January 3, 2014
News Review From Harvard Medical School -- Vitamin E May Help People with Alzheimer's
Large doses of vitamin E might slow the rate of functional decline for people with Alzheimer's disease, a new study finds. Functional decline means less ability to care for yourself. The study included 600 people with mild to moderate Alzheimer's. They were randomly divided into 4 groups. One group received 2,000 international units (IU) daily of alpha tocopherol, a form of vitamin E. This is a very large prescription dose. Another group received the Alzheimer's medicine memantine (Namenda). A third group got both medicines. A fourth group received placebo (fake) pills. Researchers kept track of people for an average of 2.3 years. People who took vitamin E alone had a 19% lower rate of functional decline each year than the placebo group. They also needed 2 fewer hours of care each day. But their rate of mental decline was not significantly lower. Memantine, with or without vitamin E, did not slow the rate of either functional or mental decline compared with the placebo group. And people who took the drug were more likely to get infections. The Journal of the American Medical Association published the study. HealthDay News wrote about it December 31.
By Howard LeWine, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
It's been a while since we heard some potentially positive news about vitamin E. This new study may put back a little shine on this vitamin's reputation.
Vitamin E is an antioxidant. These natural substances, found in food, help to protect cells from damage. Therefore, it was easy to assume that taking an antioxidant would make you healthier.
For years, taking vitamin E was touted as a way to help prevent cancer and heart disease. But several well-designed medical studies did not support the hype.
In fact, a 2005 study found that high-dose vitamin E pills were linked with an increased risk of death. A high dose was defined as greater than 400 international units (IU). In this new study, there was no increased risk of death from a very high dose (2,000 IUs) of the vitamin.
The results reported by these researchers are a bit surprising given the previous studies on vitamin E pills for people with Alzheimer's disease and other dementias. Most did not show that vitamin E could prevent or help treat dementia. And again in this study, there was no significant slowing of mental decline.
However, even a small change in the rate of functional decline is encouraging. Functional decline means less ability to keep taking care of yourself. A slower decline in self-care can mean much less stress on caregivers. It may also mean that people can stay in their own homes longer.
What Changes Can I Make Now?
If you have a family member with mild or moderate Alzheimer's, should you give him or her high-dose vitamin E? Right now, the answer is "possibly."
Usually I would say no, given that this is just one study and the results were modest. However, if your family member's goals are to stay at home and remain as functional as possible, then high-dose vitamin E may be a reasonable option. But you should definitely speak with his or her doctor first. Problems from interactions with other drugs always should be considered.
An editorial in the same journal emphasizes the importance of finding ways to prevent dementia. Clearly, vitamin E does not do that.
Meanwhile, you can reduce your risk or at least delay the onset of dementia:
- Don't smoke or use other tobacco products.
- Use alcohol in moderation. That means no more than one drink per day for women, and no more than two per day for men.
- Maintain a healthy body weight. In particular, try not to let your waist expand. People with more fat in the middle have a higher risk of developing dementia, even if their body weight is normal.
- Exercise regularly. At a minimum, get 150 minutes of moderate-intensity exercise per week.
- Keep your blood pressure in the normal range. To do this, get regular exercise, eat lots of fruits and vegetables, and cut down on salt. Your doctor can prescribe medicines if needed.
- Stay socially engaged with family and friends.
- Keep active in leisure activities such as painting, reading and gardening.
A Mediterranean-style diet also may be especially good for the brain.
What Can I Expect Looking to the Future?
Even if high-dose vitamin E is confirmed to slow functional decline in Alzheimer's, this is a baby step. Real progress in prevention and treatment has been disappointing. The costs of research are always a concern, but the costs of not finding better answers will be much higher.