Indeed, one AARP analysis of spending on just six different supplements marketed for brain health shows that 50-plus adults spend more than $93m a month on these proprietary blends alone. “These people taking these pills are spending between $20 and $60 a month and flushing dollars down the toilet that could be better spent on things that actually improve their brain health,” Lock says.
Along with providing advice consumers and health practitioners can act on, the report calls out supplement makers, whose products – unlike prescription drugs – are not regulated by the US Food and Drug Administration and not tested for effectiveness before they are permitted to be sold. “The market is so large they get by without rigorous documentation of the efficacy of their products,” says neurologist Ronald Petersen, director of the Mayo Clinic Alzheimer's Disease Research Centre in Rochester, and a member of the GCBH governance committee.
As Petersen notes, given the lack of government regulation before their products hit the market, supplement or “nutraceutical” makers have little incentive to provide scientific studies to back up any claims they may make. “They can only lose market share by doing so,” he says.
The report analyses existing studies on supplements that purport to boost cognition – from fish oil to apoaequorin (jellyfish), with the authors finding insufficient evidence to recommend any type of supplement for brain health for most adults. They do, however, note that small studies have shown that DHA (an omega-3 fatty acid) supplements may benefit those who already have mild cognitive impairment, which is often a precursor of Alzheimer's.
Overall, the authors stress, vitamins or nutrients that might be helpful in preserving brain health should be consumed as food. They note at least a few studies have shown that those who eat seafood have a lower risk of declining memory and thinking skills – as well as Alzheimer's – a benefit not obtained from taking omega-3 as a supplement.
There is, however, one key exception to the report's overall caution against supplements for brain health, and it's for those who are diagnosed as being deficient in things like B12, or B9, also known as folate. For those individuals only, supplements may be helpful for brain health. Deficiencies of B12, for instance, have been associated with cognitive function problems, including dementia.
About 5% to 15% of Americans over age 50 have a B12 deficiency, which Petersen explains is often related to a gastrointestinal absorption problem and which can also be influenced by factors like aging. “You could have this deficiency and not know it,” he says, adding that a vegan diet or gastric bypass surgery, for example, could cause you to not get enough of the vitamin or prevent your system from absorbing it sufficiently.
A simple blood test by your doctor can determine if you have a deficiency, which can be eliminated with either B12 supplements or shots, sometimes resulting in a reversal of cognitive symptoms.
Beyond the risk of wasting your money on something that won't make you one wit sharper, the report also warns against “vague or exaggerated claims about brain health” for some supplements as well as potential product impurities and inaccurate ingredient labels.
Finally, the GCBH experts urge those with certain other health conditions – as listed below – to be “especially careful about taking dietary supplements.”
People on blood thinners or certain other medications – such medications include blood thinners, heart medications, steroids and drugs that affect the immune system. Sudden increases in your vitamin K intake, for example, decrease the effect of the blood thinner Coumadin. More generally, Petersen says, supplements and other medications that need to be metabolised by organs like your kidneys and liver can “compete” for limited metabolic function, potentially “affecting the levels and performance of other drugs you're taking.”
People who are about to have surgery – the report cites warnings from the American College of Surgeons that herbal medications such as echinacea, garlic, ginkgo, ginseng, kava, saw palmetto, St John's wort and valerian can increase risks during surgery.
People who have cancer – "some vitamins and supplements may make your condition worse,” the authors write, adding that antioxidant vitamins such as vitamins E and C may reduce the effectiveness of chemotherapy.
People who have mild cognitive impairment – while acknowledging that melatonin supplements have proven at least somewhat useful in helping many boomers get to sleep (which in turn might help preserve their brain health), the authors cite studies showing that taking the hormone supplement if you are cognitively impaired increases the risk of falls and other adverse events.
[link url="https://www.aarp.org/content/dam/aarp/health/brain_health/2019/06/gcbh-supplements-report-english.doi.10.26419-2Fpia.00094.001.pdf"]AARP report[/link]