Vitamin E Slows Functional Decline in Alzheimer Patients

January 3, 2014

Vitamin E given daily was effective in slowing patients’ functional decline and in reducing caregiver time.

In patients with mild to moderate Alzheimer disease, 2000 IU of vitamin E given daily was effective in slowing patients’ functional decline and in reducing caregiver time, according to a recent study.

There were no significant differences in the groups receiving memantine alone or memantine plus vitamin E (alpha tocopherol).

Dysken and colleagues at Minneapolis VA Health Care System, Minneapolis, and other centers sought to determine whether alpha tocopherol, memantine, or both slow progression of mild to moderate Alzheimer disease in patients who were receiving an acetylcholinesterase inhibitor. They conducted a double-blind, placebo-controlled, parallel-group, randomized clinical trial that involved 613 patients at 14 Veterans Affairs medical centers. Patients received 2000 IU/d of alpha tocopherol, 20 mg/d of memantin, the combination, or placebo.

The main outcome was the Alzheimer’s Disease Cooperative Study/Activities of Daily Living (ADCS-ADL) Inventory score (range, 0 to 78). Cognitive, neuropsychiatric, functional, and caregiver measures were secondary outcomes.

ADCS-ADL Inventory scores declined by 3.15 units less in the alpha tocopherol group compared with the placebo group. In the memantine group, the scores declined 1.98 units less than the placebo group scores. The change in the alpha tocopherol group translates into a delay in clinical progression of 19% per year compared with placebo or a delay of about 6.2 months over the 2.3-year follow-up period.

Caregiver time increased least in the alpha tocopherol group. All-cause mortality and safety analyses showed a difference only on the serious adverse event of “infections or infestations”; frequencies were greater in the memantine and combination groups than with placebo.

The authors noted that although vitamin E and memantine have been shown to have beneficial effects in moderately severe Alzheimer disease, evidence is limited in mild to moderate disease.

The study appeared in the January 1 issue of the Journal of the American Medical Association.