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People sometimes believe they are having memory problems when there are no actual decreases in memory performance. Therefore, assessment of cognitive function requires specialized professional evaluation. Psychologists and psychiatrists employ sophisticated cognitive testing methods to detect and accurately measure the severity of cognitive decline. A qualified health professional should be consulted if memory impairment is suspected.
Dietary changes that may be helpful: In the elderly population of southern Italy, which eats a typical Mediterranean diet, high intake of monounsaturated fatty acids (e.g., olive oil) has been associated with protection against ARCD in preliminary research. However, the monounsaturated fatty acid content of this diet might only be a marker for some other dietary or lifestyle component responsible for a low risk of ARCD.
Caffeine may improve cognitive performance. Higher levels of coffee consumption were associated with improved cognitive performance in elderly British people in a preliminary study. Older people appeared to be more susceptible to the performance-improving effects of caffeine than were younger people. Similar but weaker associations were found for tea consumption. These associations have not yet been studied in clinical trials.
Animal studies suggest that diets high in antioxidant-rich foods, such as spinach and strawberries, may be beneficial in slowing ARCD. Among people aged 65 and older, higher vitamin C and beta-carotene levels in the blood have been associated with better memory performance, though these nutrients may only be markers for other dietary factors responsible for protection against cognitive disorders. One preliminary study found that, among middle-aged men, those who ate more tofu had a higher rate of cognitive decline compared with men who ate less tofu. Since tofu and other soy products have consistently demonstrated important health benefits in this age group (e.g., as cholesterol-lowering foods), middle-aged men should not limit their consumption of these foods until the results of this isolated study are independently confirmed.
Lifestyle changes that may be helpful: Cigarette smokers and people with high levels of education appear to have some protection against ARCD. The reason for each of these associations remains unknown. However, as cigarette smoking generally is not associated with other health benefits and results in serious health risks, doctors recommend abstinence from smoking, even by people at risk of ARCD.
Nutritional supplements that may be helpful: Several clinical trials suggest that acetyl-L-carnitine delays onset of ARCD and improves overall cognitive function in the elderly.
Vitamin B6 (pyridoxine) deficiency is common among people over age 65. 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. 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.
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. 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.
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. 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. However, in a double-blind case study of one healthy person, 1.6 mg of melatonin had no immediate effect on cognitive performance.
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). Clinical trials of these antioxidants are needed to confirm the possible benefits suggested by this study.
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