Do brain-health supplements really keep your mind sharp?

By 2060, an estimated 14 million older adults in the United States will be living with dementia, according to the Centers for Disease Control and Prevention. The condition affects not only memory, but decision-making and the overall ability to perform daily activities. Alzheimer’s disease, the most common type of dementia, currently affects about 6.7 million U.S. adults.

Despite its rising prevalence, dementia isn’t a normal or inevitable part of aging. Still, developing the condition is a widespread concern, especially among older adults. Many try various strategies to protect their brain health, including pursuing hobbies and doing mentally stimulating activities like crossword puzzles. Taking brain-health supplements is also common. In fact, the 2021 AARP Brain Health and Supplements Survey found that 21 percent of U.S. adults ages 50 and older take at least one of these products.

But do over-the-counter brain-health supplements really help sharpen fuzzy thinking or boost mental alertness? Could they really help stave off mental decline, or even Alzheimer’s?

The short answer: It’s unclear. There is little scientific evidence about the effectiveness of brain-health supplements. We do know they’re not risk-free.

Another important truth: You should not take supplements of any kind, including those labeled as “all-natural,” without talking to your healthcare provider (HCP) about it first.

Supplements aren’t regulated

The U.S. Food and Drug Administration (FDA) hasn’t approved any supplement to prevent dementia or slow its progression, cautions Kinjal Desai, MD, a vascular neurologist and neurointensivist in Texas.

The agency doesn’t regulate dietary supplements in the same way that it controls prescription and over-the-counter medications. That means health officials do not test supplements for safety or effectiveness, and they could contain harmful hidden ingredients. Brain supplements also can’t be advertised as treatments for diseases, such as Alzheimer’s, but many are marketed as being beneficial for mental focus and memory—claims that aren’t backed by iron-clad research.

Understanding the claims

What is a brain supplement anyway? Most of these products focus on a few key nutrients that are usually included as part of an overall, heart-healthy eating plan—such as the Mediterranean and DASH diets—which have been associated with greater longevity. Among these nutrients:

Omega-3 fatty acids

Some studies suggest that eating fish—particularly fatty fish, like salmon and sardines—and other seafood is associated with reduced risk for cognitive decline. But research on omega-3 fatty acid supplements, also known as fish oil, is mixed.

Some studies have hinted at the possibility that taking supplements may slow cognitive decline or even benefit those with mild cognitive impairments. But there are many variables—including dose, genes, and level of cognitive impairment—that could affect those benefits. What’s more, other studies have not shown an effect. More research is needed before a recommendation can be made.

B vitamins

Healthy levels of certain B vitamins, such as B12, B9 (folate or folic acid), and B1 (thiamine) are essential for brain health. B12 deficiency can cause reversible cognitive impairment. A deficiency in these vitamins has been linked to mental decline and dementia later in life. But there’s no conclusive evidence that B-vitamin supplementation is associated with brain benefits.

Meanwhile, most people get adequate amounts of these vitamins through their diet alone. Folate is found in a wide range of brain-healthy foods, particularly dark leafy greens, fruits, nuts, beans, peas, meat, poultry, seafood, grains, and dairy products. Vitamin B12 is found mainly in animal products, such as fish, meat, poultry, eggs, but it’s often added to breakfast cereals and other fortified foods.

Keep in mind, B12 deficiency is fairly common among older people. Those in this age group should ask their HCP if they would benefit from a supplement.

Vitamin E

This antioxidant helps keep your immune system working properly and protects against cellular damage. Some research suggests that getting a lot of vitamin E through your diet is linked to a lower risk for dementia, but there is little evidence that supplements offer the same protective benefit. And while there is no known risk from consuming vitamin E-rich foods, high-dose supplements can increase the risk for internal bleeding. It may be particularly risky for people taking blood thinners, such as warfarin (Coumadin).

Curcumin

The compound that gives turmeric its bright orange color, curcumin has been touted as a “superfood” with a range of anti-inflammatory and antioxidant properties. While some studies suggest it may benefit working memory (temporary storage of information) for some people, there is not enough evidence to suggest it could help prevent or manage dementia.

Other supplements touted for brain health include ginkgo biloba and coenzyme Q10 (CoQ10). But, once again, there is scant evidence that these products have any actual cognitive benefit.

The bottom line on brain-health supplements

It’s wise to keep your cash in your wallet, advises the AARP-founded Global Council on Brain Health (GCBH), a group of leading neurologists and other brain experts. They have found there’s simply not enough evidence that brain-health supplements actually work.

If you are interested in taking a supplement, however, Dr. Desai advises talking to an HCP. They can give you the best advice on whether a product is right for you based on your health history and any medications you may be taking.

What you should do instead

Rather than spend money on unproven and possibly risky brain-health supplements, you could focus on what has been shown to improve cognitive function, including the following.

Get moving

Exercise can benefit your brain and overall health by improving blood flow, protecting heart health, and keeping stress hormone levels and inflammation in check. Physical activities such as swimming, walking, and biking may preserve your brain cells and encourage the growth of new ones. Long-term exercise also may bolster the area of the brain that helps form memories.

Know what foods are good for the brain

Certain diets emphasizing fruits, vegetables, healthy unsaturated fats, nuts, and whole grains are associated with better brain function. These eating plans are rich in many nutrients used to make so-called brain-health supplements, but the body may not absorb nutrients from supplements in the same way that it does from food. When consumed as part of an overall healthy diet, nutrients may work together and have synergistic effects, which isn’t the case when consumed as individual supplements.

For brain health, Desai recommends the MIND diet—a combination of the low-salt DASH diet and the Mediterranean diet.

Limit alcohol

Anyone who has had a few drinks, or been around someone who’s been drinking, can attest to alcohol’s effects on the brain. In the short term, people can have walking troubles, slowed reaction times, and memory lapses. Heavy alcohol consumption is also linked to short- and long-term cognitive impairment and an increased risk for dementia.

While the effects of moderate drinking are less clear, if you don’t drink, it’s best not to start. And if you do decide to imbibe, limit your intake to reduce your risk for multiple health issues. For women, that means no more than one drink per day. Men should have no more than two daily drinks.

Don’t smoke or vape

Smoking contributes to brain aging, speeds up cognitive problems, and it may even shrink your brain, Desai says. It’s important to avoid all forms of tobacco, including e-cigarettes.

Prioritize sleep

Poor sleep can lead to “brain fog” or reduced mental alertness. It could also lead to more accumulation of beta-amyloid, a protein in the brain associated with impaired brain function and Alzheimer’s disease. Getting seven to nine hours of sleep per night is essential for brain health, Desai says.

Sleep disorders, including insomnia and sleep apnea, can disrupt sleep and have been linked to brain health issues. If you find it difficult to sleep at night, speak with an HCP about potential causes and treatments.

Protect your heart health

Good heart health is linked to better brain health. Keeping issues such as high blood pressure, diabetes, and high cholesterol under control will help protect your brain function.

Stay social

There is some evidence that maintaining strong social connections could help keep your mind sharp over time. Research suggests that having a large social network may be associated with a lower risk for dementia and better brain health. While scientists aren’t sure how being social helps, getting out for lunch with friends, watching a game or movies with your pals, or being active in volunteer groups boosts your mood and has few downsides, too.

Prevent accidents

A brain injury can increase your chances of developing cognitive problems. Wear a helmet when biking or doing any contact sport. Always use your seat belt in the car, and clear obstacles in your home or workspace that could increase your risk of falling.