Few things are more unnerving than the memory lapses most of us experience as we grow older. Younger people forget things all the time, of course, but for their elders these lapses (the mislaid word, name, key or to-do list) call up the threat of permanent memory loss, as in Alzheimer’s disease, possibly the most feared of all disorders. Naturally, we yearn for a pill to prevent mental decline.
There are numerous dietary supplements marketed to improve memory. All sorts of herbs (notably ginkgo), vitamins and fish oil, as well as countless cocktails of herbs and other ingredients (such as Focus Factor, BrainReload, and Brain Alert), come with more or less blatant claims that they aid memory and mental ability.
But all of them, with the possible exception of fish oil supplements, have little or no basis for such claims. If a supplement ever turns out to boost memory or help prevent dementia, we hope to be the first to tell you. Meanwhile, here’s a rundown of the latest scientific evidence about some of the most widely promoted ingredients.
One of the best-selling products in the U.S. for memory loss, ginkgo is an ingredient in many so-called brain boosters. It comes from the maidenhair tree (Ginkgo biloba) and is widely prescribed in Europe for “cerebral insufficiency,” which can mean anything from confusion to depression and anxiety.
A dozen years ago, a study found that ginkgo improved mental functioning in people with Alzheimer’s, but despite a flood of studies since then, the evidence remains inconsistent. In one of the few studies to compare ginkgo with a standard drug approved for use in treating Alzheimer’s disease, a small Italian study in 2006 found ginkgo as effective as donepezil (Aricept) in improving memory and attention in people with mild to moderate Alzheimer’s. However, a review of 35 studies by the Cochrane Collaboration in 2007 concluded that the overall evidence for ginkgo as a treatment for dementia or cognitive impairment is “inconsistent and unconvincing.”
As for prevention trials, a large, well-designed study of healthy people 75 and older in 2008 found no evidence that ginkgo helps prevent dementia, including Alzheimer’s. In 2009, a follow-up study published in the Journal of the American Medical Association found that the supplement did not slow cognitive decline or memory loss in any way.
Finally, in late 2012, a well-designed French study published in Lancet Neurology looked at 2,820 people aged 70 and older with self-reported memory complaints, half of whom took EGb761 (a standardized gingko extract used in many clinical trials and often prescribed in Germany and France) twice daily, half a placebo. After five years, ginkgo did not slow the rate of progression to Alzheimer’s.
Phosphatidylserine (PS) is a type of fat found in brain cells, as well as other cells in plants and animals. The Memory Cure, a perennial bestseller, touts PS supplements as a way to prevent Alzheimer’s. Derived from cow brain until the advent of mad cow disease, PS is now extracted from soy. A few preliminary studies suggested that PS might help elderly people with dementia. Though it has been much studied since, however, there’s no convincing evidence it’s useful for treating dementia or for preventing it in healthy people.
Derived from a type of Chinese moss, Huperzia serrata, this supplement is supposed to boost certain brain chemicals in somewhat the same way as some prescription drugs, such as Aricept and tacrine (Cognex), approved for use in Alzheimer’s patients. These drugs, in any case, have only a modest and brief effect. Huperzine A has been clinically studied in China for Alzheimer’s patients, though studies were generally small and short. A review of this research, published in the Journal of Neural Transmission, was optimistic that huperzine A might be useful in treating Alzheimer’s. More research is underway, but so far there’s no evidence it boosts memory in healthy people or reduces the risk of Alzheimer’s.
Found in many foods (especially egg yolk, liver, meat and fish) and now classified as a nutrient, choline is essential for brain development in the fetus. Some evidence shows that those who get a high level of dietary choline early in life may be more intelligent and better retain their mental ability. Though low choline levels have been linked to neurological disorders, there’s no evidence that a high choline intake later in life has an effect on brain function or that choline supplements improve memory.
This stands for dimethylaminoethanol, which is chemically related to choline. Almost nothing is known about DMAE or whether it has any effect on memory or cognition. Good studies are scarce. This has not kept marketers from making extravagant claims about DMAE promoting mental alertness.
This derivative of the Asian plant Bacopa monnieri has been used in ancient Indian (Ayurvedic) medicine for centuries as a “brain tonic.” Studies have been mostly brief and poorly designed; none have shown that bacopa aids memory or cognitive function. Nevertheless, it is an ingredient in many supplements.
A synthetic version of an extract from a type of periwinkle plant, this drug is approved in Europe for treating dementia, but sold as a supplement here. A few years ago an independent review of the research found no evidence that vinpocetine was useful in treating dementia.
There’s no good evidence that vitamin supplements can delay or prevent mental decline. One exception: a deficiency of vitamin B12 can cause confusion and memory loss, and may be misdiagnosed as Alzheimer’s. In such cases, large doses of B12, under a doctor’s supervision, may help.
Fish oil supplements
Fish has long been called a brain food, and it’s been theorized that the omega-3 fats in fish oil are beneficial for brain function. The evidence is confusing, however. Some evidence suggests that fish oil supplements help slow cognitive decline in healthy people. Other studies find no benefit. A 2012 review by the Cochrane Collaboration of three large studies found that omega-3 supplements, taken for 6 to 40 months, did not improve cognition, memory or verbal skills in older people without dementia. Longer studies may still find cognitive benefits, the reviewers suggested, and fish itself may have benefits the capsules don’t have.
If you eat fatty fish such as salmon, you don’t need fish oil supplements, unless you have heart disease or high triglycerides and are taking them on a physician’s advice. It’s far from clear that fish oil (from fish or supplements) will help your memory, but what benefits your cardiovascular system may well benefit your brain, too.
What to keep in mind
Memory is a complicated phenomenon, affected by genetics, physiological changes, emotions, education and experience. The cause of age-related memory loss remains largely a mystery, as does how to prevent it.
If you’re experiencing problems, get a medical evaluation. Some kinds of dementia are reversible. Another thing worth remembering: forgetfulness as you grow older does not mean you have dementia. Ignore the unsubstantiated claims made by supplements marketers. There is no convincing evidence that any brain formula, plant extract or vitamin will preserve memory.
To keep your mind functioning on a high level, exercise your brain by learning something new and playing games that require concentration or analytic thinking. Physical exercise and staying socially connected also help maintain brain health.
Perhaps most important: have your blood pressure checked regularly. If it’s above normal, follow medical advice for bringing it under control. Uncontrolled high blood pressure is a risk factor for dementia. Avoiding or at least controlling diabetes is also important; so is weight control, since obesity (especially in the abdomen) has been linked to an increased risk of dementia.
Originally published in August 2010. Updated April 2013.