By Karla Gale

NEW YORK (Reuters Health) Apr 07 - For patients at high risk of Alzheimer's disease, taking a combination of vitamins E and C plus ibuprofen significantly reduces their risk, results of a longitudinal study suggest.

"We found that for people at low risk, taking vitamin C and E alone is sufficient to further reduce their risk. But for those with apolipoprotein epsilon-4 (APOE-epsilon-4) alleles, the combination exerts a synergistic benefit," Dr. Majid Fotuhi told Reuters Health.

Dr. Fotuhi, from Johns Hopkins University in Baltimore, and his associates prospectively followed nearly 5000 elderly residents of Cache County in Utah for 8 years, taking into account their regular consumption of vitamins C and E, ibuprofen, or a combination of the three. Dr. Fotuhi reported the findings at the American Academy of Neurology's 58th Annual Meeting here in San Diego.

They identified 127 subjects who regularly consumed all three agents. Results showed that this group exhibited significantly less decline in Modified Mini-Mental State Exam scores. After adjusting for age, gender, APOE genotype, hypertension, cholesterol, stroke, coronary artery bypass surgery, and MI, those who used all three agents performed better than non-users by approximately 1 point every 2 years.

"With this approach, we've advanced a 2-point attack on the cascade of events that leads to Alzheimer's disease pathology," Dr. Fotuhi said. "On the one hand, we reduce inflammation (with vitamins E and C), and on the other hand, we reduce the amount of amyloid in the brain (with ibuprofen), the substrate that causes inflammation."

As noted, APOE-epsilon-4 carriers experienced the greatest benefit from the triple-combination treatment. According to the researchers' presentation, this subset of patients in their late 60s or 70s exhibited no decline in cognitive function during the 8-year follow-up when they took all three agents. Subjects who took just one of these agents had worsening memory over time.

"So if patients seem to be at high risk, such as having several family members with Alzheimer's disease or with early memory loss, they are likely to benefit the most from the triple-combination therapy," the researcher said.

As to what dose of ibuprofen to use, Dr. Fotuhi urges caution, since the drug is associated with gastric ulcers. He recommends a dose no higher than 100 mg/day.

He is so encouraged by these findings that he has patented a combination pill containing vitamins A and E, ibuprofen, and "a small amount of omega-3 fatty acid."

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