June 25, 2014

Alzheimer's & Vitamin E

VIDEO + ARTICLE

Researchers find that vitamin E eases problems with daily activities in Alzheimer's. This includes shopping, preparing meals, planning and traveling. See how vitamin E may slow down Alzheimer's. Read how it can decrease caregiver burden.



Difficulty with activities of daily living often affect Alzheimer's patients, which is estimated to affect as many as 5.1 million Americans. These issues are among the most taxing burdens of the disease for caregivers, which total about 5.4 million family members and friends. New research from the faculty of Icahn School of Medicine at Mount Sinai working with Veterans Administration Medical Centers suggests that alpha tocepherol, fat-soluble Vitamin E and antioxidant, may slow functional decline (problems with daily activities such as shopping, preparing meals, planning, and traveling) in patients with mild-to-moderate Alzheimer's disease and decrease caregiver burden. There was no added benefit for memory and cognitive testing with the vitamin.

Continued below video...
The study is published online in the Journal of the American Medical Association.

"Since the cholinesterase inhibitors [galantamine, donepezil, rivastigmine], we have had very little to offer patients with mild-to-moderate dementia," said Mary Sano, PhD, trial co-investigator, and professor in the department of psychiatry, Icahn School of Medicine at Mount Sinai, and director of research at the James J. Peters Veteran's Administration Medical Center, Bronx, New York. "This trial showed that vitamin E delays progression of functional decline by 19% per year, which translates into 6.2 months benefit over placebo."

The finding is valuable because vitamin E is easy to purchase at local drugstores and it is also inexpensive. The clinical trial investigators believe it can be recommended as a treatment strategy, based on the double-blind randomized controlled trial.

The Veteran's Administration Cooperative Randomized Trial of Vitamin E and memantine in Alzheimer's Disease (TEAM-AD examined the effects of vitamin E 2,000 IU/d, 20 mg/d of memantine, the combination, or placebo on Alzheimer's Disease Cooperative Study/Activities of Daily Living (ADCS-ADL) Inventory Score. Cognitive, neuropsychiatric, functional, and caregiver measures were secondary outcomes. A group of 613 patients with mild to moderate Alzheimer's disease were in the study, which was launched in August 2007 and finished in September 2012 at 14 Veterans Affairs Medical Centers.

Dr. Sano previously led a study on Vitamin E in patients with moderately severe Alzheimer's disease. She found that the vitamin slowed disease progression in this group of patients as well.

Source:
Mount Sinai Medical Center, via Newswise.

Journal Reference:
  1. Maurice W. Dysken, Mary Sano, Sanjay Asthana, Julia E. Vertrees, Muralidhar Pallaki, Maria Llorente, Susan Love, Gerard D. Schellenberg, J. Riley McCarten, Julie Malphurs, Susana Prieto, Peijun Chen, David J. Loreck, George Trapp, Rajbir S. Bakshi, Jacobo E. Mintzer, Judith L. Heidebrink, Ana Vidal-Cardona, Lillian M. Arroyo, Angel R. Cruz, Sally Zachariah, Neil W. Kowall, Mohit P. Chopra, Suzanne Craft, Stephen Thielke, Carolyn L. Turvey, Catherine Woodman, Kimberly A. Monnell, Kimberly Gordon, Julie Tomaska, Yoav Segal, Peter N. Peduzzi, Peter D. Guarino. Effect of Vitamin E and Memantine on Functional Decline in Alzheimer DiseaseJAMA, 2014; 311 (1): 33 DOI:10.1001/jama.2013.282834

4 comments :

  1. Reddog, the researchers noted that the results do not make total sense. And there have been many studies on Vitamin E for treating everything from mild cognitive impairment (MCI) to late-stage Alzheimer's -- some found no benefit at all, some produced confusing and/or contradictory results the way this study did, and some concluded it can actually be harmful. So until they figure out why the results aren't clear-cut, I'd be cautious about dosing a loved one.

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  2. For more information and a better explanation of the concerns, see TheChart on the CNN Health website, Dec 31:

    Caveats

    Some results don't completely add up, Small said.

    For him, the finding that vitamin E by itself showed benefits, but in combination with memantine it did not, is puzzling. There is also the question of why none of the treatment groups did better than the placebo group in cognitive abilities.

    “It is unclear why there were functional but not cognitive benefits of this intervention. The lack of cognitive benefit re-emphasizes the need for replication and confirmation of these results before considering this as a treatment strategy,” Carrillo said.

    Vitamin E had been shown in previous research to possibly benefit Alzheimer's patients, but other studies have raised safety concerns. Among them was a 2011 JAMA study that found dietary supplementation with vitamin E in healthy men increases the risk of prostate cancer.

    In this new study, vitamin E did not appear to increase the likelihood of mortality. None of the treatments seemed to be unsafe, according to this research, but "the size of the study did not allow us to detect infrequent but potentially significant adverse events," the researchers wrote.

    It's important for the study to be replicated, so that the results can be confirmed, but this is a good step toward positively intervening in the disease, Small said.

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