Vitamins that may be helpful
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.28 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.29 Controlled30 31 32 and
uncontrolled33 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. In an unblinded trial of ten elderly women with depressive disorders,
supplementation with PS produced consistent improvement in depressive symptoms, memory, and
behavior after 30 days of treatment.34 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.35
Most research has been conducted with PS derived from bovine tissue, but what is available
commercially is made from soy. The soy- and bovine-derived PS, however, are not structurally
identical.36 Doctors and researchers have debated whether the structural
differences could be important,37 38 but so far only a few trials have
studied the effects of soy-based PS.
Preliminary animal research shows that the soy-derived PS does have effects on brain
function similar to effects from the bovine source.39 40 41
An isolated, unpublished double-blind human study used soy-derived PS in an evaluation of
memory and mood benefits in nondemented, nondepressed elderly people with impaired memories
and accompanying depression.42 In
this three-month study, 300 mg per day of PS was not significantly more effective than a
placebo. In a double-blind study, soy-derived PS was administered in the amount of 300 or 600
mg per day for 12 weeks to people with age-related memory impairment. Compared with the
placebo, soy-derived PS had no effect on memory or on other measures of cognitive
function.43 While additional research needs to be done, currently available
evidence suggests that soy-derived PS is not an effective treatment for age-related cognitive
decline.
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.44
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.45 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.46 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.47 Other double-blind trials have reported similar effects of vinpocetine
in people with some types of dementia or age-related cognitive decline.48
49 However, a study of Alzheimer patients in the United States found vinpocetine given
in increasing amounts from 30 mg to 60 mg per day over the course of a year neither reversed
nor slowed the decline in brain function measured by a number of different
tests.50
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.51 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 65.52 A Finnish study demonstrated that approximately
25% of Finnish and Dutch elderly people are deficient in vitamin B6 as compared to 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.53 A more recent double-blind trial of 38 healthy men, aged 70 to 79
years, showed that 20 mg pyridoxine per day improved memory performance, especially long-term
memory.54
Supplementation with vitamin B12 may
improve cognitive function in elderly people who have been diagnosed with a B12 deficiency.
Such a deficiency in older people is not uncommon. In a preliminary trial, intramuscular
injections of 1,000 mcg of vitamin B12 were given once per day for a week, then weekly for a
month, then monthly thereafter for 6 to 12 months. Researchers noted “striking”
improvements in cognitive function among 22 elderly people with vitamin B12 deficiency and
cognitive decline.55 Cognitive disorders due to vitamin B12 deficiency may also
occur in people who do not exhibit the anemia that often accompanies vitamin B12 deficiency.
For example, in a study of 141 elderly people with cognitive abnormalities due to B12
deficiency, 28% had no anemia. All participants were given intramuscular injections of vitamin
B12, and all showed subsequent improvement in cognitive function.56
Vitamin B12 injections put more B12 into the body than is achievable with absorption from
oral supplementation. Therefore, it is unclear whether the improvements in cognitive function
described above were due simply to correcting the B12 deficiency or to a therapeutic effect of
the higher levels of vitamin B12 obtained through injection. Elderly people with ARCD should
be evaluated by a healthcare professional to see if they have a B12 deficiency. If a
deficiency is present, the best way to proceed would be initially to receive vitamin B12
injections. If the injections result in cognitive improvement, some doctors would then
recommend an experimental trial with high amounts of oral B12, despite a current lack of
scientific evidence. If oral vitamin B12 is found to be less effective than B12 shots, the
appropriate treatment would be to revert to injectable B12. At present, no research trials
support the use of any vitamin B12 supplementation in people who suffer from ARCD but are not
specifically deficient in vitamin B12.
Melatonin is a hormone secreted by the
pineal gland in the brain. It is partially responsible for regulating sleep-wake cycles.
Cognitive function is linked to adequate sleep and normal sleep-wake cycles. Cognitive
benefits from melatonin supplementation have been suggested by preliminary research in a
variety of situations and may derive from the ability of melatonin to prevent sleep
disruptions.57 58 59 60 A double-blind trial of
ten elderly patients with mild cognitive impairment showed that 6 mg of melatonin taken two
hours before bedtime significantly improved sleep, mood, and memory, including the ability to
remember previously learned items.61 However, in a double-blind case study of one
healthy person, 1.6 mg of melatonin had no immediate effect on cognitive
performance.62
The long-term effects of regularly taking melatonin supplements remain unknown, and many
healthcare practitioners recommend that people take no more than 3 mg per evening. A doctor
familiar with the use of melatonin should supervise people who wish to take it regularly.
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).63 Clinical trials of these antioxidants are needed to
confirm the possible benefits suggested by this study.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
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