Exercise, Medication Ineffective for the Prevention of Dementia

While various interventions have been suggested to prevent cognitive decline or delay dementia onset, the findings remain controversial. Recently, four systematic reviews sought examined the potential of preventive interventions in adults without dementia.  

The 4 reviews examined all evidence on the use of physical activity, over-the-counter supplements, pharmacological treatments, and cognitive training for the prevention or delay of cognitive decline among older adults.
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Overall, the reviews found:

• Among adults with normal or mild cognitive impairment, over-the-counter supplements, including omega-3 fatty acids, soy, ginkgo biloba, B vitamins, vitamin D plus calcium, vitamin C or β-carotene for the use of cognitive protection was not supported by evidence.¹
• Similarly, pharmacological treatments, including NSAIDs, aspirin, and antihypertension agents, for the prevention of cognitive decline was not supported by evidence.²
• Evidence for the prevention of dementia and cognitive decline through physical activity, including resistance training, tai chi, and aerobic exercise, among older adults is largely insufficient.³
• Cognitive training was found to improve the cognitive performance of the domain that was being trained among older adults with normal cognition, but lacked sufficient evidence for the prevention or delay of cognitive decline or dementia.⁴

—Melissa Weiss

References:

1) Butler M, Nelson VA, Heather Davila H, et al. Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review. [published online December 19, 2017]. Ann Intern Med. doi:10.7326/M17-1530.

2) Fink HA, Jutkowitz E, McCarten JR, et al. Pharmacologic interventions to prevent cognitive decline, mild cognitive impairment, and clinical alzheimer-type dementia: a systematic review [published online December 19, 2017]. Ann Intern Med. doi:10.7326/M17-1529.

3) Brasure M, Desai P, Davila H, et al. Physical activity interventions in preventing cognitive decline and Alzheimer-type dementia: a systematic review [December 19, 2017]. Ann Intern Med. doi:10.7326/M17-1528.

4) Butler M, McCreedy E, Nelson VA, et al. Does cognitive training prevent cognitive decline?: a systematic review [published online December 19, 2017]. Ann Intern Med. doi:10.7326/M17-1531.