Post by norbert1 on Feb 12, 2005 9:22:33 GMT -5
Why do doctors prescribe vitamin E to people with Alzheimers?
Why do doctors prescribe vitamin E to people with Alzheimers?
There were several studies on vitamin E which indicate it is helpful in delaying or slowing the progression of Alzheimers. The most widely cited study was The Alzheimers Disease Cooperative Study – the results are published in New England Journal of Medicine 1997; vol 336, pg 1216-1222. In the study they compared two anti-oxidants, vitamin E (a-topopherol) and Selegiline (Eldepryl) with a placebo. Both agents proved equally effective and delayed the time to a milestone/event of decline (such as nursing home placement) by an average of 7 months. Both agents helped equally well and the group of people taking both actually did slightly less well in their outcome, so it is not indicated to take both.
Selegiline is a MAO-A inhibitor that is used to treat Parkinson’s patients. It increases dopamine activity. It is a drug with side effects and has some expense, so it is not recommended as the anti-oxidant to be used for Alzheimers.
Vitamin E is very inexpensive with few side effects so it is the one recommended to be taken.
Vitamin E is very inexpensive with few side effects so it is the one recommended to be taken.
No one can explain exactly how vitamin E provides this benefit. The current theory is that the plaques that form in the brain cause damaging inflamation in adjacent nerve cells. The antioxidant properties of vitamin e are thought to slow the damage from the inflammation.
Note – this study shows a statistical benefit in delaying the progression - Vitamin E does not improve function that will be observed by the caregiver. (I know that some people have complained here in the past the vitamin E doesn’t seem to “help”.) Also- Deficits of Vitamin E have been associated with memory difficulties, but the doses used in Alzheimers are higher than needed just to treat a deficit.
Update –
In 2005, a retrospective study looked at the data from over a dozen previous studies involving Vitamin E. These studies had to do with normal healthy people who were taking vitamin E because it was supposed to have heart health benefits. It was found that people taking high doses of Vit. E had a slightly higher death rate. (Part of this may be do to the known interference with blood clotting .) Vitamin E is no longer recommended to be taken as a preventative health measure.
Dementia doctors have reacted to this in one of three ways:
1) Dementia doctors feel that the benefit of vitamin E for a person with Alzheimers outweighs the slight risk demonstrated in this statistical analysis and continue to prescribe at high rates of 1000 or 2000 units per day.
2) Dementia doctors now prescribe at a level of 400 units once per day (or sometimes 2x per day) because the study showed very little increased risk at this level
3) Some doctors are not convinced of the value of vitamin E for Alzheimers because so few studies were done and they do not prescribe vitamin E.
Norbert
Information Aricept, Exelon and Reminyl
www.alz.org/documents/national/FS_cholinesteraseinhibtors.pdf
www.alz.org/national/documents/topicsheet_treatments.pdf
Information on Namenda
www.alz.org/Resources/TopicIndex/memantine.asp
Information on Vitamin E
www.alz.org/Resources/TopicIndex/vitaminE.asp
Why do doctors prescribe vitamin E to people with Alzheimers?
There were several studies on vitamin E which indicate it is helpful in delaying or slowing the progression of Alzheimers. The most widely cited study was The Alzheimers Disease Cooperative Study – the results are published in New England Journal of Medicine 1997; vol 336, pg 1216-1222. In the study they compared two anti-oxidants, vitamin E (a-topopherol) and Selegiline (Eldepryl) with a placebo. Both agents proved equally effective and delayed the time to a milestone/event of decline (such as nursing home placement) by an average of 7 months. Both agents helped equally well and the group of people taking both actually did slightly less well in their outcome, so it is not indicated to take both.
Selegiline is a MAO-A inhibitor that is used to treat Parkinson’s patients. It increases dopamine activity. It is a drug with side effects and has some expense, so it is not recommended as the anti-oxidant to be used for Alzheimers.
Vitamin E is very inexpensive with few side effects so it is the one recommended to be taken.
Vitamin E is very inexpensive with few side effects so it is the one recommended to be taken.
No one can explain exactly how vitamin E provides this benefit. The current theory is that the plaques that form in the brain cause damaging inflamation in adjacent nerve cells. The antioxidant properties of vitamin e are thought to slow the damage from the inflammation.
Note – this study shows a statistical benefit in delaying the progression - Vitamin E does not improve function that will be observed by the caregiver. (I know that some people have complained here in the past the vitamin E doesn’t seem to “help”.) Also- Deficits of Vitamin E have been associated with memory difficulties, but the doses used in Alzheimers are higher than needed just to treat a deficit.
Update –
In 2005, a retrospective study looked at the data from over a dozen previous studies involving Vitamin E. These studies had to do with normal healthy people who were taking vitamin E because it was supposed to have heart health benefits. It was found that people taking high doses of Vit. E had a slightly higher death rate. (Part of this may be do to the known interference with blood clotting .) Vitamin E is no longer recommended to be taken as a preventative health measure.
Dementia doctors have reacted to this in one of three ways:
1) Dementia doctors feel that the benefit of vitamin E for a person with Alzheimers outweighs the slight risk demonstrated in this statistical analysis and continue to prescribe at high rates of 1000 or 2000 units per day.
2) Dementia doctors now prescribe at a level of 400 units once per day (or sometimes 2x per day) because the study showed very little increased risk at this level
3) Some doctors are not convinced of the value of vitamin E for Alzheimers because so few studies were done and they do not prescribe vitamin E.
Norbert
Information Aricept, Exelon and Reminyl
www.alz.org/documents/national/FS_cholinesteraseinhibtors.pdf
www.alz.org/national/documents/topicsheet_treatments.pdf
Information on Namenda
www.alz.org/Resources/TopicIndex/memantine.asp
Information on Vitamin E
www.alz.org/Resources/TopicIndex/vitaminE.asp
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