The most common health fear among people over age 50 is Alzheimer’s disease. One solution to this angst for many people is a brain health supplement. About 25 percent of Americans over age 50 are taking at least one product that’s advertised for brain health. The problem is that there is very little evidence that these products actually do anything.

You’ve probably seen or heard commercials for Prevagen, Neuriva, Neuro Health, or Focus Factor. It’s hard to miss them. A recent review of brain health supplements in the journal Senior Care Pharmacist found these are some of the most common brands. It also found that many of these brands have similar ingredients, such as ginkgo biloba, B vitamins, huperzine-A, Bacopa monnieri, and phosphatidylserine. Fish oil (omega-3 fatty acid), curcumin, and vitamin E are also popular ingredients.

Brain health supplements are not inexpensive. Fifty Neuriva gummies may cost you well over $50.

What the science says

Supplement studies are hard to do, and there is very little research for most ingredients. Pharmaceutical companies and major health organizations are not investing in studies on supplements like huperzine-A and Bacopa monnieri, but there is some research on ginkgo biloba, omega-3 fatty acids, B vitamins, and vitamin E. 

Ginkgo biloba has been studied in some big and well-funded clinical trials. In a trial of 3,000 older adults, it failed to reduce the risk of dementia or Alzheimer’s disease. Some smaller trials found that it improved cognitive function in patients with Alzheimer’s, but not enough to improve quality of life. There is also some small-trial evidence for improvement in people with early cognitive impairment. These studies conclude that more research is needed.

Omega-3 fatty acids. According to the National Center for Complementary and Integrative Health, omega-3 fatty acids show consistently good results in studies—but those benefits show up only when looking at high omega-3 diets. Diets high in fish, like mackerel or salmon, are consistently linked to better brain health. Supplements don’t show the same benefits.

According to the Harvard School of Public Health, the reason vitamins and other nutrients—even antioxidants—have benefits in whole foods but not supplements is due to nutrient synergy. Nutrients from foods are absorbed in a balanced mix of vitamins, minerals, phytochemicals, and antioxidants. Pulling out one nutrient and giving it as a high-dose supplement is like pulling one instrument out of a symphony orchestra.

Vitamin B. A 2022 review of 95 studies, including about 50,000 people, concluded that vitamin B supplements may slow cognitive decline. However, an earlier review of five studies with about 900 people did not find any benefits for people over age 50 with or without Alzheimer’s disease.

Vitamin E studies have been less hopeful. A 2021 review of five studies including over 14,000 people found no benefits for people with or without AD.

Other supplements

This is what we know about the other supplements:

  • Curcumin is the active ingredient in the spice turmeric, and it has a long history of use as medicine for its anti-inflammatory effects. A 2019 review found some benefits for mind health, but not consistently.
  • Huperzine is a Chinese herb used to treat Alzheimer’s disease in China. A review of 20 clinical trials with close to 2,000 patients found that huperzine may have beneficial effects for AD, but the trials were small and inconsistent, with more research needed.
  • Phosphatidylserine is an important fatty substance needed in animal nerve cells. Supplements made from cow brains were stopped due to fear of mad cow disease. Today this supplement is made from soybeans or cabbage, and support for cognitive health is limited.
  • Bacopa monnieri is an Asian herb used in India for memory. Research is scarce. A review of six small studies found that people without dementia had some improved memory performance when taking it.
  • Apoaequorin is found only in Prevagen, and it is the only active ingredient in Prevagen. The only research supporting the product was done by the manufacturer, and there is no evidence that this supplement reaches the brain.

Some brain health supplements may help, but no supplement has the kind of support that would be required for FDA approval. Fortunately for supplement makers, the FDA does not approve supplements for safety, content, or effectiveness. That is why, no matter what a supplement claims to do, the label must say that the product has not been evaluated by the FDA and that the product is not intended to diagnose, treat, cure, or prevent any disease.

What really works

There is a lot of research on preventing dementia through lifestyle changes. The Finnish Geriatric Intervention (FINGERS) Study to Prevent Cognitive Impairment and Disability was a three-year trial that included more than 1,200 older adults. It found that exercise, diet, social activity, and challenging brain activities (cognitive stimulation) improved memory by 40 percent and cognition by 25 percent. The study continues today as the Worldwide FINGERS study.

Two recent studies presented at the Alzheimer’s Association International Conference followed close to 2,000 older adults for about 14 years. Those who had healthier diets, more exercise, and more cognitive stimulation had a 60 percent lower risk of developing dementia than others in the study.

The bottom line: Try a supplement if you want, but don’t ignore the proven ways to improve mind health and reduce your risk of dementia.

Most supplements are harmless, and some people do swear by them. The main danger of taking a supplement is that you may think you are doing all you can for brain health. That would be a mistake because there are other things you can do that science more strongly supports.

Proven Ways to Protect Cognition

  • Eat a brain-healthy diet, such as the Mediterranean, MIND, or the DASH diet.
  • Exercise regularly.
  • Keep your brain active.
  • Be socially active.
  • Get at least seven hours of sleep every night.
  • Don’t smoke, and limit or avoid alcohol.
  • Maintain a healthy weight.
  • If you experience depression, talk to your doctor about treatment options.

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