol (a form of vitamin E), memantine, or both in slowing the progression of mild to moderate Alzheimer’s in patients taking an acetylcholinesterase inhibitor. Patients from 14 Veterans Affairs medical centers were randomly assigned to receive 2000 IU/day of vitamin E, 20 mg/day of memantine, both vitamin E and memantine, or placebo from August 2007 to September 2012. Patients were evaluated every 6 months using the Alzheimer’s Disease Cooperative Study/Activities of Daily Living (ADCS-ADL) Inventory, which assesses the ability to perform daily activities. Secondary outcomes included Mini-Mental State Examination (MMSE) scores, caregiver surveys, and other neuropsychiatric measures. A total of 561 patients were included in the analysis and they were followed for 2.27 years each on average.

The study’s results indicated that patients taking vitamin E alone had significantly slower disease progression than those who received placebo. ADCS-ADL Inventory scores declined 3.15 units less in the alpha tocopherol group than in the placebo group. This difference translates to an annual 19% delay in disease progression or approximately 6.2 months delay during the follow-up period. The authors of the study note that the delay is statistically significant, and that the level of decline seen in the placebo group could translate to the complete loss of the ability to dress and bathe independently. ADCS-ADL inventory scores also declined less in the memantine and combination groups than in the placebo group, but these differences were not statistically significant.

Patients who received alpha tocopherol also appeared to be more independent since caregiver time increased the least among these patients compared with those in the other intervention groups. There were no differences observed in the number of adverse reactions reported among the treatment groups.

Although the study suggests that Vitamin E may be a viable way to delay the progression of Alzheimer’s disease, the authors of an accompanying editorial stress the importance of preventing the disease rather than treating symptoms.

“[T]he therapeutic effect seen was modest and more relevant to [Alzheimer’s disease] symptoms and consequences than to reversal of the disease process,” they write. “The importance of treating patients with [Alzheimer’s disease] is clear, but finding the best balance between treatment and prevention efforts is challenging.”

Despite these concerns, the authors of the study suggest that vitamin E may help to reduce the burden of care associated with the disease. “Because vitamin E is inexpensive, it is likely these benefits are cost-effective as alpha tocopherol improves functional outcomes and decreases caregiver burden,” they conclude.