Daily supplementation with antioxidants, vitamins E and C, and alpha acid, did not improve memory function in patients with Alzheimer?s disease, according to a new study.
Daily supplementation with antioxidants, vitamins E and C, and alpha acid (ALA), did not improve memory function in patients with Alzheimer’s disease (AD), according to a new study.
In fact, researchers who conducted the study, published in the Archives of Neurology, noted a faster decline as measured with the Mini-Mental State Examination (MMSE).
“Antioxidant randomized clinical trials in AD have had mixed results,” stated the researchers, led by Douglas Galasko, MD, from the University of California, San Diego. “We hypothesized that if antioxidant treatment affects key pathogenic mechanisms in patients with AD, this would be reflected by cerebrospinal fluid (CSF) biomarker changes.”
The researchers randomly assigned 78 patients with mild-to-moderate Alzheimer's disease, seen at 12 different medical centers, to 1 of 3 different supplement groups:
A daily combination of vitamin C (500 mg/d), vitamin E (800 IU/d), and ALA (900 mg/d) administered 3 times per day.
Coenzyme Q (CoQ; 400 mg) 3 times per day.
Placebo administered 3 times per day.
The primary outcome measures were levels of 4 biochemical markers measured in CSF: Aβ42, a 42–amino acid peptide that leads to plaques on the brain of patients with AD; tau and tau phosphorylated (P-tau), which relate to neuron damage; and F2-isoprostane levels, which relates to oxidative damage to the central nervous system.
The researchers comparatively assessed cognition with the MMSE at baseline and 16 weeks as well as functional abilities rated by an informant interview using the ADCS Activities of Daily Living Scale (ADCS-ADL).
They found that patients taking vitamins E and C and ALA showed greater decline in cognitive abilities compared to patients taking placebo. Patients taking vitamins E and C and ALA showed a small but significant mean 19% decrease from baseline in levels of F2-isoprostane, suggesting a decrease in oxidative stress in the brain.
The researchers also noted that it is not clear whether this small reduction could have any clinical impact in AD. There was no change for patients taking CoQ or placebo. And the combination of vitamins E and C and ALA did not affect CSF biomarkers related to Aβ, tau, or P-tau.
“Increased decline on the MMSE and a trend in this direction on the ADCS-ADL in the E/C/ALA group raises a concern that this combination could adversely affect cognition in AD,” the researchers wrote.
“The lack of correlation of changes in these measures with changes in CSF biomarkers suggests that the cognitive changes may not be due to worsening of AD-related pathology. Although a mechanism is uncertain, this cognitive finding raises a caution and will need to be carefully monitored if longer-term studies are planned.”
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.