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Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: the Cache County Study
Zandi PP, Anthony JC, Khachaturian AS, Stone SV, Gustafson D, Tschanz JT, Norton MC, Welsh-Bohmer KA et al.. Archives of neurology, 2004-01-01
Topic: Amyloid, tau and blood-test diagnosis
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.
Key findings
- Background Antioxidants may protect the aging brain against oxidative damage associated with pathological changes of Alzheimer disease (AD).
- 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).
- Conclusions Use of vitamin E and vitamin C supplements in combination is associated with reduced prevalence and incidence of AD.
Why it matters
In this study, combined use of vitamin E and C supplements was associated with reduced prevalence and incidence of Alzheimer disease. No evidence of a protective effect was seen with use of vitamin E or vitamin C supplements alone, or with multivitamins alone.
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Study details
- Study designcross-sectional
- Evidence strengthLow
How this study scored 50/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, so that was left out: it earned 48 of the 96 points we could judge it on, which is 50 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Archives of neurology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2004 — 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 | 6 / 7 | Cited 718 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 29.9 citations a year over 24 year(s) since 2004 |
| Impact for its field and year | 5 / 6 | Cited 37.0× 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 | 2 / 4 | Cited 43 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author John C.S. Breitner: h-index 93 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 14732624) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 48 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 48 of the 96 points we could judge it on is 50 out of 100. |
| Total | 50 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1001/archneur.61.1.82
- PubMed: 14732624
- Original source →
- Free full text: Digital Commons - USU (Utah State University) →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Zandi, P. P., Anthony, J. C., Khachaturian, A. S., Stone, S. V., Gustafson, D., Tschanz, J. T., et al. (2004). Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: the Cache County Study. Archives of neurology. https://doi.org/10.1001/archneur.61.1.82
Vancouver
Zandi PP, Anthony JC, Khachaturian AS, Stone SV, Gustafson D, Tschanz JT, et al. Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: the Cache County Study. Archives of neurology. 2004. doi:10.1001/archneur.61.1.82. PMID: 14732624.
BibTeX
@article{zandi2004-14732624,
author = {Zandi, P. P. and Anthony, J. C. and Khachaturian, A. S. and Stone, S. V. and Gustafson, D. and Tschanz, J. T. and Norton, M. C. and Welsh-Bohmer, K. A. and others},
title = {{Reduced risk of Alzheimer disease in users of antioxidant vitamin supplements: the Cache County Study}},
journal = {Archives of neurology},
year = {2004},
doi = {10.1001/archneur.61.1.82},
pmid = {14732624},
url = {https://doi.org/10.1001/archneur.61.1.82}
}
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