The second alarming event (the first was here) concerns an announcement that never happened. Two years ago a high quality randomised trial showed that taking high doses of B vitamins significantly reduced brain shrinkage in patients who were beginning to have problems with memory and general thinking.
Given that Alzheimer’s is such a huge problem and that there are no really effective treatments and that there is nothing available to spot who is risk and reduce it might think this research would have been seized on and money poured in to develop it further. But there has been nothing.
The oft-repeated claim that if complementary-type treatments worked they would be accepted and become proper medicine,doesn’t hold water if promising pilots like this aren’t followed up
As few points about what was involved in the original research and why it is worth taking seriously.
*It was headed by Professor David Smith a pharmacologist at Oxford University who an extensive knowledge of B vitamin
*The 270 elderly patients involved in the trial all had been diagnosed with a recognised condition call mild cognitive impairment (MCI) This means that your memory and thinking skills are fading a bit but you can still function. About half of these patients go on to develop Alzheimer’s but you can’t tell in advance which they are.
*The Smith trial not only showed that you could slow down brain shrinkage by an average of 30% a year but that you could predict who was going to benefit most. One aim of running more trials would be to test the reasonable idea that B vitamins could slow or stop the progression to Alzheimer’s.
*The key to knowing who was going to benefit most – and possibly who was most at risk — would be to measure the level of an amino acid called homocysteine (pronounced as if it were a gay chapel). That is because the trial found that you only benefited from the vitamins if you had a homocysteine level above 13. with a drop in brain shrinkage by up to 50% A normal healthy level is considered to be between 6 and 9.
I spoke recently to Professor Smith who said that he had applied to the American National Institute for Health Research for £3 million to run a study involving 1000 patients treated at 15 centres around the UK. He was shortlisted but turned down at the final stage for reasons that weren’t clear.
Of course research proposals are rejected all the time but if a really badly done study is enough to get a three-year patent extension surely a high quality study published in a top journal is worth a proper follow-up?
Although none of the funding bodies will admit to this, it is hard to avoid the conclusion that a treatment involving cheap unpatentable vitamins, however promising, is going to find it very hard to get serious backing. That is the way of the world but is it evidence based medicine?
And should we just accept it?
You can have a free test on-line that has been developed by Professor Smith that can show if you have any mental deterioration. If you want to take high doses of B vitamins it is recommended that you test your homocysteine level. Some doctors will do this or it can be done privately. The test is hosted by a website for a charity called Food for the Brain.
Declaration of interest: This charity was set up by Patrick Holford, my co-author on our latest book The 10 Secrets of Healthy Ageing. I am interested in sales of the book but do not benefit from any other form of merchandise.