May 4, 2009

By Megan Rauscher

NEW YORK (Reuters Health) - An analysis of "real-world" clinical data indicates that vitamin E, and drugs that reduce generalized inflammation, may slow the decline of mental and physical abilities in people with Alzheimer's disease (AD) over the long term.

"Our results are consistent for a potential benefit of vitamin E on slowing functional decline and a smaller possible benefit of anti-inflammatory medications on slowing cognitive decline in patients suffering from Alzheimer's disease," Dr. Alireza Atri told Reuters Health.

Atri, at Massachusetts General Hospital (MGH), the VA Bedford Medical Center, and Harvard Medical School, Boston, led the National Institutes of Health-sponsored research. The findings, reported at the annual meeting of the American Geriatrics Society in Chicago, stem from data on 540 patients treated at the MGH Memory Disorders Unit.

All of the patients were receiving standard-of-care treatment with a drug intended to help patients with Alzheimer's. As part of their clinical care, 208 patients also took vitamin E but no anti-inflammatory, 49 took an anti-inflammatory but no vitamin E, 177 took both vitamin E and an anti-inflammatory, and 106 took neither.

While the daily dose of vitamin E ranged from 200 to 2000 units, the majority of patients were given high doses that ranged from 800 units daily to 1000 units twice daily.

Each patient's performance on cognitive tests and their ability to carry out daily functions such as dressing and personal care were assessed every 6 months. After an average of 3 years, "there was a modest slowing of decline in function in those patients taking vitamin E," study investigator Michael R. Flaherty noted in a telephone interview with Reuters Health.

Flaherty, a second-year student at the University of New England College of Osteopathic Medicine in Biddeford, Maine, presented the findings at the meeting. He added that the treatment benefit from vitamin E was "small to medium" but increased with time.

Taking an anti-inflammatory medication was associated with "very consistent but generally only small effects on slowing long-term decline in cognitive functioning," Atri told Reuters Health.

However, in patients who took both vitamin E and anti-inflammatory medications, there appeared to be an additive effect in terms of slowing overall decline.

Given that past studies have produced equivocal results, the investigators conclude that further studies are needed to assess the long-term balance of risks versus benefits for people with Alzheimer's disease from taking vitamin E and anti-inflammatory drugs.

Thomson Reuters 2009