Alzheimer Disease: Effect of Vitamin E on Slowing Functional Decline

Maurice Dysken, MD Professor, School of Medicine Department of Psychiatry Minneapolis VA Health Care System, Minneapolis, Interview Invitation
Maurice Dysken, MD
Professor, School of Medicine
Department of Psychiatry
Minneapolis VA Health Care System,
Minneapolis, Minnesota What are the main findings of the study?

Dr. Dysken: In patients with mild-to-moderate Alzheimer’s disease who were taking an acetylcholinesterase inhibitor, a dosage of 2000 IU/d of vitamin E significantly slowed functional decline compared to placebo by 6.2 months over the mean follow-up period of 2.27 years.  Over this period of time caregiver time increased least in the vitamin E group compared to the other three groups (memantine alone, vitamin E plus memantine, and placebo) although the only statistically significant difference was between vitamin E alone and memantine alone.  There were no significant safety concerns for vitamin E compared to placebo and mortality was lowest in the vitamin E alone group.  It should be noted that patients who were on warfarin were excluded from the study because of a possible interaction with vitamin E that could have possibly increased bleeding events. Were any of the findings unexpected?

Dr. Dysken: The combination of vitamin E and memantine did not significantly slow functional decline compared to placebo.  Although one measure of cognition (ADAS-cog) favored vitamin E compared to placebo, after adjustment for multiple comparisons, this difference was not statistically significant. What should clinicians and patients take away from your report?

Dr. Dysken: We concluded that 2000 IU/d of vitamin E appears to be beneficial in patients with mild-to-moderate Alzheimer’s disease by slowing functional decline and decreasing caregiver burden.   Vitamin E appears to be safe and is also inexpensive.   It should be emphasized that our study was not a prevention trial in subjects without a diagnosis of Alzheimer’s disease and as a consequence, vitamin E should be recommended only to patients who have a diagnosis of Alzheimer’s disease. What recommendations do you have for future research as a result of this study?

Dr. Dysken: It would be interesting to study different dosages of vitamin E and the effectiveness of other antioxidants as well.  A combination study with aerobic exercise would be interesting since aerobic exercise also appears to have benefit in slowing decline in AD patients.  Although vitamin E is an antioxidant, basic studies are needed to elucidate vitamin E’s specific mechanism of action in Alzheimer’s disease.  Additional safety data are needed on the interaction between warfarin and vitamin E.


Dysken MW, Sano M, Asthana S, et al. Effect of Vitamin E and Memantine on Functional Decline in Alzheimer Disease: The TEAM-AD VA Cooperative Randomized Trial. JAMA. 2014;311(1):33-44. doi:10.1001/jama.2013.282834.