High daily doses of vitamin E seem to help people with Alzheimer's live on their own for about 7 months longer than untreated patients, scientists have found. Another drug, currently prescribed for Parkinson's disease, has a similar effect. But it isn't clear whether either treatment, reported in tomorrow's issue of The New England Journal of Medicine, delays the onset of symptoms.
In the past, researchers have monitored the deterioration of Alzheimer's patients using tests of memory and cognition. But Mary Sano, a neuroscientist at Columbia University College of Physicians and Surgeons, and her colleagues took a different approach: gauging the effect of two drugs on how well patients could take care of themselves. "We focused on outcomes that we think are important to patients and their families," she says. For 2 years, her team tracked the symptoms of 341 people who had been diagnosed 5 years earlier with moderately severe Alzheimer's disease. Each day, the patients swallowed either 2000 milligrams of vitamin E, 10 milligrams of selegiline, both medications, or neither.
None of the patients got better, but deterioration in the ability to eat, dress, or cook was 25% slower in those taking one or both drugs. On average, patients on the medication lasted about 220 days longer--for a total of about 21 months--before they developed severe dementia, lost their ability to perform daily living tasks, became institutionalized, or died. Surprisingly, the combination therapy was not as protective as vitamin E or selegiline alone. Both are thought to act as antioxidants, protecting nerve cells from charged molecules. "We believe there was some sparing of neurons," says co-author Leon Thal, a neuroscientist at the University of California, San Diego.
Experts are encouraged by the finding, but a bit perplexed. Because neither vitamin E nor selegiline seems to affect cognition, it's puzzling how these medications helped the patients, says David Drachman, a neurologist at the University of Massachusetts Medical Center in Worcester. "These results are preliminary," he cautions.