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March 28, 2000

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

March 28, 2000 issue
54 (6) 1265-1272

Abstract

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.

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References

1.
Jorm AF, Korten AE, Henderson AS. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand 1987;76:465–479.
2.
Bachman DL, Wolf PA, Linn R, et al. Prevalence of dementia and probable senile dementia of the Alzheimer type in the Framingham Study. Neurology 1992;42:115–119.
3.
White L, Petrovitch H, Ross GW, et al. Prevalence of dementia in older Japanese-American men in Hawaii: the Honolulu–Asia Aging Study. JAMA 1996;276:955–960.
4.
Breteler MBM, Claus JJ, van Duijin CM, Launer LJ, Hofman A. Epidemiology of Alzheimer’s disease. Epidemiol Rev 1992;14:59–82.
5.
Evans DA, Funkenstein HH, Albert MS, et al. Prevalence of Alzheimer’s disease in a community population of older persons: higher than previously reported. JAMA 1989;262:2551–2556.
6.
U.S. Bureau of the Census.Current population reports, special studies. 65+ in the United States. Washington, DC:U.S. Government Printing Office, 1996.
7.
Frei B. Reactive oxygen species and antioxidant vitamins: mechanisms of action. Am J Med 1994;97:3, 55–135.
8.
Halliwell B. Reactive oxygen species and the central nervous system. J Neurochem 1992;59:1609–1623.
9.
Benzi G, Moretti A. Are reactive oxygen species involved in Alzheimer’s disease? Neurobiol Aging 1995;16:661–674.
10.
Gaziano JM. Antioxidant vitamins and coronary artery disease risk. Am J Med 1994;97:3, 185–215.
11.
Meydani M. Vitamin E. Lancet 1995;345:170–175.
12.
Losonczy KG, Harris TB, Havlik RJ. 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. Am J Clin Nutr 1996;64:190–196.
13.
Kushi LH, Folsom AR, Prineas RJ, Mink PJ, Wu Y, Bostick RM. Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med 1996;334:1156–1162.
14.
Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet 1996;347:781–786.
15.
Rapola JM, Virtamo J, Haukka JK, et al. Effect of vitamin E and beta carotene on the incidence of angina pectoris: a randomized, double-blind, controlled trial. JAMA 1996;275:693–698.
16.
Mark SD, Wang W, Fraumeni JF, et al. Lowered risks of hypertension and cerebrovascular disease after vitamin/mineral supplementation. Am J Epidemiol 1996;143:658–664.
17.
Yoshida S, Busto R, Watson BD, Santiso M, Ginsberg MD. Postischemic cerebral lipid peroxidation in vitro: modification by dietary vitamin E. J Neurochem 1985;44:1593–1601.
18.
Hara H, Kato H, Kogure K. Protective effect of α-tocopherol on ischemic neuronal damage in the gerbil hippocampus. Brain Res 1990;510:335–338.
19.
Steiner M, Glantz M, Lekos A. Vitamin E plus aspirin compared with aspirin alone in patients with transient ischemic attacks. Am J Clin Nutr 1995;62:1381S–1384S.
20.
Jandak J, Steiner M, Richardson PD. Reduction of platelet adhesiveness by vitamin E supplementation in humans. Thromb Res 1988;49:393–404.
21.
Penn ND, Purkins L, Kelleher J, Heatley RV, Mascie–Taylor BH, Belfield PW. 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. Age Ageing 1991;20:169–174.
22.
Kelleher J. Symposium on “Micronutrients and the immune response;” Vitamin E and the immune response. Proc Nutr Soc 1991;50:245–249.
23.
Aisen PS, Davis KL. Inflammatory mechanisms in Alzheimer’s disease: implications for therapy. Am J Psychiatry 1994;151:1105–1113.
24.
Mark RJ, Lovell MA, Markesbery WR, Uchida K, Mattson MP. A role for 4-hydroxynonenal, an aldehydic product of lipid peroxidation, in disruption of ion homeostasis and neuronal death induced by amyloid B-peptide. J Neurochem 1997;68:255–264.
25.
Jeandel C, Nicolas MB, Nabet–Belleville F, Penin F, Cuny G. Lipid peroxidation and free radical scavengers in Alzheimer’s disease. Gerontology 1989;35:275–282.
26.
Behl C, Davis J, Cole GM, Schubert D. Vitamin E protects nerve cells from amyloid β protein toxicity. Biochem Biophys Res Commun 1992;186:944–950.
27.
Worth RM, Grove JS. Methods. In: Kagan A, ed. The Honolulu Heart Program. An epidemiological study of coronary heart disease and stroke. Amsterdam:Harwood Academic Publishers, 1996:5–19.
28.
Heilbrun LK, Kagan A, Nomura A, Wasnich RD. The origins of epidemiologic studies of heart disease, cancer and osteoporosis among Hawaii Japanese. Hawaii Medical Journal 1985;44:294–296.
29.
Teng EL, Hasegawa K, Homma A, et al. The Cognitive Abilities Screening Instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia. Int Psychogeriatr 1994;6:45–58.
30.
Morris JC, Heyman A, Mohs RC, et al. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), part 1: clinical and neuropsychological assessment of Alzheimer’s disease. Neurology 1989;39:1159–1165.
31.
Welsh K, Butters N, Hughes J, Mohs R, Heyman A. Detection of abnormal memory decline in mild cases of Alzheimer’s disease using CERAD neuropsychological measures. Arch Neurol 1991;48:278–281.
32.
American Psychiatric Association.Diagnostic and statistical manual of mental disorders. 3rd ed., rev. Washington, DC:American Psychiatric Association, 1987.
33.
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984;34:939–944.
34.
Chiu HC, Victoroff JI, Margolin D, Jagust W, Shankle R, Katzman R. Criteria for the diagnosis of ischemic vascular dementia proposed by the state of California Alzheimer’s Disease Diagnostic and Treatment Centers. Neurology 1992;42:473–480.
35.
Launer LJ, Masaki K, Petrovitch H, Foley D, Havlik RJ. The association between mid-life blood pressure levels and late life cognitive function: the Honolulu–Asia Aging Study. JAMA 1995;274:1846–1851.
36.
Volicer L, Crino PB. Involvement of free radicals in dementia of the Alzheimer type: a hypothesis. Neurobiol Aging 1990;11:567–571.
37.
Zaman Z, Roche S, Fielden P, Frost PG, Niriella DC, Cayley ACD. Plasma concentrations of vitamins A and E and carotenoids in Alzheimer’s disease. Age Ageing 1992;21:91–94.
38.
Tohgi H, Abe T, Nakanishi M, Hamato F, Sasaki K, Takahashi S. Concentrations of α-tocopherol and its quinone derivative in cerebrospinal fluid from patients with vascular dementia of the Binswanger type and Alzheimer type dementia. Neurosci Lett 1994;174:73–76.
39.
Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer’s disease. The Alzheimer’s Disease Cooperative Study. N Engl J Med 1997;336:1216–1222. [see comments]
40.
Nunes GL, Sgoutas DS, Redden RA, et al. Combination of vitamins C and E alters the response to coronary balloon injury in the pig. Arterioscler Thromb Vasc Biol 1995;15:156–165.
41.
Kritchevsky SB, Shimakawa T, Tell GS, et al. Dietary antioxidants and carotid artery wall thickness. The ARIC Study. Circulation 1995;92:2142–2150.
42.
Jacques P, Halpner AD, Blumberg JB. Influence of combined antioxidant nutrient intakes on their plasma concentrations in an elderly population. J Clin Nutr 1995;62:1228–1233.
43.
Chan AC. Partners in defense, vitamin E and vitamin C. Can J Physiol Pharmacol 1993;71:725–731.
44.
Wefers H, Sies H. The protection by ascorbate and glutathione against microsomal lipid peroxidation is dependent on vitamin E. Eur J Biochem 1988;174:353–357.
45.
Kagan A. Stroke. In: Kagan A, ed. The Honolulu Heart Program. An epidemiological study of coronary heart disease and stroke. Amsterdam:Harwood Academic Publishers, 1996:111–126.
46.
Kittner SJ, White LR, Losonczy KG, Wolf PA, Hebel JR. Black–white differences in stroke incidence in a national sample. The contribution of hypertension and diabetes mellitus. JAMA 1990;264:1267–1270.

Information & Authors

Information

Published In

Neurology®
Volume 54Number 6March 28, 2000
Pages: 1265-1272
PubMed: 10746596

Publication History

Received: April 5, 1999
Accepted: December 10, 1999
Published online: March 28, 2000
Published in issue: March 28, 2000

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Authors

Affiliations & Disclosures

K.H. Masaki, MD
From the Honolulu–Asia Aging Study (Drs. MasakiPetrovitch, 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.
K.G. Losonczy, MA
From the Honolulu–Asia Aging Study (Drs. MasakiPetrovitch, 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.
G. Izmirlian, PhD
From the Honolulu–Asia Aging Study (Drs. MasakiPetrovitch, 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.
D.J. Foley, MS
From the Honolulu–Asia Aging Study (Drs. MasakiPetrovitch, 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.
G.W. Ross, MD
From the Honolulu–Asia Aging Study (Drs. MasakiPetrovitch, 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.
H. Petrovitch, MD
From the Honolulu–Asia Aging Study (Drs. MasakiPetrovitch, 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.
R. Havlik, MD
From the Honolulu–Asia Aging Study (Drs. MasakiPetrovitch, 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.
L.R. White, MD
From the Honolulu–Asia Aging Study (Drs. MasakiPetrovitch, 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.

Notes

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: [email protected]

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