Alternative Therapies & Lifestyle Modifications

Dietary supplements, herbal remedies, and “medical foods” are frequently promoted to enhance memory. Some claims even assert such products can prevent AD and dementia.49 The use of these products remains controversial. In 2010 the National Institutes of Health’s “State-of-the-Science Conference Statement on Preventing Alzheimer’s Disease and Cognitive Decline” concluded the “evidence is insufficient to support the use of pharmaceutical agents or dietary supplements to prevent cognitive decline or Alzheimer’s disease.”50 The American Academy of Family Physicians have similar concerns and note the evidence to support alternative treatments is wide-ranging and often limited.14 The Alzheimer’s Association also has concerns regarding these products due to the lack of FDA approval and the many unknowns regarding effectiveness, safety, and purity. Dietary supplements, herbal remedies, and “medical foods” have many undesirable interactions and adverse effects,49 which are summarized in in Table 3.

Table 3. Dietary Supplements, Herbal Remedies, and “Medical Foods” Marketed to Enhance Memory, Prevent Dementia and Prevent AD.48,65-67
Alternative Therapy Interactions Adverse Effects
*effects that affect the provision of oral health care in bold
Vitamin E
alpha tocopherol
None listed Can interact with antioxidants and medications prescribed to lower cholesterol or prevent blood clots; may slightly increase risk of death
Caprylic acid & Coconut oil (Axona) Contains caseinate, whey, lectithin, but is lactose free. Consume after full meal Diarrhea, flatulence, dyspepsia
Coenzyme Q10 Moderate interactions with chemotherapy drugs, warfarin, and antihypertensive drugs Nausea,vomiting, diarrhea, appetite suppression, heartburn, epigastric discomfort
Ginkgo biloba Avoid when using antiplatelets, antieliptics, avoid with BuSpar, Prozac, melatonin, and St. John’s wort May cause GI upset, headache, dizziness, palpitations, constipation, or allergic skin reactions. Also may cause spontaneous bleeding or lower seizure threshold
Huperzine A Moderate interactions with AChE inhibitors, anticholinergics, and cholinergics Descreased heart rate, theoretically may exacerbate epilepsy, GI obstruction, PUD, asthma, or urogenital obstruction
Omega-3 fatty acids Alcohol may increase triglycerides None severe
Phosphatidylserine Moderate interactions with AChE inhibitors, anticholinergics, and cholinergics GI upset
Tramiprosate None known Nausea,vomiting, diarrhea, dizziness, headache

Research suggests certain lifestyle factors, such as consuming a Mediterranean diet high in omega-3 fatty acids, exercising on regular basis, continual mental stimulation (e.g., pursuing advanced degrees, cognitive engagement) might help to reduce the risk of developing AD.11,12,14,51-58 The evidence supporting the use of other therapies such as consuming selegiline, testosterone, or ginko biloba is conflicting and more research is needed to determine potential value.14,59 The use of vitamin E, estrogen, non-steroidal anti-inflammatory drugs, lecithin, and acetyl-L-carnitine have been shown to be ineffective.14,60-64