Association of vitamin E and C supplement use with cognitive function and dementia in elderly men

Objective: To determine whether use of vitamin E and C supplements protects against subsequent development of dementia and poor cognitive functioning. Methods: The Honolulu–Asia Aging Study is a longitudinal study of Japanese-American men living in Hawaii. Data for this study were obtained from a subsample of the cohort interviewed in 1982, and from the entire cohort from a mailed questionnaire in 1988 and the dementia prevalence survey in 1991 to 1993. The subjects included 3,385 men, age 71 to 93 years, whose use of vitamin E and C supplements had been ascertained previously. Cognitive performance was assessed with the Cognitive Abilities Screening Instrument, and subjects were stratified into four groups: low, low normal, mid normal, and high normal. For the dementia analyses, subjects were divided into five mutually exclusive groups: AD (n = 47), vascular dementia (n = 35), mixed/other types of dementia (n = 50), low cognitive test scorers without diagnosed dementia (n = 254), and cognitively intact (n = 2,999; reference). Results: In a multivariate model controlling for other factors, a significant protective effect was found for vascular dementia in men who had reported taking both vitamin E and C supplements in 1988 (odds ratio [OR], 0.12; 95% CI, 0.02 to 0.88). They were also protected against mixed/other dementia (OR, 0.31; 95% CI, 0.11 to 0.89). No protective effect was found for Alzheimer’s dementia (OR, 1.81; 95% CI, 0.91 to 3.62). Among those without dementia, use of either vitamin E or C supplements alone in 1988 was associated significantly with better cognitive test performance at the 1991 to 1993 examination (OR, 1.25; 95% CI, 1.04 to 1.50), and use of both vitamin E and C together had borderline significance (OR, 1.18; 95% CI, 0.995 to 1.39). Conclusions: These results suggest that vitamin E and C supplements may protect against vascular dementia and may improve cognitive function in late life.

[1]  W. Jagust,et al.  Clinical criteria for the diagnosis of vascular dementia: a multicenter study of comparability and interrater reliability. , 2000, Archives of neurology.

[2]  C. Berr.  [Epidemiology of Alzheimer's disease]. , 1999, Servir.

[3]  C. Bouras,et al.  Sensitivity and specificity of newly proposed clinical criteria for possible vascular dementia , 1997, Neurology.

[4]  P Woodbury,et al.  A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. , 1997, The New England journal of medicine.

[5]  M. Mattson,et al.  A Role for 4‐Hydroxynonenal, an Aldehydic Product of Lipid Peroxidation, in Disruption of Ion Homeostasis and Neuronal Death Induced by Amyloid β‐Peptide , 1997, Journal of neurochemistry.

[6]  D J Foley,et al.  Prevalence of dementia in older Japanese-American men in Hawaii: The Honolulu-Asia Aging Study. , 1996, JAMA.

[7]  T. Harris,et al.  Vitamin E and vitamin C supplement use and risk of all-cause and coronary heart disease mortality in older persons: the Established Populations for Epidemiologic Studies of the Elderly. , 1996, The American journal of clinical nutrition.

[8]  M. Brown,et al.  A Randomised Controlled Trial of Vitamin E in Patients with Coronary Disease: The Cambridge Heart Antioxidant Study (CHAOS) , 1996 .

[9]  A. Folsom,et al.  Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. , 1996, The New England journal of medicine.

[10]  J. Fraumeni,et al.  Lowered risks of hypertension and cerebrovascular disease after vitamin/mineral supplementation: the Linxian Nutrition Intervention Trial. , 1996, American journal of epidemiology.

[11]  D. Albanes,et al.  Effect of vitamin E and beta carotene on the incidence of angina pectoris. A randomized, double-blind, controlled trial. , 1996, JAMA.

[12]  R. Havlik,et al.  The association between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study. , 1995, JAMA.

[13]  M. Steiner,et al.  Vitamin E plus aspirin compared with aspirin alone in patients with transient ischemic attacks. , 1995, The American journal of clinical nutrition.

[14]  J. Blumberg,et al.  Influence of combined antioxidant nutrient intakes on their plasma concentrations in an elderly population. , 1995, The American journal of clinical nutrition.

[15]  G. Heiss,et al.  Dietary antioxidants and carotid artery wall thickness. The ARIC Study. Atherosclerosis Risk in Communities Study. , 1995, Circulation.

[16]  G. Benzi,et al.  Are reactive oxygen species involved in Alzheimer's disease? , 1995, Neurobiology of Aging.

[17]  M. Meydani.  Vitamin E , 1995, The Lancet.

[18]  B. Frei.  Reactive oxygen species and antioxidant vitamins: mechanisms of action. , 1994, The American journal of medicine.

[19]  J. Gaziano.  Antioxidant vitamins and coronary artery disease risk. , 1994, The American journal of medicine.

[20]  K. Davis,et al.  Inflammatory mechanisms in Alzheimer's disease: implications for therapy. , 1994, The American journal of psychiatry.

[21]  Satoshi Takahashi,et al.  Concentrations of α-tocopherol and its quinone derivative in cerebrospinal fluid from patients with vascular dementia of the Binswanger type and Alzheimer type dementia , 1994, Neuroscience Letters.

[22]  E. Teng,et al.  The Cognitive Abilities Screening Instrument (CASI): A Practical Test for Cross-Cultural Epidemiological Studies of Dementia , 1994, International Psychogeriatrics.

[23]  A. C. Chan.  Partners in defense, vitamin E and vitamin C. , 1993, Canadian journal of physiology and pharmacology.

[24]  Barry Halliwell,et al.  Reactive Oxygen Species and the Central Nervous System , 1992, Journal of neurochemistry.

[25]  G. Cole,et al.  Vitamin E protects nerve cells from amyloid βprotein toxicity , 1992 .

[26]  W. Jagust,et al.  Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers , 1992, Neurology.

[27]  P. Frost,et al.  Plasma concentrations of vitamins A and E and carotenoids in Alzheimer's disease. , 1992, Age and ageing.

[28]  R. D'Agostino,et al.  Prevalence of dementia and probable senile dementia of the Alzheimer type in the Framingham Study , 1992, Neurology.

[29]  J. Kelleher.  Vitamin E and the immune response , 1991, Proceedings of the Nutrition Society.

[30]  R. Heatley,et al.  The effect of dietary supplementation with vitamins A, C and E on cell-mediated immune function in elderly long-stay patients: a randomized controlled trial. , 1991, Age and ageing.

[31]  N Butters,et al.  Detection of abnormal memory decline in mild cases of Alzheimer's disease using CERAD neuropsychological measures. , 1991, Archives of neurology.

[32]  P. Wolf,et al.  Black-white differences in stroke incidence in a national sample. The contribution of hypertension and diabetes mellitus. , 1990, JAMA.

[33]  P. Crino,et al.  Involvement of free radicals in dementia of the Alzheimer type: A hypothesis , 1990, Neurobiology of Aging.

[34]  K. Kogure,et al.  Protective effect of α-tocopherol on ischemic neuronal damage in the gerbil hippocampus , 1990, Brain Research.

[35]  M. Albert,et al.  Prevalence of Alzheimer's disease in a community population of older persons. Higher than previously reported. , 1989, JAMA.

[36]  J. Morris,et al.  The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neuropsychological assesment of Alzheimer's disease , 1989, Neurology.

[37]  H. Sies,et al.  The protection by ascorbate and glutathione against microsomal lipid peroxidation is dependent on vitamin E. , 1988, European journal of biochemistry.

[38]  M. Steiner,et al.  Reduction of platelet adhesiveness by vitamin E supplementation in humans. , 1988, Thrombosis research.

[39]  Anthony F. Jorm,et al.  The prevalence of dementia: A quantitative integration of the literature , 1987, Acta psychiatrica Scandinavica.

[40]  L. Heilbrun,et al.  The origins of epidemiologic studies of heart disease, cancer and osteoporosis among Hawaii Japanese. , 1985, Hawaii medical journal.

[41]  R. Busto,et al.  Postischemic Cerebral Lipid Peroxidation In Vitro: Modification by Dietary Vitamin E , 1985, Journal of neurochemistry.

[42]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.

[43]  Margo J. Anderson,et al.  The Census , 1921, The Hospital.

[44]  A. Kagan.  The Honolulu heart program : an epidemiological study of coronary heart disease and stroke , 1996 .

[45]  T. Wetterling,et al.  Comparison of different diagnostic criteria for vascular dementia (ADDTC, DSM-IV, ICD-10, NINDS-AIREN). , 1996, Stroke.

[46]  D. Sgoutas,et al.  Combination of vitamins C and E alters the response to coronary balloon injury in the pig. , 1995, Arteriosclerosis, thrombosis, and vascular biology.

[47]  C. Jeandel,et al.  Lipid peroxidation and free radical scavengers in Alzheimer's disease. , 1989, Gerontology.