Key Takeaways
- So far, no supplements have been proven to enhance memory or prevent cognitive decline.
- Supplements sold on the U.S. market are not evaluated by the U.S. Food and Drug Administration for safety or efficacy.
- Brain health can be improved through lifestyle changes like being physically and socially active.
If you take a supplement to support brain health, stay cognitively sharp, or reduce your risk for dementia, you’re in good company. More than 1 in 4 Americans take at least one supplement for brain health, which translates to nearly $6 billion in sales.
The urge to find a vitamin, mineral, or herb that preserves memory and thinking abilities is understandable. Dementia is near the top of the list when it comes to the health conditions that people fear the most, and it’s estimated that as the population ages, the disease could affect more than 9 million Americans by 2030. Worldwide, nearly 10 million new cases occur every year.
But it’s important to separate wishful thinking from scientific evidence, especially when it comes to supplements of any kind. Unlike drugs, which have to go through several rigorous trials to prove efficacy and safety before they’re approved by the U.S. Food and Drug Administration (FDA), supplements aren’t approved by the FDA before they are marketed, and the “agency often does not know when new products come on the market,” according to its website.
The FDA also doesn’t test supplements before they hit the shelves, and due to limited resources, it doesn’t routinely analyze the content of supplements to ensure that they are safe, effective, or even contain the ingredients listed on the label, per the FDA website.
Given this hands-off, buyer-beware approach, educating yourself about brain health supplements is essential. Here’s what top experts on cognitive health and supplements have to say about which — if any — brain-boosting supplements are worth your time and money, and which ones to look out for because they may contain untested ingredients.
Who Needs Supplements?
“Broadly speaking, good nutrition is important to a lot of health outcomes, and really poor nutrition is harmful to health in a lot of ways,” says Victor Henderson, MD, the director of the Stanford Alzheimer’s Disease Research Center and a professor of epidemiology and population health at Stanford Medicine in Palo Alto, California.
But if you’re talking about people in the United States who are fairly well nourished, there’s really not strong evidence that taking a supplement is going to boost cognitive outcomes or brain health, or do anything to prevent dementia, says Dr. Henderson.
Omega-3 Fatty Acid Supplements: Worth the Investment?
There has been interest in omega-3 fatty acids for brain health for a while, says Henderson. “If you look at cell membranes, cell functions, cell metabolism, it makes sense that omega-3 supplements might have an effect on the process,” he says.
Two types of omega-3s typically marketed as brain health supplements are docosahexaenoic acid (DHA) and eicosatetraenoic acid.
The underlying scientific question isn’t why these substances might be important but do they really make a difference if people take them, says Henderson. “And unfortunately, the clinical trials that have been done with those kinds of supplements haven’t shown much of a difference,” he says.
The Alzheimer’s Association, a nonprofit organization that supports Alzheimer’s research and advocates for people affected by the disease, states that there’s not enough evidence to recommend DHA or any other omega-3 fatty acid to treat or prevent Alzheimer’s disease.
Are There Benefits to Phosphatidylserine?
What about phosphatidylserine? This fatty substance protects nerve cells in the brain and helps brain cells communicate with one another. It occurs naturally in the body as well as in foods such as soy, fish, and eggs.
The amount of the phosphatidylserine in your body decreases as you age, so theoretically, increasing it via a supplement could have benefits for cognitive function, says Pieter Cohen, MD, an associate professor of medicine at Harvard Medical School in Boston and a leading researcher in supplement safety at the Cambridge Health Alliance.
“There are some small studies that show it may have some benefit and some that don’t show much of anything, so right now there’s not enough to make a recommendation,” Dr. Cohen says.
As far as supplements containing herbs or other chemical substances, there isn’t strong evidence that taking these types of supplements have brain benefits either, he says.
No Quick Fixes, and Possible Harm, From Brain-Boosting Supplements
In the Wild West of the supplement industry, companies can advertise their supplement as improving memory, cognition, or brain health without any clinical trials in humans that actually show that, says Cohen.
“The advertising opportunities of the companies are really limitless, as long as they avoid specific drug claims, like ‘This will cure Alzheimer’s disease.’ Something like that would strike the FDA as a drug claim,” he says.
But the truth is, there’s no supplement ingredient that you could take to feel smarter or to give you a sharper memory in a matter of days, weeks, or months — a notion that Cohen completely dismisses as possible.
“The only thing that supplements might potentially do in the future is that maybe you take it for 10 years, and it somehow slightly decreases the risk of memory loss. That’s theoretically possible, and that’s the kind of thing that’s being investigated,” he says.
But companies want consumers to keep buying the supplements, absent evidence that there’s a magic substance that boosts memory and thinking, says Cohen.
“This raises a situation where some companies, in an effort to try to match or keep up with what they’ve advertised, then reach for illegal drugs, experimental drugs, or unapproved or foreign drugs,” he says.
Cohen has reported on this trend in research. “Sometimes these ingredients are listed on the label, and sometimes they aren’t, but it’s concerning either way, because these drugs are experimental and could pose a health risk,” he says.
What ‘Clinically Tested’ Really Means (Spoiler Alert: Not Much)
Does buying a supplement that’s advertised as “clinically tested” ensure that it has evidence to back up any claims? Nope.
“Because ‘clinically tested’ isn’t a regulated, defined term in the supplement world, it doesn’t even mean it’s been through a clinical trial,” says Henderson.
In that context, “clinically tested” just means it’s been tested on people, but it could have been tested on a half a dozen college students, family members of a supplement executive, or just about anyone, he says.
“A supplement labeled ‘clinically tested’ could also mean that it really was tested in an actual clinical trial — it probably does not, but it could. If you want to know for certain, go to ClinicalTrials.gov, where all clinical trials are registered. Put in the name of the compound and search to see if there are clinical trials have been completed or are currently underway,” says Henderson.
Can Multivitamins Preserve Memory or Cognitive Function?
What about the recent study that found a basic multivitamin had cognitive benefits?
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Multivitamin benefits were observed in three nonoverlapping groups of people enrolled in the same parent trial, says co-author Laura D. Baker, PhD, a professor of gerontology and geriatric medicine at Wake Forest University School of Medicine in Winston-Salem, North Carolina. “That increases our confidence that daily multivitamin supplementation holds promise as a strategy to support cognitive health in older adults,” Dr. Baker says.
Researchers found evidence of multivitamin benefits for both global cognition and episodic memory, which they estimated added up to slowed global cognitive aging by an estimated two years compared with a placebo.
However, researchers don’t have an explanation why supplementing with a multivitamin would improve cognitive health in people without any vitamin deficiencies, and more research is needed to see if the findings can be confirmed in studies with real-world outcomes, says Cohen. “At this point, I’m not going to recommend multivitamins to my patients as a way to maintain or improve their memory,” he says.
Baker agrees that it’s too early for widespread recommendations on multivitamins to preserve cognitive function or memory.
“Although the trials increased our confidence, it’s important to note that the group studied here was predominantly white and well educated. We don’t know about efficacy and safety in underrepresented groups that are at a higher risk for cardiovascular and other co-morbidities,” she says. Investigators are planning a new trial that aims to address this issue, adds Baker.
Bottom Line: Brain Health Supplements Aren’t Ready for Prime Time
Experts generally agree that there isn’t enough evidence to recommend any type of supplement for brain health — at least not yet.
“I think that there are some interesting scientific questions swirling around some types of supplements that need to be sorted out, and maybe there will be a role for supplements and cognition in the future. But we’re not there yet,” says Cohen.
Henderson agrees: “The supplement industry is a huge multibillion-dollar industry, and there’s very little evidence behind any of them. There are some mechanisms in the brain where it seems plausible that certain ingredients may help preserve function, but as of right now, any clinical data in humans showing that they have any positive effect is weak.”
Because nothing is ready for prime time, Cohen doesn’t recommend any types of vitamins or supplements to improve cognition, decrease memory loss, or reduce the risk of dementia including Alzheimer’s disease.
“If a patient really wants to take a multivitamin every day, I don’t think the evidence is strong enough to recommend that, but I’m not going to spend a lot of time during the visit trying to talk them out of it, because it’s not going to harm them to do that,” Cohen says.
Although supplements aren’t the key to maintaining brain health, many lifestyle changes are associated with reduced risk of cognitive impairment and dementia.
Evidence-Based Ways to Improve Brain Health
Money spent on health supplements would be better spent on a healthy lifestyle — for example, eating healthy foods, getting physical activity, and taking any prescribed medications to help manage chronic conditions, says Henderson.
Controlling blood sugar, maintaining a healthy weight, and managing blood pressure can reduce the risk of future dementia, according to the Centers for Disease Control and Prevention.
Quality sleep is important for brain health, too. A lack of sleep (over many months or years, not just a night or two here and there) may increase dementia risk.
Finally, having a sense of purpose, staying socially connected, reading, and engaging in other mentally stimulating activities may also help protect your brain and reduce the risk of cognitive impairment.
