Vital Vitamin E
Antioxidant slows Alzheimer's disease
By Louisa C. Brinsmade
The cruelty of Alzheimer's disease is one of the hardest to fathom.
It strips people of their normal physical and mental functioning,
making them completely dependent on others. It destroys memory,
steals the ability to recognize loved ones, and eats away at identity
until entire lives have been erased.
Researchers are still unsure of its causes, although they do
know that Alzheimer's disease forms abnormal structures in the
brain called plaques and tangles and that these structures reduce
or block nerve connections, particularly in the area of the brain
that controls short-term memory. As the disease progresses, other
sections of the brain are also affected. Over several years, Alzheimer's
disease results in dementia, loss of coordination, and eventually
death. There is no cure for Alzheimer's disease, and only two
drugs approved by the Food and Drug Administration (FDA) -- tacrine
(Cognex) and donepezil (Aricept) -- are currently being prescribed
to slow it down (see sidebar). One unconventional medicine, however,
is gaining popularity in treating Alzheimer's: vitamin E (alpha-tocopherol),
a supplement normally taken orally for its antioxidant properties
and applied topically to improve skin tone and prevent scarring.
Scientists have learned that antioxidants may have a positive
effect on patients already suffering from Alzheimer's disease.
The New England Journal of Medicine reported on trial studies
at 35 hospitals and research centers on the effects of both vitamin
E and the Parkinson's-disease drug selegiline, also known for
its antioxidant properties. Although both drugs separately and
in combination had a beneficial effect, vitamin E, taken at a
high therapeutic dosage of 2,000 IU (international units) per
day, performed the best, actually slowing the progression of the
Why does vitamin E make a difference? Antioxidants work to counteract
the negative effects of "free radicals," or oxygen atoms missing
an electron, in the body. In seeking to complete their atomic
structure, free radicals attach themselves to healthy atoms, causing
a chemical reaction. Many scientists think this chemical reaction
can eventually lead to heart disease, cancer, or other illnesses.
For Alzheimer's patients, free radicals destroy brain cells, leading
to further loss of mental acuity.
Delaying the major milestones in the progression of the disease
-- the loss of ability to care for oneself, institutionalization,
and death -- could turn many doctors into vitamin E champions.
"Vitamin E for Alzheimer's has been advocated to help memory loss
by alternative-medicine practitioners for a long time," wrote
Norman L. Foster, M.D., an associate professor of neurology at
the University of Michigan Medical School who participated in
the trial, "but [before now] there has been no evidence to support
its use... Now we are going to start routinely recommending vitamin
E to our Alzheimer's patients."
Still, vitamin E is not a cure for the disease. Doctors at the
Mayo Clinic who also took part in the trial studies noted that
while vitamin E and selegiline detoxified free radicals and slowed
the progression of the disease, they did not improve the memory,
attention span, language skills, or comprehension of patients.
But researchers there have not been dissuaded from further study
on the issue. Along with more than 65 medical research institutions
in the United States and Canada, the Mayo Clinic will soon begin
trials on the cognitive benefits of antioxidants.
It is also important to note that a proper dosage of vitamin
E for Alzheimer's disease has not yet been determined and that
high dosages of vitamin E (2,000 IU is 200 times the recommended
daily allowance) can cause gastrointestinal problems and excess
bleeding due to the vitamin's anticlotting effects. It is important
that Alzheimer's patients talk to their doctor before beginning
any new treatment.
Treating Alzheimer's Disease
Two medications now have approval from the FDA for treatment
of Alzheimer's disease, but many new drugs are being studied,
both conventional and alternative. A list of the more common treatments
being examined is available here; contact your doctor or the Alzheimer's
Association chapter in your area for information on how to participate
in a study. You can also review the Alzheimer's Association website
These drugs act by preventing the breakdown of acetylcholine,
an essential neurotransmitter needed to relay messages in the
brain and to form new memories. Only the first two of the following
drugs are FDA-approved for the treatment of Alzheimer's disease.
The rest are still in trial studies, but participation in the
studies may be possible. Ask your doctor for information on access
to these new medications.
Rivastigmine, or ENA-713
The drug Arecoline is being tested in clinical trials for the
treatment of Alzheimer's disease. It acts to stimulate the acetylcholine
receptors, which in theory should make more of the essential neurotransmitter
available to the body. It has not been approved yet by the FDA
as treatment for Alzheimer's disease, but it may be possible to
participate in a study. Ask your physician for information on
access to this new medication.
Agents with antioxidant activity, such as vitamin E (alpha-tocopherol)
and the Parkinson's- disease drug selegiline (Eldepryl), may slow
the progression of Alzheimer's disease by fighting harmful free
radicals in the body, which attack and destroy healthy cells.
The Alzheimer's Disease Cooperative Study brought together 35
U.S. hospitals and research centers to test the effectiveness
of vitamin E and selegiline in Alzheimer's disease patients. Both
medications were shown to delay progression of the disease.
Estrogen may do a lot of things to slow down Alzheimer's disease.
The hormone may act as a modified anti-inflammatory agent, stimulate
the growth of brain neurons and make their connections healthier,
promote the natural production of acetylcholine, and convey antioxidant
effects. The Woman's Health Initiative Memory Study of Estrogen
is an ongoing study of women between the ages of 65 and 79 who
are eligible for hormone replacement therapy. Ask your doctor
for information on how to participate in this study.
Noting that rheumatoid arthritis patients have a lower incidence
of Alzheimer's disease, researchers have studied the connection
between nonsteroidal anti-inflammatory drugs (NSAIDs), such as
ibuprofen, and Alzheimer's disease. The research is encouraging
but not consistent; the FDA has not approved anti-inflammatory
agents for Alzheimer's disease treatment for that reason. Use
of NSAIDs for Alzheimer's disease should not be undertaken without
a physician's approval due to the risk of excess bleeding and
Calcium channel blockers
Calcium channel blockers, like nimodipine (Nimotop), are being
studied for their ability to prolong the survival of nerve cells,
but conclusive results are not yet available. Again, talk to your
doctor about the use of these drugs.
Is it Alzheimer's?
This is never an easy question to answer, but early intervention
can result in a better outcome for patients and their families.
Alzheimer's disease is difficult to diagnose because some early
signs may seem like ordinary consequences of aging. Over time,
however, Alzheimer's disease results in drastic physiological
and personality changes that are specific to the disorder. There
is no specific test for the disease; rather there are a series
of determinates such as blood tests, brain scans, and mental function
and neurological tests that together can indicate Alzheimer's
disease. The sooner a diagnosis is made the better, because early
treatment may help slow the progression of the disease. Here are
some helpful lists of warning signs visible throughout the stages
of Alzheimer's disease: http://www.alz.org
Loss of short-term memory
Inability to recall the names of familiar
people or common objects
Disruptions in daily routine
Lapses in personal hygiene and household
Inability to complete simple mental tasks
Disorientation with regard to time, month,
Trouble with decision making
Loss of interest in favorite pastimes
Trouble with daily chores -- washing,
shaving, eating, cooking, dressing
Tendency to misplace items
Increased difficulty recognizing close
friends and relatives
Illogical, unfocused conversations
Belligerent, emotional, sometimes violent
Restlessness and agitation in the late
afternoon (called sundowning)
Difficulty walking, loss of dexterity
Extreme hostility, aggression, and violent
Inability to take care of oneself
Loss of muscular control
Loss of all memory and speech