An estimated 298,000 people live with dementia in Australia and much has been written on complementary remedies to beat memory loss.

But what are your treatment options really? We take a look at what the research shows.

Oestrogens
Oestrogen hormonal replacement therapy in postmenopausal women has shown some benefits in terms of memory loss. It seems to protect against decline in verbal memory, while decreasing the risk for Alzheimer’s disease.

However, research studies have shown inconsistent results and currently this is not a widely recommended strategy for cognitive preservation.

One study has shown that hormone replacement therapy, together with exercise, improved cardiovascular function in participants. It also indicated that the walls of the arteries were thinner, which led to improved circulation. This may be helpful in preventing vascular conditions of the brain, such as brain aneurysm.

It’s interesting to note that women have a higher risk of developing Alzheimer’s disease than men.

Ginkgo biloba
Ginkgo biloba shows promising evidence for improvement of cognition, but larger research trials are needed before firm recommendations can be made.

Ginkgo has shown an improvement of age-associated memory decline and some improvement of memory and other cognitive functions in dementia. The drug has also shown benefits in intermittent claudication – a condition of painful lower legs after exercise due to poor blood supply in the lower limbs. Ginkgo has also shown possible benefits for cardiovascular disease.

The dose of ginkgo required for cognitive benefits are varied. However, studies with dosages below 200mg/day have proven beneficial. If you also take warfarin and aspirin, you’re advised to discuss your treatment with your doctor, as ginkgo increases bleeding times.

Arginine
The amino acid arginine is a precursor in the production of nitric oxide in the body. This means it participates in the chemical reaction that produces nitric oxide. This process, in turn, is involved in memory function.

Some studies have evaluated arginine in dementia, but sadly no conclusive proof exists that it has any beneficial effect.

Brahmi
An extract of Bacopa monnieri (brahmi) has been examined for its possible benefits on cognitive function in humans and animals. Preliminary results suggest that brahmi may improve higher-order cognitive processes, which include learning and memory.

Brahmi seems to decrease the rate of forgetting newly acquired information. Do take note, however, of the side effects, which may include stomach cramps, nausea, fatigue and diarrhoea.

Carnitine
The amino acid L-acetylcarnitine (also called acetyl-L-carnitine) has been studied in older adults with mild cognitive decline. A single blind study showed significant improvement of memory and psychological symptoms during treatment with L-acetylcarnitine.

Other reports indicate that this medication may be useful in the treatment of dementia, but conclusive results are needed.

Choline
Lecithin, found in in many foods such as eggs and soybeans, is a major dietary source of choline (a compound that’s similar to vitamin B). Choline, in turn, has been examined for its possible benefits on cognitive performance.

A study in healthy men did not show any enhancement of cognitive ability following treatment with choline, but other studies have shown that decreased choline levels are associated with memory dysfunction.

Choline supplementation may be beneficial in some conditions, but conclusive evidence is still lacking.

DHEA
Several studies have shown that a decline in dehydroepiandrosterone (DHEA) may contribute to Alzheimer’s disease. DHEA is a hormone that’s produced by the adrenal glands and which can be taken in supplement form.

However, double-blind studies with DHEA replacement have not shown significant improvement of cognition. Some of these studies have shown preliminary evidence for mood-enhancing and antidepressant effects for DHEA.

Long-term studies, in which DHEA is taken for longer than a year, are still lacking, but it looks like it may provide some benefits.

DMAE
Dimethylaminoethanol (DMAE) has been examined as a possible memory enhancer. This chemical is involved in the production of the neurotransmitter acetylcholine.

Studies done on rats have shown significant improvements in working memory performance, but robust studies on humans are still lacking.

Ginseng
Ginseng has been studied for its possible beneficial effects on cognition, and short-term use of ginseng has shown some benefits in terms of memory performance.

A Chinese study used Chinese ginseng for treatment of dementia after stroke and found some improvement. However, some researchers say that even well-conducted clinical trials do not support the use of ginseng for the treatment of impaired cognition.

Garlic
Aged garlic extract seems to have some antioxidant health effects. Long-term extraction of garlic for up to 20 months ages the extract and creates more pronounced antioxidant properties. This may protect against the development of Alzheimer’s disease.

Additional research is required, but aged garlic seems to decrease the risk of developing the condition.

Glutathione
A metabolic pathway called the “glutathione cycle” and its influence on Alzheimer’s disease has been studied.

This pathway is linked to oxidative stress, in which damaging free radicals (e.g. from smoking or pollution) are not properly neutralised in the body. Research shows that oxidative stress can damage the brain.

However, no conclusive evidence exists for the use of glutathione in preventing or treating Alzheimer’s disease.

Taurine
The amino acid and neurotransmitter taurine has been examined for its possible cognitive-enhancement effects. Significant improvements have been shown in healthy volunteers for reaction time, concentration and memory.

These improvements reflect the effects of a combination of ingredients. Taurine on its own has not shown any clear benefits in cognitive disorders.

Zinc
Zinc deficiencies may affect cognitive development. In fact, it appears that zinc is essential for the formation of new brain cells and new brain cell connections.

However, zinc supplementation doesn’t seem to have any real benefits in dementia conditions.

Vitamin C & E
Oxygen stress injury is caused by activated oxygen that’s released in metabolic reactions. These chemicals destroy membranes of mitochondria and the genome of the cell, which leads to cell death.

Vitamin C, vitamin E and beta-carotene are considered antioxidants. Dietary supplementation of these vitamins in laboratory animals prolongs mean (average) lifespan, but does not seem to affect maximum lifespan (the age at which the oldest member of the group has died).

Various human studies have shown beneficial effects of these antioxidants. Vitamin C and E preserve health in old age, and seems to protect against artherosclerosis. Vitamin E and C also seem to have some beneficial effects on immunity. Vitamin E and C supplements may protect against vascular dementia and may improve cognitive function in late life.

A 1997 study examined the effectiveness of vitamin E in people with moderate to severe Alzheimer’s disease. In these patients, vitamin E delayed the progression of the illness and preserved functioning in activities of daily living. The dosage of vitamin E in the study was 1000 IU twice daily. For persons without Alzheimer’s disease, a dose of 400 IU is recommended.

People taking “blood thinners” like warfarin should take care when they start taking vitamin E, as the vitamin may lead to a prolongation of bleeding time.

B vitamins
Several B vitamins have shown beneficial effects on memory.

Deficiencies of thiamine (vitamin B1) are associated with poor memory, but supplements in healthy persons have not shown benefits.

Niacin (vitamin B3), on the other hand, may have some benefits.

Vitamin B6 (pyridoxine) and vitamin B12 (cyanocobalamin) are involved in metabolic processes that are important for memory, but supplementation has not proven beneficial.

Folate (folic acid)
Folate supplementation during pregnancy is important to prevent brain and spinal cord defects in the newborn baby.

In healthy adults, however, supplementation has shown no significant benefits.

Anti-inflammatory substances
The use of anti-inflammatories such as non-steroidal anti-inflammatory drugs (e.g. ibuprofen) and aspirin seems to protect against Alzheimer’s disease. This protective effect is present at a low or high dose.

However, anti-inflammatories and aspirin do not seem to protect against vascular dementia.

Grape seed proanthocyanidin extract
The grape seed extract proanthocyanidin has shown antioxidant properties (more so than vitamin E and C, and beta-carotene, some researchers say). Proanthocyanidin is also present in grape skins.

These extracts may show some benefit in artherosclerosis, but no evidence exists for any effects on memory.

Omega-3 fatty acids
Docosahexaenoic acid (DHA, an omega-3 fatty acid) and arachidonic acid (AA, an omega-6 fatty acid) are both long-chain polyunsaturated fatty acids that are important for cognitive development and brain function.

Omega-3 may play a role in mental well-being and may have mood-stabilising effects. In some studies, preparations with omega-3 to omega-6 ratios ranging from 1:4 produced significant, favourable effects on learning performance.

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