People of retirement age who took supplements of both vitamin E and C daily saw their risk of Alzheimer's disease plummet by almost 70 per cent, studies show.

A population-based study of antioxidants, appearing in the Journal of the American Medical Association (JAMA), suggests that a diet rich in foods containing vitamin E may help protect some people against Alzheimer's disease (AD). The study is also noteworthy for its finding that vitamin E in the form of supplements was not associated with a reduction in the risk of AD. 1

The JAMA study was conducted by Martha Clare Morris, Sc.D., of the Rush Institute for Healthy Aging at Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL, Denis A. Evans, M.D., and colleagues. A related study by Morris and colleagues, in the July 2002 Archives of Neurology, a JAMA publication, also associates vitamin E with protection against more general cognitive decline. Both studies were supported by the National Institute on Aging (NIA) at the National Institutes of Health.

The June 26 issue of JAMA includes similar findings from scientists in The Netherlands, who also reported a link between high dietary intake of vitamins C and E and protection against AD in certain people. In addition, the journal contains an editorial on the epidemiological study of dietary intake of antioxidants and the risk of AD by Daniel J. Foley, M.S., of the NIA's Laboratory of Epidemiology, Demography, and Biometry, and Lon White, M.D., Pacific Health Research Institute, Honolulu.

"This and a number of important population studies have pointed to vitamin E as possibly protective against oxidative damage or other mechanisms associated with cognitive decline and dementia,” says Neil Buckholtz, Ph.D., head of the Dementias of Aging Branch at the NIA. "The only way this association can really be tested is through clinical studies and trials now underway. These will help us determine whether vitamin E in food or in supplements – or taken together – can prevent or slow down the development of mild cognitive impairment or AD.” 

The Morris study included participant age 65 and older and free of dementia at the start of the study. They were followed for an average of 3.9 years. At an average of 1.7 years from their baseline assessment, participants completed a questionnaire, asking them in detail about the kinds and quantities of foods consumed in the previous year.

Some 131 participants had been diagnosed with AD by the end of the study period, when researchers examined the relationship between intake of antioxidants, including dietary and supplemental vitamins E and C, beta carotene, and a multivitamin, and development of AD. The most significant protective effect was found among people in the top fifth of dietary vitamin E intake (averaging 11.4 IU/d), whose risk of AD was 67 percent lower when compared to people in the group with the lowest vitamin E consumption from food (averaging 6.2 IU/d). (The recommended dietary allowance of vitamin E is 22 IU/d.)

No significant change in risk of AD was found when the scientists looked at vitamin E supplements, the other antioxidants and their supplements, or a general multivitamin. There was some evidence, though not statistically significant, that increased intake of dietary vitamin C and beta carotene was moving in a "protective direction,” the researchers said.

The data were also analyzed to see if age, gender, race, education, or possible genetic risk for AD would influence the findings. Only the presence or lack of apoE-4, one form of a protein associated with increased risk of late-onset AD, seemed to matter: the protective effect of vitamin E from food was strongest among people who did not have the apoE-4 risk factor allele. "Dietary vitamin E may protect against Alzheimer's disease,” says Morris, "but the protection may only occur among people without the apoE-4 allele.”

Morris suggests that further study in key areas is needed to confirm and explain some of the study's findings, including the link with apoE status and the study's striking distinction between dietary intake of vitamin E and use of supplements. For example, the lack of a protective effect for the supplements could be explained by several factors

Some participants in the study started taking supplements only recently and there may not have been sufficient time for the supplement to be found effective. Also, people who believe they have memory problems could be more likely to take the supplements in the first place. Another possible explanation might be variations in the forms of vitamin E, scientists note. Most vitamin E supplements consist of alpha tocopherol while foods are generally more rich in gamma tocopherol.

 

References:
1. The American Society for Nutrition J. Nutr. 137:186S-193S, January 2007