New Clinical Trial of Vitamin E Published in JAMA
On Jan. 1, 2014, the Journal of the American Medical Association (JAMA) will publish online an article describing the results of a clinical trial of vitamin E and memantine in people with mild-to-moderate Alzheimer’s disease — according to the authors, it is the first study to show a benefit for vitamin E in mild-to-moderate Alzheimer’s. A previous study found some benefits for vitamin E in people with severe Alzheimer’s disease dementia.
In this trial, over the average follow-up time of 2.3 years, participants receiving vitamin E had slower functional decline than those receiving placebo, with the annual rate of decline reduced by almost 20 percent. Functional decline includes problems with daily activities such as shopping, preparing meals, bathing, eating, planning and traveling. No benefits were seen on any cognitive tests, which assess changes in thinking and memory. It is unclear why there were functional but not cognitive benefits of this intervention. The lack of cognitive benefit emphasizes the need for replication and confirmation of these results.
Neither memantine nor the combination of vitamin E and memantine showed functional or cognitive benefits in this trial.
The results of this clinical trial are positive enough to warrant more research to replicate and confirm the results, but the position of the Alzheimer’s Association is that current medical practice should not change based on this study. No one should take vitamin E for Alzheimer’s except under the supervision of a physician.
While these results are encouraging, we remain cautious because studies have shown high dose vitamin E may increase risk of death, particularly in those with cardiovascular disease. In addition, taking vitamin E may interact negatively with certain medications, for example, blood thinners, cholesterol lowering treatments and antidepressants. Many people with Alzheimer’s also have other health conditions that require treatment, such as heart disease.
Alzheimer’s Association Involvement
At this time, we do not know why or how vitamin E might have an effect on people with Alzheimer’s. The Alzheimer’s Association has funded several studies to examine this question further. For example, the Association awarded a 2011 New Investigator Research Grant to Dr. Ramit Ravona-Springer to examine how vitamin E may protect the brain from oxidative stress and cognitive decline. The research team will study the potential therapeutic qualities of different forms of vitamin E and assess whether certain individuals will benefit more than others from the vitamin.
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