by Taeh A. Ward, Ph.D.
Among brain health supplements, memory enhancing products represent the largest category. The term nootropics has become a buzzword referring to medication, supplements, or other substances that may improve brain function and cognitive performance which are part of a million-to-billion-dollar industry. There is presently no dietary supplement or medication confirmed by research to prevent or cure dementia, but some products show promise.
Selecting a Product
The FDA regulates dietary supplements, but products do not currently have to be proven safe or effective to be sold in U.S. However, in February 2019, the FDA commissioner announced a plan to improve oversight of dietary supplements aimed at increasing the safety of these products and stronger actions against those making false claims regarding their products. This regulation is important because dietary supplements can have adverse effects, and individuals wasting time and money on ineffective products may miss out on more effective strategies. The phrase “supported by research” does not always mean that a product works or has been tested in humans. The gold standard for this type of research is a randomized control trial (RCT) with an adequate number of participants to answer questions regarding how effective the product is in humans.
The majority of substances researched as potential treatments for Alzheimer’s disease have unfortunately not been proven effective so far. However, there are medications (e.g. donepezil, memantine) with some benefits for memory and other cognitive abilities in individuals with at least mild-to-moderate dementia. In addition, there are many dietary supplements and other products on the market aimed at brain protection and cognitive enhancement.
Coconut oil is theorized to increase energy in the brain, but there is no current evidence that coconut oil can treat Alzheimer’s disease and it can raise LDL cholesterol. While studies show that simply taking B vitamin supplements does not significantly improve cognitive performance, having an untreated vitamin deficiency (e.g. B1, B12) can negatively impact brain function and should be treated. Research on coenzyme Q10, vitamin D, soy, and ginseng do not strongly suggest prevention of cognitive declines or potential for treatment of dementia. Several well-designed studies showed no benefit of ginkgo biloba for memory enhancement or prevention of dementia, and there is no statistically significant evidence that Prevagen improves cognitive performance. Research does not suggest that herbal cannabis or CBD oil can prevent or treat dementia.
Although there is presently no strong evidence that fish oil supplements prevent cognitive declines in older adults, research indicates that higher levels of polyunsaturated fatty acids (e.g. omega-3 EPA+DHA) are associated with less atrophy and greater blood flow to areas of the brain. There may also be some benefit of fish oil supplements in mild Alzheimer’s disease when combined with curcumin or lipoic acid. Current studies do not support L-carnitine as a treatment for dementia, but there is potential for brain protection and possible benefit in individuals with mild cognitive impairment (MCI), which can be a precursor to dementia.
There is some evidence of a link between caffeine consumption and lower risk of developing cognitive impairment including dementia, although caffeine has some negative effects and these findings are not yet supported by RCTs. Initial research also shows a modest benefit of nicotine (patch) to enhance cognitive function in individuals with MCI (e.g. Memory Improvement Through Nicotine Dosing study, which is still recruiting participants).
Some of the more encouraging results regarding brain health comes from dietary and exercise research. An initial study of the ketogenic diet (modified Adkins Diet) in older adults shows possible benefits for improving cognition. The MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) as well as sustained cardiovascular exercise have shown benefits for better brain function, brain protection in general, and potentially reducing the risk of developing Alzheimer’s dementia. While this is not an exhaustive review of brain health products, there are some positive results so far and additional research is ongoing.
Be an Informed Consumer
If you are considering the use of a memory enhancing or brain protection product, remember that not all researched products have been proven safe or effective. Do your own research about the product so that you will be aware of the true potential benefits and risks/side effects. It is important that you inform your medical provider of any supplements/vitamins or other products you are taking or planning to take, and only use the recommended dose.
Dr. Taeh Ward, a clinical neuropsychologist at Pinehurst Neuropsychology, can be reached at 910-420-8041 or by visiting pinehurstneuropsychology.com