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A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study
Mary Sano, Christopher Ernesto, Ronald G. Thomas, Melville R. Klauber, Kimberly A Schafer, Michael Grundman, Peter Woodbury, John H. Growdon, Carl W. Cotman, Eric A. Pfeiffer, Lon S. Schneider, Leon J. Thal. New England Journal of Medicine, 1997-04-24
Topic: Amyloid, tau and blood-test diagnosis
BACKGROUND: There is evidence that medications or vitamins that increase the levels of brain catecholamines and protect against oxidative damage may reduce the neuronal damage and slow the progression of Alzheimer's disease. METHODS: We conducted a double-blind, placebo-controlled, randomized, multicenter trial in patients with Alzheimer's disease of moderate severity. A total of 341 patients received the selective monoamine oxidase inhibitor selegiline (10 mg a day), alpha-tocopherol (vitamin E, 2000 IU a day), both selegiline and alpha-tocopherol, or placebo for two years. The primary outcome was the time to the occurrence of any of the following: death, institutionalization, loss of the ability to perform basic activities of daily living, or severe dementia (defined as a Clinical Dementia Rating of 3). RESULTS: Despite random assignment, the baseline score on the Mini-Mental State Examination was higher in the placebo group than in the other three groups, and this variable was highly predictive of the primary outcome (P<0.001). In the unadjusted analyses, there was no statistically significant difference in the outcomes among the four groups. In analyses that included the base-line score on the Mini-Mental State Examination as a covariate, there were significant delays in the time to the primary outcome for the patients treated with selegiline (median time, 655 days; P=0.012), alpha-tocopherol (670 days, P=0.001) or combination therapy (585 days, P=0.049), as compared with the placebo group (440 days). CONCLUSIONS: In patients with moderately severe impairment from Alzheimer's disease, treatment with selegiline or alpha-tocopherol slows the progression of disease.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Sano, M., Ernesto, C., Thomas, R. G., Klauber, M. R., Schafer, K. A., Grundman, M., et al. (1997). A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. New England Journal of Medicine. https://doi.org/10.1056/nejm199704243361704
Vancouver
Sano M, Ernesto C, Thomas RG, Klauber MR, Schafer KA, Grundman M, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study. New England Journal of Medicine. 1997. doi:10.1056/nejm199704243361704. PMID: 9110909.
BibTeX
@article{sano1997-9110909,
author = {Sano, Mary and Ernesto, Christopher and Thomas, Ronald G. and Klauber, Melville R. and Schafer, Kimberly A and Grundman, Michael and Woodbury, Peter and Growdon, John H. and Cotman, Carl W. and Pfeiffer, Eric A. and Schneider, Lon S. and Thal, Leon J.},
title = {{A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study}},
journal = {New England Journal of Medicine},
year = {1997},
doi = {10.1056/nejm199704243361704},
pmid = {9110909},
url = {https://doi.org/10.1056/nejm199704243361704}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 12 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Why it matters
In a two-year trial of 341 patients with moderately severe Alzheimer's disease, selegiline, vitamin E (alpha-tocopherol) or both were compared with placebo. Unadjusted results showed no significant difference, but after adjusting for differences in starting Mini-Mental State Examination scores, all three treatments delayed outcomes such as death, institutionalization or severe dementia.
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How this study scored 61/100
Published in a top-tier journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on strength of evidence, so that was left out: it earned 58 of the 95 points we could judge it on, which is 61 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (New England Journal of Medicine) |
| Journal's citation record | 4 / 4 | New England Journal of Medicine: journal h-index 1,505 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | — / 5 | No evidence rating recorded — left out of this score |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1997 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 2,386 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 77.0 citations a year over 31 year(s) since 1997 |
| Impact for its field and year | 6 / 6 | Cited 113.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 3 / 4 | Cited 79 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Leon J. Thal: h-index 90 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 9110909) |
| Free to read | 2 / 2 | Free to read |
| Points | 58 / 95 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 58 of the 95 points we could judge it on is 61 out of 100. |
| Total | 61 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1056/nejm199704243361704
- PubMed: 9110909
- Original source →
- Free full text: New England Journal of Medicine →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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