Dietary Supplements in the Prevention of Dementia
Betty Chaffee, PharmD, is owner and sole proprietor of BetterMyMeds, a Medication Management service devoted to helping people get the maximum benefit from their medications.
There are many dietary supplements on the market to prevent dementia and age-related cognitive decline. And it turns out that in the US about one in four adults over 50 takes a supplement to maintain or improve brain health. In 2016 alone, about $3 billion was spent globally on supplements for brain health. But what do we really know about the effectiveness of these products?
In a previous post about dietary supplements we pointed out that the United States Food and Drug Administration (FDA) regulates dietary supplements more like food than medicine. Because of that, manufacturers aren't required to prove that supplements are effective at preventing or treating health problems before they're marketed. In fact, the FDA prohibits manufacturers of dietary supplements from claiming that their product can "diagnose, treat, cure, or prevent" any disease. (You'll find that disclaimer on the label of every dietary supplement if you look for it.)
On the other hand, though, marketing and advertising can provide information that's not allowed on the product label. How much of that information is based on scientific research, and how much is based on theory (and the desire to sell product)? In other words, when we take supplements for brain health, are we protecting our brains or wasting our money? Let's take a look at what the research says.
First, let's define some terms
What is "age-related cognitive decline"?
The cognitive ability of the brain involves thinking, reasoning, and remembering. Brains change with age, and it's normal to have decline in some areas of thinking as we move past our 50's into our 60's and 70's and beyond. Age-related cognitive decline is a normal consequence of aging rather than a disease process.
What is dementia?
Dementia is a group of conditions, including Alzheimer's disease, that result in cognitive decline, memory loss, and ultimately the inability to function independently. Dementia is a disease process rather than a result of normal aging.
Next, what question are we asking?
In this article we'll focus on the use of dietary supplements to prevent dementia and/or age-related cognitive decline. We'll focus here because the majority of adults who use dietary supplements for brain health don't have a diagnosis of dementia. Our question is, "is there evidence to support using dietary supplements to prevent dementia and/or normal age-related cognitive decline?"
Research has also looked at a different question, "Can supplements slow the progression of decline in people already diagnosed with dementia?" Though we won't be trying to answer that question here, stay tuned to the BetterMyMeds blog for a future article on that subject.
Let's look at what the experts say.
The Global Council on Brain Health (GCBH) is a group of 94 experts on brain health from all over the world. The task of the GCBH is to evaluate research on brain health and disease, then reach a consensus on the best ways to maintain and improve brain health. The goal is to help people understand how to apply new research to stay sharp and enjoy life.
The GCBH identified supplements that have been used over the years to maintain brain health. Some of the most common include:
- Omega-3 fatty acids
- Proprietary blends (Prevagen, Conifen, BriteSmart and others)
- Gingko biloba
- Green tea (caffeine)
- Coenzyme Q10
- Antioxidants (such as vitamin E and selenium)
- Vitamin B Complex
The council reviewed all the scientific research on these and other supplements used for brain health. They concluded that there isn't reliable evidence to support their use to improve or maintain brain health. In other words, dietary supplements have NOT been proven to improve or maintain brain health in healthy older adults. (One exception: vitamin deficiencies such as vitamin D or B12 can result in problems with memory and thinking, and should be treated with vitamin supplements.)
So why are there so many supplements promoted for brain health, then? It gets back to the looser FDA regulation of supplements - it's easy and relatively cheap to bring that type of product to market, and they sell! As we pointed out earlier, advertisements can make claims that aren't allowed on the label, so it's easy to believe these products will improve health. But the billions of dollars being spent annually are most likely not improving anyone's health.
There are people who'd rather take a chance that a supplement will help them stay sharp, though. If you're one of them, be sure to research the supplement to look for safety concerns before you start taking it. Go to rxlist.com to check for drug interactions, possible side effects, and disease precautions, and be sure your doctor knows about your plan.
There are things you can do to stay sharp, though!
Scientific research has shown conclusively that people can take charge of maintaining brain health. Here are some ideas:
Eating a heart-healthy, balanced diet can prevent chronic health problems like heart disease and diabetes, and their resulting harm to brain health.
Regular physical activity decreases your risk of cognitive decline. Find activities you enjoy, mix them up, and stay active!
Staying engaged with friends and community improves our sense of well-being and gives us a sense of purpose.
Doing and learning new things, like learning a new skill or volunteering with an organization provides stimulation for the brain. Playing cards, doing puzzles, and similar activities during leisure time also challenges the brain to keep it sharp.
Getting the right amount of sleep is also key to staying sharp. Avoiding too much stress also helps the brain to rest after all that activity we just talked about!
Maintaining brain health is important to maintaining a good quality of life.
While evidence doesn't support the use of dietary supplements to prevent decline in healthy older adults, there are many other steps we can and should take to stay sharp. Please leave your comments below to start a conversation right here. For specific questions you are always welcome to contact us at BetterMyMeds!
Excellent article and topic, Betty!
Unfortunately, even with approved prescription medications, treatment options for dementia and memory loss are mediocre at best. It’s understandable that some people who may be considered at higher risk for dementia or early decline of cognitive skills to feel desperate to find something to help them. As you noted above, the majority of these products do not have significant clinical evidence to improve memory or slow the loss of cognitive decline (despite some of them even advertising that the results are “clinically proven” to help). What makes this even more disturbing is the high price of some of these products.
In addition, some of these products have significant drug-drug interactions that are commonly overlooked. Among the most significant includes the use of gingko and tumeric, which when used along with blood thinners such as warfarin, Eliquis, Xarelto, and others, could increase the risk for dangerous bleeding.
You’re right, Alan. It’s totally understandable when people choose to use supplements in the hope that they will provide benefit. Being sure to check objective information on http://www.rxlist.com or talking with a pharmacist about side effects and drug interactions is key to making sure supplement use is safe.
Good article. Alan T always has interesting feedback. It’s worth noting that another age related cause of cognitive decline is hearing loss. People that develop hearing loss avoid social interaction, which is important, as you’ve noted, to maintain brain health.
I agree, Tony. And sometimes being willing to admit to hearing loss is half of the battle, right? It makes us feel old so we deny there’s a problem. Paying attention to hearing loss and getting it checked out and dealt with is a great way to help maintain brain health as we age.
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