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VITAL - VITamins to Slow ALzheimer's Disease (Homocysteine Study)

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ClinicalTrials.gov Identifier: NCT00056225
Recruitment Status : Completed
First Posted : March 10, 2003
Last Update Posted : June 12, 2009
Alzheimer's Disease Cooperative Study (ADCS)
Information provided by:
National Institute on Aging (NIA)

Brief Summary:
The purpose of this study is to determine whether reduction of homocysteine levels with high-dose folate (folic acid), B6, and B12 supplementation will slow the rate of cognitive decline in persons with Alzheimer's disease.

Condition or disease Intervention/treatment Phase
Alzheimer's Disease Drug: Folate Drug: Vitamin B6 Drug: Vitamin B12 Phase 3

Detailed Description:

Blood levels of homocysteine are elevated in Alzheimer's disease (AD), and hyperhomocysteinemia may contribute to disease pathophysiology by vascular and direct neurotoxic mechanisms. Homocysteine levels can be reduced by administration of high dose supplements of folate (folic acid) and vitamins B6 and B12. The proposed study is for a multicenter, randomized, controlled clinical trial to determine whether reduction of homocysteine levels with high-dose folate/B6/B12 supplementation will slow the rate of cognitive decline in subjects with AD.

This will be a parallel design study, including two groups of unequal size: 60% of subjects will receive daily high-dose supplements (folate 5mg, vitamin B6 25mg, vitamin B12 1 mg), and 40% will receive an identical looking placebo. The duration of treatment will be 18 months, and participants will make eight visits to the assigned study site for safety and efficacy assessments of the medications. The primary outcome measure will be the longitudinal decline in the ADAScog, a psychometric instrument that evaluates memory, attention, reasoning, language, orientation and praxis (Rosen et al 1984). To power the trial to detect a 25% reduction in rate of ADAScog decline (80% power, alpha=0.05, drop-out estimate 20%, drop-in estimate 10%), it will enroll a total of 400 participants. Persons of minority racial groups are also being recruited, although all participants must be able to speak either English or Spanish.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 340 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Official Title: High Dose Supplements to Reduce Homocysteine and Slow the Rate of Cognitive Decline in Alzheimer's Disease (Vitamins to Slow Alzheimer's - VITAL)
Study Start Date : January 2003
Actual Primary Completion Date : June 2007
Actual Study Completion Date : June 2007

Resource links provided by the National Library of Medicine

Information from the National Library of Medicine

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Ages Eligible for Study:   55 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • National Institute of Neurological Disorders and Stroke (NINDS)/Alzheimer's Disease and Related Disorders Association (ADRDA) criteria for probable Alzheimer's disease.
  • Mini-Mental Status Examination (MMSE) score between 14 and 26, inclusive
  • Stable medical condition for 3 months
  • Stable medications for 4 weeks prior to the screening visit
  • Physically acceptable for this study as confirmed by medical history, physical exam, neurologic exam and clinical laboratory tests
  • Supervision available for administration of study medications
  • Study partner to accompany subject to all scheduled visits
  • Fluent in English or Spanish
  • Modified Hachinski equal to or less than 4 CT or magnetic resonance imaging (MRI) since onset of memory impairment demonstrating absence of clinically significant focal lesion
  • Able to complete baseline assessments
  • 6 years of education or work history sufficient to exclude mental retardation
  • Able to ingest oral medication

Exclusion Criteria:

  • B12 or folate deficiency
  • Renal insufficiency (serum creatinine >=2.0)
  • Active neoplastic disease (skin tumors other than melanoma are not exclusionary; patients with stable prostate cancer may be included at the discretion of the project director)
  • Use of another investigational agent within 2 months
  • History of clinically significant stroke
  • Current evidence or history in the past 2 years of epilepsy, focal brain lesion, head injury with loss of consciousness and/or immediate confusion after the injury, or DSM-IV criteria for any major psychiatric disorder including psychosis, major depression, bipolar disorder, alcohol or substance abuse
  • Blindness, deafness, language difficulties or any other disability which may prevent the subject from participating or cooperating in the protocol

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00056225

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Sponsors and Collaborators
National Institute on Aging (NIA)
Alzheimer's Disease Cooperative Study (ADCS)
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Principal Investigator: Paul Aisen, MD Georgetown University, Department of Neurology
Publications of Results:
Other Publications:
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ClinicalTrials.gov Identifier: NCT00056225    
Other Study ID Numbers: IA0041
First Posted: March 10, 2003    Key Record Dates
Last Update Posted: June 12, 2009
Last Verified: June 2009
Keywords provided by National Institute on Aging (NIA):
Additional relevant MeSH terms:
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Alzheimer Disease
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Neurodegenerative Diseases
Neurocognitive Disorders
Mental Disorders
Vitamin B 12
Vitamin B 6
Vitamin B Complex
Physiological Effects of Drugs