A cheap daily dose of vitamin E may slow mental decline for people with mild to moderate forms of Alzheimer’s disease, lowering requirements for caregiving.

Investigators with the Veterans Administration (VA) found more evidence in a clinical trial supporting the power of vitamin E in preserving mental functioning among the elderly. Among 614 patients followed in the study, those taking high daily doses of vitamin E experienced less decline than others, including patients taking lower doses of the vitamin or 20 mg/d of memantine, a new medication intended to reduce memory loss in Alzheimer’s patients.

After two years or so, patients taking the vitamin scored 19 percent higher on a standard test of mental functioning, gaining a reprieve from disease progression of more than six months on average. Moreover, those patients required approximately two hours fewer per day from a caregiver, living more independently.

“In the current study, the placebo group lost approximately three units more on the [psychological] inventory than the [other group],” lead investigator Maurice W. Dysken wrote in a paper published Tuesday. “A loss of this magnitude could translate into either the complete loss of being able to dress or bath independently, for example, or losing independence on any three different [tests].”

Essentially, patients gained significant medical benefits from an inexpensive over-the-counter treatment: Alpha tocopherol, a fat-soluble vitamin E and antioxidant. Although past work has shown the efficacy of vitamin E — and memantine — on patients with moderately severe Alzheimer’s, the study was the first to examine the vitamin’s power in this particular demographic. It was also one of the largest to study the effects of vitamin E in general.

Dysken says the study contradicts a 2005 review of studies showing that high-dose vitamin E, at greater than 400 IU per day, increased risk of death. “In contrast to the conclusion drawn, which showed that high-dose vitamin E may increase the risk of all-cause mortality, we found no significant increase in mortality with vitamin E.”

By contrast, those who received memantine experienced a 9.4 percent yearly death rate, compared to 7.3 percent for those taking neither vitamin E nor the new Alzheimer’s drug. Yet, not everyone’s sold on the idea. In an an editorial accompanying the paper, Denis A. Evans of Rush University Medical Center, praised the study for its size, duration, and non-commercial incentives.

“However, as with almost all previous [Alzheimer’s trials, the therapeutic effect seen was modest and more relevant to AD symptoms and consequences than to reversal of the disease process,” he wrote. “The importance of treating patients with AD is clear, but finding the best balance between treatment and prevention efforts is challenging for this grim disease affecting millions of people from all developed countries."

Given the difficulty of treating later-stage Alzheimer’s, Evans says researchers should marshal resources to focus on prevention.

Source: Dysken MD. Use Of Vitamin E By Patients With Mild To Moderate Alzheimer Disease Slows Functional Decline. JAMA. 2013.