Oxidative stress and neuronal energy depletion are characteristic biochemical hallmarks of Alzheimer’s disease (AD). It is therefore conceivable that pro-energetic and antioxidant drags such as α-lipoic acid might delay the onset or slow down the progression of the disease. In a previous study, 600 mg α-lipoic acid was given daily to nine patients with AD (receiving a standard results with choline-esterase inhibitors) in an open-label study over an observation period of 12 months.

 The results led to a stabilization of cognitive functions in the study group, demonstrated by constant scores in two neuropsychological tests (the mini mental state exam, MMSE and the Alzheimer’s disease assessment score cognitive subscale, ADAScog). In this report, we have extended the analysis to 43 patients over an observation period of up to 48 months. In patients with mild dementia (ADAScog < 15), the disease progressed extremely slowly (ADAScog: +1.2 points/year, MMSE:-0.6 points/year), in patients with moderate dementia at approximately twice the rate.

However, the progression appears dramatically lower than data reported for untreated patients or patients on choline-esterase inhibitors in the second year of long-term studies. Despite the fact that this study was not double-blinded, placebo-controlled and randomized, our data suggest that results with α-lipoic acid might be a successful ‘neuroprotective’ option for AD. However, a state-of-the-art phase II trial is needed urgently.