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Alzheimer’s Disease and Vitamin E

by Jason Poquette, BPharm, R.Ph.

Alzheimer’s disease (AD), first described by German physician Alois Alzheimer in 1906 and so named in 1910, is a degenerative condition causing progressive memory loss affecting over 5 million patients in the U.S.  Incidents of Alzheimer’s disease rise with age, and with the number of individuals aged 65 years or older expected to double over the next 40 years, prevention and treatment are a growing concern.  To date there are only a small handful of prescription medications approved to treat Alzheimer’s disease, but a recently published study might offer new hope in the near future. 

The study, just published in the Journal of the American Medical Association (JAMA), looked at the effectiveness of high dose Vitamin E on slowing down the progression of mild to moderate forms of AD.  The results were promising, though further studies will undoubtedly need to follow.  The participants, mostly male, who took Vitamin E showed a statistically significant difference in the rate of their decline when compared to placebo or to the prescription drug memantine (Namenda®).  Reports of this discovery hit the health pages of many major newspapers across the country.  As a pharmacist, I thought it might be appropriate to offer a brief review of Vitamin E and some thoughts on this study.

Vitamin E

Vitamin E is a fat-soluble naturally occurring vitamin with antioxidant properties.  We don’t actually need very much.  The recommended daily allowance for Vitamin E is only15mg.  Dietary sources include nuts (like almonds or hazelnuts), seeds (especially sunflower seeds) and vegetable oils (wheat germ oil has the most).  Green leafy vegetables like spinach and broccoli are also reasonably good sources of Vitamin E.  

True deficiency in Vitamin E is rare, as most individuals get sufficient quantities from food sources to satisfy their daily requirements.  Patients with difficulty absorbing fats, Crohn’s disease, cystic fibrosis or chronic diarrhea may need vitamin E supplementation.  Symptoms of deficiency in Vitamin E could include neuropathy (a dysfunction of the nerves, including numbness or weakness), retinopathy (visual impairment) or a compromised immune system. 

Vitamin E has historically suffered from mixed reviews with respect to scientific studies for its health benefits.  For example, one study suggests a benefit for preventing heart disease, another suggests a danger associated with prostate cancer, and yet another study seems to show no effects at all.  Several years ago some fairly strong data emerged suggesting Vitamin E at doses greater than 400IU daily increased overall risks for mortality.  Such is the nature of this kind of research.  After 20 years of following this type of information, I’ve learned not to get my hopes up too quickly.  But this study about delaying the progression of cognitive impairment was at least encouraging, if not conclusive.

The Study

The study published in JAMA followed 600 patients for 5 years.  Those taking Vitamin E had a 19% slower rate of decline than that seen in other groups.  However, they used much higher doses of Vitamin E than are typically recommended (2,000IU daily to be exact).  Such high doses should not be taken without the advice of a physician.

Patients concerned about prevention or slowing the progression of AD should talk to their doctors.  It may be appropriate to consider a lower dose Vitamin E (< 400IU/d) supplement, understanding that we don’t have the scientific evidence yet to really guarantee its usefulness.  For those persuaded that antioxidants might be the key, consider food sources such as blueberries, kidney beans, raspberries and pecans.  Finally, physical exercise is still one of the best approaches to help support our brain health and slow down mental decline. 

Jason Poquette, BPharm, R.Ph, is a practicing pharmacist who lives in Whitinsville. His columns comment on drugs and pharmaceutical issues in the news. He maintains a blog at  www.TheHonest