Is this the way to delay Alzheimer's?
A simple vitamin supplement may be a major development in the treatment of this devastating disease. Lesley Dobson reports
New research carried out by scientists at Oxford University has found that taking vitamin B tablets reduces the amount by which the brain shrinks as we grow older.
The trial involved 168 people over the age of 70 suffering mild memory problems, known as Mild Cognitive Impairment, or MCI. This is relatively common. It affects around one in six of the over 70s in this country - and about 50 per cent of the people affected go on to develop Alzheimer's.
"What we've done with this trial is looked at the biological rate of shrinkage of the brain, which we believe is the underlying cause of cognitive decline," said Professor David Smith, of the Department of Pharmacology at Oxford, the co-leader of the trial.
"But clearly, for the purpose of practising medicine, you actually need to show that the treatment has an effect on cognitive decline and conversion to Alzheimer's."
Study volunteers took either high doses of B vitamins (20mg of vitamin B6, 0.8mg of vitamin B9 or folate, and 0.5mg of vitamin B12) or a placebo. MRI scans that measured the rate of brain shrinkage at the beginning and the end of the two-year trial showed how the disease had had progressed in each of the participants.
The scans revealed that, on average, the brains of those given the supplement shrank at 0.76 per cent a year, whereas those on the placebo had an average shrinkage rate of 1.08 per cent.
The B vitamins used in the trial are known to control the blood levels of an amino acid called homocysteine, high volumes of which are associated with increased risk of Alzheimer's. Those in the active group who had the highest levels of homocysteine in their blood and were taking the genuine treatment showed the most benefit.
Their atrophy rates were half those observed among the placebo group.
"The result was much, much better than we could have hoped, to be honest," said Professor Smith. "With these trials you tend to get quite small effects that may be statistically significant, but this was a whopping effect.
"Normally in medicine you don't base a change in clinical practice on a single trial, which is sensible. But in this case, where the treatment is really very safe and the results are very strong, it wouldn't surprise me if individual physicians said 'Why don't you take the B vitamin?' That's a personal decision between the physician and the patient.
"It's our hope that this will become part of the treatment for people with MCI. If I had it, then I would certainly take the B vitamins that were used in our trial."
He added: "We're not recommending that healthy elderly people rush out and buy large doses of these vitamins. What we are saying is that people with memory impairment, especially if they've been to a memory clinic and have been told they're affected by memory impairment, should discuss with their doctor whether or not it would be appropriate for them to up their vitamins."
Dr Marie janson, the Director of Development at the Alzheimer's Research Trust, which part-funded the study, says: "If you're doing research with psychological testing, there's always a bit of variation. Being able to look at something as measurable as brain shrinkage on an MRI scan is very solid evidence.
"With Alzheimer's, the disease process goes on for a long time - perhaps 20 or 30 years - before you see noticeable clinical loss of function. In the past we have had to wait for this. Now research is finally getting us the tools we need.
"Taking B vitamins if you have MCI could help to slow it down, so it doesn't progress as quickly. With a disease that affects this age group, those 70 and over, just postponing it by three or four years can make a huge impact.
"It's not just about the number of years you live for, it's also about your quality of life. That is terribly important."
www.saga.co.uk NOVEMBER 2010 SAGA 125
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