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Stay Sharp: Tips to Slow Age-Related Cognitive Decline

With a little help you can reduce the effects of age-related cognitive decline, such as memory problems. According to research or other evidence, the following self-care steps may be helpful:

  • Go for the ginkgo: Boost mental function by taking 120 to 240 mg a day of a standardized herbal extract of Ginkgo biloba
  • Explore acetyl-L-carnitine: Taking 1,500 mg a day of this supplement may improve memory, mood, and responses to stress
  • Boost your memory with B vitamins: Treat deficiencies of vitamins B6 for improved memory and other brain functions
  • Get moving: Start a walking program or join an exercise group to gain brain-function benefits
  • Give your brain a workout: Improve thinking (cognitive) functioning with a memory-enhancement program

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth information.

About age-related cognitive decline

A decline in memory and cognitive function is considered by many authorities to be a normal consequence of aging. While age-related cognitive decline (ARCD) is therefore not considered a disease, authorities differ on whether ARCD is in part related to Alzheimer’s disease and other forms of dementia or whether it is a distinct entity. People with ARCD experience deterioration in memory and learning, attention and concentration, thinking, use of language, and other mental functions.

ARCD usually occurs gradually. Sudden cognitive decline is not a part of normal aging. When people develop an illness such as Alzheimer’s disease, mental deterioration usually happens quickly. In contrast, cognitive performance in elderly adults normally remains stable over many years, with only slight declines in short-term memory and reaction times.

People sometimes believe they are having memory problems when there are no actual decreases in memory performance. Therefore, assessment of cognitive function requires specialized professional evaluation. Psychologists and psychiatrists employ sophisticated cognitive testing methods to detect and accurately measure the severity of cognitive decline. A qualified health professional should be consulted if memory impairment is suspected.

Some older people have greater memory and cognitive difficulties than do those undergoing normal aging, but their symptoms are not so severe as to justify a diagnosis of Alzheimer’s disease. Some of these people go on to develop Alzheimer’s disease; others do not. Authorities have suggested several terms for this middle category, including “mild cognitive impairment” and “mild neurocognitive disorder.” Risk factors for ARCD include advancing age, female gender, prior heart attack, and heart failure.

Helpful dietary changes

In the elderly population of southern Italy, which eats a typical Mediterranean diet, high intake of monounsaturated fatty acids (for example, olive oil) has been associated with protection against ARCD in preliminary research. However, the monounsaturated fatty acid content of this diet might only be a marker for some other dietary or lifestyle component responsible for a low risk of ARCD.

Caffeine may improve cognitive performance. Higher levels of coffee consumption were associated with improved cognitive performance in elderly British people in a preliminary study. Older people appeared to be more susceptible to the performance-improving effects of caffeine than were younger people. Similar but weaker associations were found for tea consumption. These associations have not yet been studied in clinical trials.

Animal studies suggest that diets high in antioxidant-rich foods, such as spinach and strawberries, may be beneficial in slowing ARCD. Among people aged 65 and older, higher vitamin C and beta-carotene levels in the blood have been associated with better memory performance, though these nutrients may only be markers for other dietary factors responsible for protection against cognitive disorders.

One preliminary study found that, among middle-aged men, those who ate more tofu had a higher rate of cognitive decline compared with men who ate less tofu. Since tofu and other soy products have consistently demonstrated important health benefits in this age group (for example, as cholesterol-lowering foods), middle-aged men should not limit their consumption of these foods until the results of this isolated study are independently confirmed.

Helpful lifestyle changes

A large, preliminary study in 1998 found associations between hypertension and deterioration in mental function. Research is needed to determine if lowering blood pressure is effective for preventing ARCD.

A randomized, controlled trial determined that group exercise has beneficial effects on physiological and cognitive functioning, and well-being in older people. At the end of the trial, the exercisers showed significant improvements in reaction time, memory span, and measures of well-being when compared with controls. Going for walks may be enough to modify the usual age-related decline in reaction time. Faster reaction times were associated with walking exercise in a British study. The results of these two studies suggest a possible role for exercise in preventing ARCD. However, controlled trials in people with ARCD are needed to confirm these observations.

Psychological counseling and training to improve memory have produced improvements in cognitive function in persons with ARCD.

Helpful vitamins

Several clinical trials suggest that acetyl-L-carnitine delays onset of ARCD and improves overall cognitive function in the elderly. In a controlled clinical trial, acetyl-L-carnitine was given to elderly people with mild cognitive impairment. After 45 days of acetyl-L-carnitine supplementation at 1,500 mg per day, significant improvements in cognitive function (especially memory) were observed. Another large trial of acetyl-L-carnitine for mild cognitive impairment in the elderly found that 1,500 mg per day for 90 days significantly improved memory, mood, and responses to stress. The favorable effects persisted at least 30 days after treatment was discontinued. Controlled and uncontrolled clinical trials on acetyl-L-carnitine corroborate these findings.

Phosphatidylserine (PS) derived from bovine brain phospholipids has been shown to improve memory, cognition, and mood in the elderly in at least two placebo-controlled trials. In both trials, geriatric patients received 300 mg per day of PS or placebo. A double-blind trial of 494 geriatric patients with cognitive impairment found that 300 mg per day of PS produced significant improvements in behavioral and cognitive parameters after three months and again after six months. Most research has been conducted with PS derived from bovine tissue, but what is available commercially is made from soy. Preliminary animal research shows that the soy-derived PS does have effects on brain function similar to effects from the bovine source. However, current available evidence suggests that soy-derived PS does not improve cognitive function in humans.

In a double-blind trial, elderly people with high homocysteine levels received 800 mcg of folic acid per day or a placebo for three years. Compared with placebo, folic acid supplementation significantly slowed the rate of decline of memory and of other measures of cognitive function. Whether folic acid would slow cognitive decline in people with normal homocysteine levels is not known.

A double-blind trial found both 30 mg and 60 mg per day of vinpocetine improved symptoms of dementia in patients with various brain diseases. Another double-blind trial gave 30 mg per day of vinpocetine for one month, followed by 15 mg per day for an additional two months, to people with dementia associated with hardening of the arteries of the brain, and significant improvement in several measures of memory and other cognitive functions was reported. Other double-blind trials have reported similar effects of vinpocetine in people with some types of dementia or age-related cognitive decline (though not Alzheimer’s disease). Vincamine, the unmodified compound found naturally in Vinca minor, has also been tested in people with dementia. A large double-blind trial found 60 mg per day of vincamine was more effective than placebo for improving several measures of cognitive function in patients with either Alzheimer’s disease or dementia associated with vascular brain disease. A small double-blind study of vascular dementia also reported benefits using 80 mg per day of vincamine.

Vitamin B6 (pyridoxine) deficiency is common among people over age 65. A Finnish study demonstrated that approximately 25% of Finnish and Dutch elderly people are deficient in vitamin B6 as compared with younger adults. In a double-blind trial, correcting this deficiency with 2 mg of pyridoxine per day resulted in small psychological improvements in the elderly group. However, the study found no direct correlation between amounts of vitamin B6 in the cells or blood and psychological parameters. A more recent double-blind study of 38 healthy men, aged 70 to 79 years, showed that 20 mg pyridoxine per day improved memory performance, especially long-term memory.

Helpful herbs

While it has not been shown to prevent serious dementia such as Alzheimer’s disease, most clinical trials, many of them double-blind, have found Ginkgo biloba supplementation to be a safe and effective treatment for ARCD.

Huperzine A, an isolated alkaloid from the Chinese medicinal herb huperzia (Huperzia serrata), has been found to improve cognitive function in elderly people with memory disorders. One double-blind trial found that huperzine A (100 to 150 mcg two to three times per day for four to six weeks) was more effective for improving minor memory loss associated with ARCD than the drug piracetam. More research is needed before the usefulness of huperzine A is considered a proven treatment for mild memory loss associated with ARCD.


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