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Reduced Risk of Alzheimer Disease in Users of
Antioxidant Vitamin Supplements
The Cache County Study
Peter P. Zandi, PhD; James C. Anthony, PhD;
Ara S. Khachaturian, PhD; Stephanie V. Stone,
PhD; Deborah Gustafson, PhD; JoAnn T.
Tschanz, PhD; Maria C. Norton, PhD;
Kathleen A. Welsh-Bohmer, PhD; John C. S. Breitner,
MD; for the Cache County Study Group
Arch Neurol. 2004;61:82-88.
Background Antioxidants may protect the aging brain against
oxidative damage associated with pathological changes of
Alzheimer disease (AD).
Objective To examine the relationship between
antioxidant supplement use and risk of AD.
Design Cross-sectional and prospective study of
dementia. Elderly (65 years or older) county
residents were assessed in 1995 to 1997 for prevalent
dementia and AD, and again in 1998 to 2000 for
incident illness. Supplement use was ascertained at
the first contact.
Setting Cache County, Utah.
Participants Among 4740 respondents (93%) with data
sufficient to determine cognitive status at the
initial assessment, we identified 200 prevalent cases
of AD. Among 3227 survivors at risk, we identified
104 incident AD cases at follow-up.
Main Outcome Measure Diagnosis of AD by means of
multistage assessment procedures.
Results Analyses of prevalent and incident AD yielded
similar results. Use of vitamin E and C (ascorbic acid)
supplements in combination was associated with
reduced AD prevalence (adjusted odds ratio, 0.22; 95%
confidence interval, 0.05-0.60) and incidence
(adjusted hazard ratio, 0.36; 95% confidence interval,
0.09-0.99). A trend toward lower AD risk was also
evident in users of vitamin E and multivitamins
containing vitamin C, but we saw no evidence of a
protective effect with use of vitamin E or vitamin C supplements
alone, with multivitamins alone, or with vitamin B–complex
supplements.
Conclusions Use of vitamin E and vitamin C
supplements in combination is associated with reduced
prevalence and incidence of AD. Antioxidant
supplements merit further study as agents for the
primary prevention of AD.
From
the Department of Mental Health, Bloomberg School of Public
Health (Drs Zandi, Anthony, and Khachaturian), and Advanced
Academic Programs: Developmental Psychology (Dr Stone), The
Johns Hopkins University, Baltimore, Md; Departments of
Nutrition and Food Sciences (Dr Gustafson), Psychology (Drs
Tschanz and Norton), and Family, Consumer, and Human Development
(Dr Norton), and the Center for Epidemiologic Studies (Drs
Tschanz and Norton), Utah State University, Logan; Department of
Psychiatry and Behavioral Sciences and the Joseph and Kathleen
Bryan Alzheimer's Disease Research Center, Duke University
Medical Center, Durham, NC (Dr Welsh-Bohmer); and Veterans
Affairs Puget Sound Health Care System and Department of
Psychiatry and Behavioral Sciences, University of Washington
School of Medicine, Seattle (Dr Breitner). A list of the
additional members of the Cache County Study Group appears in
the box.
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