BY Samuel Mathis MD
Recently, I have received numerous inquiries regarding supplements for memory and cognition. These supplements make up a significant portion of the dollars spent per year with over $7 billion spent in 2021. With so many advertizements and options in the grocery store, patients can quickly become overwhelmed with the various options available. We will now review integrative strategies that help improve memory and reduce the risk of dementia and cognitive decline.
One of the best ways to address cognitive decline is to prevent it. A recent study of over 131 thousand participants found that higher caffeine intake was associated with improved cognitive function and lower dementia rates (1). The study followed participants for approximately 43 years, comparing coffee and tea intake of these individuals. The researchers found that those who drank the most caffeine containing drinks had lower rates of cognitive decline (7.8% vs 9.5%, respectively) (1). Researchers found that the best effect was seen with 2-3 cups of coffee or 1-2 cups of tea per day. The prevailing thought is that the higher caffeine content reduces brain inflammation and amyloid buildup in the brain. Consuming more than 6 cups of coffee a day has been shown to increase risk of dementia and lead to small total brain volume.
When we review supplements, there are numerous ingredients that are persistently found in the ingredient lists. A comprehensive 2023 review found that there were 18 common ingredients that are regularly used for memory (2). Their review found that there was some evidence that memory is improved with supplements such as ashwagandha, choline, curcumin, ginger, Lion’s mane, polyphenols, and phosphatidylserine (2). Ashwagandha may improve cognitive function through its impact on reducing stress-induced cortisol and antioxidant activity. Curcumin works in a similar way through its anti-inflammatory and antioxidant effect. There is research now looking at how it reduces amyloid and tau signals associated with Alzheimer’s. Lion’s mane, a mushroom compound has been shown to promote nerve growth factor which may help with neuroplasticity and memory. Ginger has high antioxidant and anti-inflammatory action which helps to reduce inflammation in the brain. Finally compounds such as choline, polyphenols, and phosphatidylserine all work through impacting neurotransmitter response, reducing inflammation, and improving cellular function within the brain (2).
This same study also evaluated common ingredients that are not found to help with memory. The study found that “there is no compelling evidence for use of apoaequorin, coenzyme Q10, coffee xtracts, L-theanine, omega 3 fatty acids, vitamin B6, vitamin B9, or vitamin B12 supplementation for memory” (2). They also found mixed evidence for the supplements carnitine, gingko biloba, Huperzine A, vitamin D, and vitamin E (2). In this regard, I often recommend not using these supplements or doing a one-month trial to see if the patient or caregiver notices any improvement.
Finally, other integrative strategies that may provide some benefit include mind body practices such as mindful movement like yoga, tai chi, and qigong. Some studies have found that these practices may provide some mild improvement in cognition and mental health (3). Mindfulness-based cognitive therapy and mindfulness-based stress reduction may also provide some benefit. Some RTCs showed that individuals with neurocognitive concerns had improved stress and lower levels of mood disruptions which can improve cognitive function, though further studies are needed as these studies were relatively small sample sizes (3). Healthy diet and regular physical activity are always of benefit for cognition. Multiple studies have found that regular physical activity has a significant benefit on global cognition (3). In those studies, it appears that resistance exercise seems to have the better potential in slowing down cognitive decline compared to aerobic exercise (3). Acupuncture can be a safe modality that has some evidence for its effectiveness as well. Other modalities such as ayurvedic medicine and body-based practices (chiropractor, aromatherapy, massage) have limited scientific evaluation regarding their benefit (3).
Cognitive decline is a significant concern for many of our aging populations. Finding ways to address and encourage patients to protect their cognitive function and live longer healthier lives benefits our entire society. While many integrative options still require further evaluation, we can see that some therapies can work with pharmacological options to promote health and wellbeing.
References:
- Zhang Y, Liu Y, Li Y, et al. Coffee and Tea Intake, Dementia Risk, and Cognitive Function. JAMA. 2026;335(11):961–974. doi:10.1001/jama.2025.27259
- Hersant H, He S, Maliha P, Grossberg G. Over the Counter Supplements for Memory: A Review of Available Evidence. CNS Drugs. 2023;37(9):797-817. doi:10.1007/s40263-023-01031-6
- Nguyen SA, Oughli HA, Lavretsky H. Complementary and Integrative Medicine for Neurocognitive Disorders and Caregiver Health. Curr Psychiatry Rep. 2022;24(9):469-480. doi:10.1007/s11920-022-01355-y