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Vitamin E and Alzheimer's

 A new study of Vitamin E.:

A study just reported in AMDA’s “Caring For The Ages”, now finds that Vitamin E aids in improved survival for Alzheimer’s. This is a study of 847 patients seen between 1990 and 2004 at Baylor College of Medicine in Houston, Texas. “For those receiving vitamin E, (2000 IU) with or without a cholinesterase inhibitor, there was a 26% reduction in risk of dying during the study compared with those not taking vitamin E.” These were all patients with Alzheimer’s disease.

 Prior History: 

 In 1997 a study indicated that vitamin E at doses of 2000 IU a day appeared to slow the disease progression of Alzheimer’s. As a result of this study, the prescribing of Vitamin E gained popularity.

 This approach however fell into disfavor in 2005, when a meta-analysis of 19 randomized controlled trials found that vitamin E supplements at doses greater than 400 IU a day for a least a year was associated with increased all cause mortality. (Reported in Ann.Intern. Med. 2005;142:37-46) Another 2005 double blind study found no effect of vitamin E on the development of Alzheimer’s in 769 participants with mild cognitive impairment. 

Dr. Pavlik one of the investigators in the Baylor study distinguishes between their study and the former meta-analysis studies in that in the meta-analysis studies the vitamin E was not being used for treatment as it was in the Baylor patients. What difference this fact would make is hard to understand.

 So where are we really at with Vitamin E. and Alzheimer’s and what has been accomplished? 

The following assessment of the future use of Vitamin E for Alzheimer’s treatment based on current data is offered by Dr. David Smith, DO CMD, a Texas Physician and Medical Director: “I don’t recommend vitamin E for Alzheimer’s disease patients, as there is no data suggesting it has a significant role in slowing the disease or associated dementia. However, this study is reassuring that we aren’t doing any harm when we give it to patients who ask for it or when family members request if for a loved one.”

If this is true, then what has really been accomplished by extending the survival time – survival in a black pit? Do we give the researcher’s an “A” for extending their suffering? 

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10 January  2014How many times are we going to beat a dead horse…this is the umpteenth time that Vitamin E has been dusted off and proposed as a solution for something it has previously been found to come up short on…and here we go again…a simple vitamin is not going to be the solution to a complex problem of Alzheimer’s dementia diseases…we need a cure not a bunch of band aids of questionable and little value…and the same dreary story continues on…

“Taking high doses of vitamin E appears to help people in all stages of Alzheimer’s disease, a new study suggests. Research a decade ago showed that vitamin E was helpful in late-stage Alzheimer’s disease. Now a study published Tuesday by the Journal of the American Medical Association finds the benefits extend to people with mild to moderate forms of the disease. ”This looks very promising,” said lead researcher Mary Sano, director of the Alzheimer’s Disease Research Center at the James J. Peters VA Medical Center, and the Icahn School of Medicine at Mount Sinai, both in New York City. Vitamin E is far from a cure, only somewhat improving functional activities such as planning and organizing, the study found. But it did allow trial participants, who were studied for an average of more than two years, to get less help from caregivers and therefore retain more independence longer. ”It’s not something where you must do this, it’s going to make all the difference,” said Rachelle Doody, director of the Alzheimer’s Disease and Memory Disorders Center at Baylor College of Medicine in Houston. But Doody, who was not involved in the current study, said she thinks it’s worthwhile for most Alzheimer’s patients, in consultation with their doctor, to take 2,000 IU of vitamin E per day.

That amount far exceeds the government’s recommended dose for healthy adults, which is 22.4 IU or 15 mg per day. There is no indication that high doses of vitamin E help healthy adults, and research shows an increased risk of death with such high doses, particularly for people with congestive heart failure. That’s why Heather Snyder, Director of Medical & Scientific Relations at the Alzheimer’s Association, thinks that people with mild to moderate Alzheimer’s should wait for more research before jumping to add vitamin E to their pill box. The new study looked at patients in the Veteran’s Affairs system, so they were virtually all male. It’s not yet clear, Snyder said, that the benefits of vitamin E will be true for women as well. It’s also unclear why high doses of vitamin E would help people with Alzheimer’s, Snyder said, so the Alzheimer’s Association is funding research to uncover a possible mechanism…"

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(The below right photo of June was taken in San Francisco in February 1998 just one month after diagnosis.)

June in San Francisco 1998 June’s use of Vitamin E. 

June and I both were taking 1000 IU’s of Vitamin E. in the years preceding June’s diagnosis with Alzheimer’s in 1998. Her first symptoms were noted in 1997. Because of the recommendations based on the earlier studies and the concurrence of Mayo Clinic, we continued with the Vitamin E following her diagnosis. Later however, because June had a bruising problem and Vitamin E was associated with blood thinning, her daily intake was reduced to 400 IU. When the later studies suggested increased mortality with doses of vitamin E over 400 IU and no significant other health benefits, June’s use of Vitamin E. was discontinued in the year 2006. My usage was discontinued shortly thereafter. June has had a significantly longer than average survival since her diagnosis with Alzheimer’s. The average survival after diagnosis is said to be 8 years. June has completed 10 plus years since diagnosis. (January 1998- January 2008) June is presently in the late/final stages of Alzheimer’s. What part June’s many years on Vitamin E has played in this extended survival time may never be known.

What are the implications to be found and considered in simple survival without quality of life – and that is a hard cold fact that cannot be ignored in the late and final stages. Where is the morality in all of this? As I arrive and as I leave June each of the days that I spend with her, my mind is engulfed in emotions and grief as I think of how June was and how she is now. I visualize what her life must be like, lying motionless, with eyes closed, or when partially open, staring straight ahead, not recognizing people about her, being frightened when she has to cough, waking at night in a darkened room not knowing where she is at, having difficulty eating and swallowing, being incontinent, not being able to walk or talk - and the list goes on........!

 

Final Note: On October 23rd, 2008 June passed away after almost twelve years of an exhausting battle with Alzheimer’s. June's last three years and 8 plus months were in an Alzheimer’s facility. Her last years were at the Alzheimer’s “Villa” of the Benedictine Health Care Center of Innsbruck, New Brighton, MN. See the funeral notice as published in the Minneapolis Star - Tribune. It is located on the top blue navigation strip under the label: “In Memoriam”. Click on:

 

June K. (Rolstad) Berg – In Memoriam”.