Resveratrol is an antioxidant compound found in grapes and red wine.
Like a competing Time story, this CNN piece overreaches in its description of a randomized controlled trial of resveratrol’s effects on biomarkers associated with Alzheimer’s disease. It suggests that resveratrol “may actually have benefit in slowing progression of this disease,” which goes beyond anything that this small safety-focused study could tell us. But after that early misstep (and a sensational headline that touts “new hope”), the story recovers to highlight the need for additional work before it can be determined whether resveratrol may be beneficial. And in that respect it goes well beyond the Time coverage. All in all, the story does a nice job of balancing the promise of the work while keeping readers grounded in the reality that we are a long way from finding a new tool to fight Alzheimer’s.
Alzheimer’s affects more than 5 million people in the United States, and that number is expected to double over the next 35 years. It is the sixth leading cause of death in the United States. And while the number of patients diagnosed is great, the number of people affected is even greater. It is difficult for loved ones to watch a friend or family member lose his or her sense of self, to say nothing of the financial and emotional burden that comes with increased responsibilities for taking care of Alzheimer’s patients as the condition advances. New tools and treatments that can slow the progress of Alzheimer’s are important and worth covering. But it is also important to present the limitations of new studies, so as to avoid giving a false impression of the findings to doctors, patients and their loved ones.
The story does not address cost at all. But as with the competing Time coverage, we’ll rule this Not Applicable since the story clearly indicates that the supplements studied are not on the market.
The key finding of the study is that high doses of resveratrol can have an effect on the production of amyloid-beta40, a biomarker that declines in spinal fluid as Alzheimer’s disease advances. The story describes these effects, but doesn’t provide specifics. Similarly, the story mentions that some patients “had slight improvements in their ability to carry out a daily task,” but — again — doesn’t give readers any way to quantify what “slight improvements” means (more on this under “Quality of Evidence”).
Another problem is the statement that resveratrol “may actually have benefit in slowing progression of this disease,” which is not consistent with the findings of the journal article. In fact, the journal article specifically states that “The altered biomarker trajectories must be interpreted with caution. Although they suggest CNS effects, they do not indicate benefit.”
While we have to rate the story Not Satisfactory for those concerns, the story does a good job of noting that the real goal of the study was to determine whether high doses of resveratrol are safe, so that more research can be done. That’s an important point, and one worth making. Similarly, the story makes clear that: “The study was not big enough to answer some important questions, such as whether patients taking resveratrol actually had lower levels of amyloid-beta plaques in their brain, and most importantly, whether they experienced less decline in their mental faculties.” That’s crucial, and the story is clear on the point.
The story specifically discusses the safety of resveratrol, noting that the one concern researchers found was that there appeared to be a slight weight loss (two pounds) in patients taking resveratrol over the course of the one-year study, compared to a one pound weight gain in patients taking placebo. This is significant because weight loss can be a problem for Alzheimer’s patients. The story could also have addressed the concerns raised in some quarters that resveratrol may affect blood clotting, which would be important information for patients taking blood thinners.
The story does note that size of the study, and the maximum dosage that patients received. But, more importantly, the story repeatedly stresses that a great deal of additional work needs to be done in order to determine whether resveratrol could affect Alzheimer’s, and — if so — how it might fit into treatment plans. That said, there was one point where the story could have been much better. The story mentions the “slight improvement” in patients’ ability to do daily tasks. But the story does not mention that the study included five tests that measured patient’s mental processes — and found slight improvements in only one of them. There was no difference between the resveratrol group and the placebo group on the other four tests.
The story includes input from two outside sources who provided important insight into the work. The story is much stronger thanks to the input of these two sources, who addressed the novelty of the work, the need for additional research, and how resveratrol could potentially become part of a multifaceted treatment regimen. The story doesn’t mention who funded the research (NIH), which would have been good. And while the story doesn’t mention that several study authors had ties to pharmaceutical companies, it’s not clear that those companies have any ties to the research.
So the overall rating here is Satisfactory, although we did notice the spokesperson from the Alzheimer’s Association mentioned that the currently available cholinseterase inhibitors slow progression of disease, which they do not — they treat symptoms in a minority of patients for a short period of time. He also opined that eventually the likelihood is that treatment will take a combination of several drugs (and lifestyle measures). Both lines are consistent with the huge amount of pharma money pumped in to the Alzheimer’s Association.
Similarly, the other source apparently holds a patent on the use of a grape seed extract to treat Alzheimer’s and Parkinsons — an interest that could impact his views on this similar approach.
The story mentions both drugs used in Alzheimer’s treatment and lifestyle factors — such as diet and exercise — that may help slow mental decline in Alzheimer’s patients.
However, we thought one of the comments from Dr. Turner on this subject was confusing and not backed by evidence.
One glass of red wine a day could help those with mild Alzheimer’s, “but no more than that,” Turner said.
The study addresses this specifically: “Even if concentrated forms of resveratrol pills like the kind used in this study were available, it’s too soon to recommend going out and getting some just yet.”
The story notes that this is “the first study in people with Alzheimer’s” — which clearly sets the study apart from earlier research. That said, there have been many other studies on resveratrol and Alzheimer’s using animal models, and a quick paragraph on what those other studies have told us would have been both interesting and useful.
This went well beyond any news release on the work.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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