In the news: Education lags for AREDS2 Supplement Use; Multi-vitamins Tied to Better Cognitive Aging

Many with AMD Do Not Use AREDS Supplements

The AREDS trial – and the subsequent AREDS2 study to evaluate lutein and omega-3 fats – showed that a specific high dose dietary supplement can reduce the progression of intermediate stage age-related macular degeneration (AMD) to the advanced stage of the disease.

However, past surveys of patients in retinal clinics conducted between 2003-2014 revealed that wide-spread adoption of AREDS formula for eligible patients has fallen short. paragraph

Researchers from Wilmer Eye Institute at John Hopkins recently revisited this issue, looking at whether AMD patients use dietary supplements and what type, whether home monitoring for non-neovascular (dry) AMD is used, and the prevalence of genetic testing(1).

Assessment of the completed self-administered questionnaires showed that over 90% of patients were taking vitamins and a little more than 60% reported taking AREDS or AREDS2 vitamins.

Unfortunately, nearly 38% of the AMD patients who were eligible candidates for AREDS2 supplements (intermediate or advanced AMD in one or both eyes) did not take them.

Similarly, despite AREDS2 data published in 2014 supporting the benefit of home monitoring for eyes with intermediate AMD at risk of conversion to neovascular AMD, only 61% did some type of home monitoring. Just 1.1% reported undergoing genetic testing for AMD – testing which remains controversial.

According to the authors, the significant gap in usage provides further support for improving education about AREDS2 supplements and home monitoring.

RCT Ties ‘Multi’ Use with Slower Brain Aging

Researchers from Wake Forest University presented findings from a large-scale study at the 14th Clinical Trials on Alzheimer’s Disease conference this month. The investigators reported that daily multivitamin-mineral supplementation for 3 years was associated with a 60% (1.8 years) slowing of cognitive aging(2).

The placebo-controlled trial (COSMOS-Mind) is an ancillary study of the COcoa Supplement and Multivitamin Outcomes Study or COSMOS – a randomized, controlled trial of a cocoa extract sup-plement and a multivitamin supplement to reduce the risk of cardiovascular disease and cancer in 21,000 older participants.

COSMOS-mind included 2,262 men and women with a mean age of 73 who were dementia-free at baseline and who underwent baseline cognitive testing and annually for 3 years. The study examined whether the cocoa extract supplement or the multivitamin sup-plement improves cognitive function and reduces risk of cognitive impairment vs. placebo.

Baseline cognitive scores were similar between study groups. While there was no effect of cocoa on global cognitive function, there was a significant difference between the multi-supplement and placebo groups for global cognitive function composite, memory composite and executive function composite scores.

The study outcomes included the impact of multivitamins and cocoa extract on prespecified subgroups, including those with a history of CVD. The effect of the multivitamins was particularly pronounced in CVD patients.

Those with CVD had lower cognitive scores at baseline. However, after an initial bump due to the ‘practice effect’ at year one, the CVD group continued to benefit from multivitamins while those assigned to placebo continued to decline over time, according to the lead researcher. Still to come are results on the effects of multivitamins on Alzheimer’s disease prevalence and progression.

References

1. Tsou BC, et al. Patient use of dietary supplements, home monitoring, or genetic testing for non-neovascular age-related macular degeneration. J VitreoRetinal Dis. 5:389-395, 2021.
2. Multivitamins, but Not Cocoa, Tied to Slowed Brain Aging. https://www.medscape.com/viewarticle/962772.