The aim of this study was to examine associations between vitamin E status and cognitive performance in elderly people. The study subjects were a group of 34 men and 86 women, aged 65-91 y, who were free of significant cognitive impairment. Dietary intake was monitored using a "weighed food record" for 5 consecutive days including a Sunday. Serum levels of alpha-tocopherol and cholesterol were determined by HPLC and colorimetric methods, respectively. The cognitive capacity of subjects was tested using the Pfeiffer's Mental Status Questionnaire (PMSQ). Subjects with vitamin E intakes lower than 50% of those recommended had higher PMSQ scores, demonstrating a greater number of errors in comparison to participants with a greater intake of the vitamin (0.91 +/- 1.22 vs. 0.47 +/- 0.60, respectively, P < 0.05). Subjects who made no errors in the PMSQ test had significantly higher serum alpha-tocopherol concentrations (19.7 +/- 8.6 micromol/L in men and 20.0 +/- 8.4 micromol/L in women) and alpha-tocopherol/cholesterol ratios (3.5 +/- 2.0 micromol/mmol in men 2.9 +/- 1.4 micromol/mmol in women) compared with those who made errors (alpha-tocopherol 15.1 +/- 5.6 micromol/L in men and 14.9 +/- 6.1 micromol/L in women; alpha-tocopherol/cholesterol ratio 2.4 +/- 0.8 and 2.3 +/- 1.3 micromol/mmol in men and women, respectively). This study shows there to be a relationship between vitamin E status and cognitive function, and that vitamin E status could be improved in this population of elderly individuals.