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From the Honolulu–Asia Aging Study (Drs. Masaki, Petrovitch, and White), Kuakini Medical Center, Honolulu, HI; the Division of Geriatric Medicine (Drs. Masaki, Petrovitch, and Ross), University of Hawaii, John A. Burns School of Medicine, Honolulu, HI; the Epidemiology, Demography, and Biometry Program (Drs. Izmirlian, Havlik, and White, and K. Losonczy and D. Foley), National Institute on Aging, National Institutes of Health, Bethesda, MD; and the Department of Veteran’s Affairs (Dr. Ross), Honolulu, HI.
Address correspondence and reprint requests to Dr. Kamal H. Masaki, The Honolulu Heart Program, 347 North Kuakini Street, HPM 9, Honolulu, HI 96817; e-mail: kamal{at}hhp2.hawaii-health.com
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.
Key words: Dementia—Vitamin E—Vitamin C—Aged (more than 60 years of age)—Japanese-Americans—Men.
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