Functional decline, measured as the loss of ability to accomplish activities of daily living, such as bathing and dressing, planning or cooking a meal, and paying bills, is the major symptom in individuals with Alzheimer’s disease and the primary source of caregiver burden. Yet, few studies have focused on ways to slow this functional decline.
In a recently published study in The Journal of the American Medical Association, researchers, co-led by an investigator from Icahn School of Medicine at Mount Sinai, reported that vitamin E, also known as alpha tocopherol, reduced functional decline in patients with mild-to-moderate Alzheimer’s disease.
The findings come from a clinical trial that involved several hundred participants at 14 Veterans Affairs medical centers across the country, who were also taking currently approved medications for Alzheimer’s disease, and spanned up to four years in duration. The study also showed significantly fewer deaths in the vitamin E group.
“There has been little to offer patients with mild-to-moderate dementia since a new class of drugs was introduced in the 1990s,” says Mary Sano, PhD, the trial’s co-investigator. “This trial revealed that vitamin E delays progression of functional decline by 19 percent per year, which can translate to a 6.2-month benefit.” Dr. Sano is Associate Dean for Clinical Research and Professor of Psychiatry at Icahn School of Medicine, Director of Mount Sinai’s Alzheimer’s Disease Research Center, and Director of Research at the James J. Peters VA Medical Center in the Bronx, New York. The findings were consistent with an earlier study led by Dr. Sano that revealed a similar delay in functional decline in moderately severe Alzheimer’s patients. No added benefit in memory or cognition was seen in either study.
Specifically, researchers investigated the effectiveness of 2,000 IU daily of alpha tocopherol alone, and in combination with memantine, a commonly prescribed drug for Alzheimer’s marketed as Namenda® and approved only for moderate-to-severe Alzheimer’s disease. The study also evaluated memantine alone and a placebo. Only the group using alpha tocopherol experienced results of slower functional decline. It was the first large-scale clinical trial to assess not only the effectiveness of alpha tocopherol in patients with mild-to-moderate Alzheimer’s disease, but also in combination with memantine.
“The delay in functional decline also translated to a reduction of an estimated two hours of caregiver time per day, which has the potential, after further research, to have a major effect on informal and direct medical care costs,” says Dr. Sano. “Maintaining the ability to perform activities of daily living is very relevant to patients and to caregivers.”