Efficacy of antioxidants as a therapy for Alzheimer's disease: a meta-analysis

作者：Jianwei Li, Binghui Chen, Jiajun Jiang, Yingqi Feng, Runze Zhang, D M Li, Rutong Wang, Zifan Long, Linfeng Ge, Yujia Guo, Ziyu Zhou, Wenhui Zou, Chi Zhong, Liang Liao · 发表于：Frontiers in Nutrition · 年份：2026 · DOI：10.3389/fnut.2026.1878597 · 研究领域：Alzheimer's disease research and treatments、Dementia and Cognitive Impairment Research、Vitamin C and Antioxidants Research

Background: Oxidative stress plays a central role in the pathogenesis of Alzheimer's disease (AD), contributing to neuronal damage, amyloid-beta aggregation, tau hyperphosphorylation, and neuroinflammation. Although antioxidants have been proposed as potential therapeutic agents, clinical trials have yielded inconsistent results. Objective: To systematically evaluate the efficacy of various antioxidants-including vitamins, polyphenols, and other antioxidant preparations-on cognitive function, oxidative stress biomarkers, neuropsychiatric symptoms, and disease progression in patients with AD. Methods: > 50%). Outcomes included cognitive function scales (e.g., ADAS-Cog, MMSE), oxidative stress markers, neuropsychiatric symptoms, daily living abilities, neuroimaging measures, and fluid biomarkers. Results: A total of 23 RCTs comprising 10,537 participants were included. Antioxidants showed mixed effects across outcomes. While certain oxidative stress markers (urinary 8-iso-prostaglandin F2α: SMD 0.75, 95% CI 0.12-1.38) and neuropsychiatric symptoms (NPI: SMD -0.85, 95% CI -1.13 to -0.57) improved significantly, core cognitive endpoints such as ADAS-Cog (SMD 0.01, 95% CI -0.21 to 0.23) and MMSE (SMD 0.19, 95% CI -0.17 to 0.56) showed no significant benefit. Fluid biomarkers including Aβ42, p-tau, and t-tau remained unchanged. High heterogeneity was observed across multiple outcomes, reflecting variability in antioxidant types, dosages, and patient populations. Conclusion: Antioxi...