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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 standardised 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 and B12 for improved memory and other brain functions
- Get moving - Start a walking programme or join an exercise group to gain brain-function benefits
- Give your brain a workout - Improve cognitive functioning with a memory-enhancement programme
These recommendations are not comprehensive and are not intended to replace medical advice but the following information on medicines, vitamins, herbs, dietary and lifestyle changes may be helpful.
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About age-related cognitive decline
A decline in memory and cognitive (thinking) 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 specialised 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 a few terms for this middle category, including “mild cognitive impairment" and “mild neuro-cognitive disorder."
Risk factors for ARCD include advancing age, female gender, prior heart attack and heart failure.
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Dietary changes that may be helpful
- In the elderly population of southern Italy, which eats a typical Mediterranean diet, high intake of mono-unsaturated fatty acids (eg olive oil) has been associated with protection against ARCD in preliminary research.
- 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 anti-oxidant-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.
Lifestyle changes that may be helpful
- Cigarette smokers appear to have some protection against ARCD. The reason for this association remains unknown. As cigarette smoking generally is not associated with other health benefits and results in serious health risks, doctors recommend abstinence from smoking, even by people at risk of ARCD.
- 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.
- People with high levels of education have some protection against ARCD
- A randomised, 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.
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Vitamins that may be helpful
- A few 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 favourable effects persisted at least 30 days after treatment was discontinued.
- In a double-blind trial, supplementing with 50 mg of beta-carotene every other day for 18 years appeared to slow the loss of cognitive function in middle-aged healthy males. Short-term supplementation (1 year) was not beneficial.
- Use of vitamin C or vitamin E supplements, or both, has been associated with better cognitive function and a reduced risk of certain forms of dementia (not including Alzheimer’s disease). Clinical trials of these anti-oxidants are needed to confirm the possible benefits suggested by this study.
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Herbs that may be helpful
Most, but not all clinical trials, have found ginkgo biloba supplementation to be a safe and effective treatment for ARCD.
Whilst ginkgo is probably the herb most associated with memory, there are several others that are also well regarded in this area including lemon balm, sage and rosemary.
How much is usually taken?
Most clinical trials have used between 120 and 240 mg of ginkgo (standardised to contain 6% terpene lactones and 24% flavone glycosides) per day, generally divided into two or three portions. The higher amount (240 mg per day) has been used in some people with mild-to-moderate Alzheimer’s disease, age-related cognitive decline, intermittent claudication and resistant depression. Ginkgo may need to be taken for eight to twelve weeks before desired actions such as cognitive improvement are noticed. Although nonstandardised Ginkgo biloba leaf and tinctures are available, there is no well-established amount or use for these forms.
Certain medicines interact with Ginkgo biloba: Some interactions may increase the need for Ginkgo biloba, other interactions may be negative and indicate Ginkgo biloba should not be taken without first speaking with your pharmacist.
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Wellness:
A key to help your brain function well is to keep on using it – learn new things, play complex games and try doing things with your non-dominant hand.
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