BMJ  2003;326 (31 May), doi:10.1136/bmj.326.7400.0-f

Filler

POEM^*

Antioxidants don't prevent dementia

Clinical question Are antioxidants associated with a decreased risk of Alzheimer's disease?

Synopsis In this outpatient prospective cohort study, patients completed diaries of diet and vitamin supplementation (vitamin C, vitamin E, carotene). The researchers evaluated the patients at baseline and included only those who were free of dementia. After an average of four years of follow up of 980 patients, they compared antioxidant consumption with subsequent development of dementia using standardised criteria. A total of 242 of these patients developed Alzheimer's disease. After adjusting for educational level and other covariates that might affect cognition, they found no association between use of antioxidants and the development of dementia. Some limitations of this study include the role of recall bias, since patients had to report on their dietary intake from the previous year. For those of us who can't recall what we had for breakfast (or even if we ate breakfast), this would be a major challenge.

Bottom line In this study and in at least one other cohort study (Engelhart MJ. JAMA 2002;287: 3223-9[Abstract/Free Full Text]), antioxidant consumption in the elderly was not associated with protection against developing dementia. At least one randomised controlled trial (Sano M. N Engl J Med 1997;336: 1216-22[Abstract/Free Full Text]) showed that vitamin E may slow the progression of moderately severe Alzheimer's disease.

Level of evidence 2b (see www.infopoems.com/resources/levels.html): individual cohort study or low quality randomised controlled trials (< 80% follow up)

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Luchingser JA, Tang MX, Shea S, Mayeaux R. Antioxidant vitamin intake and risk of Alzheimer disease. Arch Neurol 2003;60: 203-8[Abstract/Free Full Text].

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^* Patient-Oriented Evidence that Matters. See editorial ( BMJ 2002;325: 983[Free Full Text])

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Alan Challoner MA MChS
bmj.com, 30 May 2003 [Full text]