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Vitamin E and Alzheimer's - Previously On then Off, Now On Again?

 A new study on Vitamin E.: 

 A new study just reported in AMDA’s “Caring For The Ages”, 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 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 without improvement – survival in a black pit? Do we give the researcher’s an “A” for extending their suffering?

 

 June’s use of Vitamin E.:

 June and I were both taking 1000 IU’s of Vitamin E in the years preceding June’s diagnosis with Alzheimer’s in 1998. 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 other significant 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.

             June Berg in 1998.      (Photo below right is June in San Francisco one month after her diagnosis in 1998)

What are the implications to be found and considered in simple survival without quality of life? – and that is a hard 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 often 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 is at, having difficulty eating and swallowing, being incontinent, not being able to walk or talk - and the list goes on..........!

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