Although aging does not cause memory loss, advancing age is the greatest risk factor for cognitive impairment. This creates a fear of progressive decline such as that caused by dementing conditions like Alzheimer’s disease. Furthermore, we are confronted by many who propose that aging is a disease and the solution lays in “Anti-Aging Medicine.” The notion here is that there are “natural” cures for aging that traditional medicine is hiding from us.

The problem is that creative marketing often hides the facts. As recently as 5 years ago there were a number of supplements that were viewed as essential to slow aging and prevent cardiovascular as well as memory decline. Epidemiological studies demonstrated a clear association between consumption of several herbs, vitamins, anti-inflammatory agents, and hormones (e.g., Gingko Biloba, ibuprofen, estrogen replacement therapy, high dose vitamin E, and vitamin B12) and thinking and the rate of cognitive decline. Hence, the conclusion was reached that these agents “prevent” or slow the progress of Alzheimer’s disease.

During the last five years a number of longitudinal, prospective studies have been published. Participants in these studies are randomly given either the supplement (e.g., vitamin B12, Gingko Biloba, estrogen replacement) or a placebo and followed forward. These studies allow inferences of cause and effect. So far the results have been disappointing.

Take for example the case for replacement of vitamin B12. Many epidemiological studies demonstrated an association between vitamin B deficiency, mental skills, and mood. Lowered levels of vitamin B raised the blood levels of homocysteine (an amino acid). Replacement of B12 lowered homocysteine to “normal” levels. The hypothesis was that replacement of B12 would prevent or delay cognitive decline. The logic was compelling and randomized clinical trials were begun. The results of studies completed to date are clear. Despite the fact that treatment with vitamin B12 returned homocysteine to normal levels, there was no improvement in cognitive function or decline in rates of dementia.

This is not to say that no supplement will help us remember, feel, or think better. Rather the point is that none of the supplements have proven themselves in well designed studies so far completed. Why is this? The logic from epidemiological studies sounds so good and the evidence they provide give us a starting point for investigation. However, epidemiological studies have a bias that cannot be overcome. Those who volunteer for these studies probably already lead healthier lifestyles including a number of factors that may make them different from most of us and there are a multitude of possible causes for any effect that is found. As you decide what supplements you are going to take, be careful to distinguish clever marketing from effective supplements. As with medications, there is no magic bullet.

Dr. Beckwith is a neuropsychologist, speaker, and author of Managing Your Memory: Practical Solutions for Forgetting. He has an office in Naples and can be reached at memoryseminars@aol.com or (239)851-1968.