We often think of age-related cognitive decline as almost inevitable. Like physical fitness, it’s often better to preserve and protect your mental wellness rather than try to reverse decline or impairment. However, nootropics have a wide range of effects on brain function and cognition, so can nootropics help with dementia?
What are Nootropics?
Nootropics are compounds that improve brain function and cognition, especially in healthy people, with low toxicity and few side effects. Many of these compounds have been discovered only in recent decades, like racetams, while many have been in use for centuries, like ginkgo biloba and ginseng.
Because there are so many nootropics, and they derive from so many different sources, they are usually classified as medically effective drugs or simple dietary supplements in the US. However, how other nootropics are classified, approved, and used varies widely worldwide.
Recent years have seen increasing research around the use of nootropics to treat medical conditions that affect brain function, memory, and cognition, especially in degenerative conditions like dementia and Alzheimer’s disease.
So, while nootropic supplements are usually intended for use by healthy adults, there is a growing body of research around whether nootropics can help with dementia.
Best Nootropics for Dementia
Nootropic is a term for many compounds that are thought to improve brain function. First discovered in the 1970s, today, we are aware of many of these compounds, but not all of them have been rigorously researched and studied. Here are some of the most promising nootropics that have been researched with dementia:
- Racetams. Racetams like piracetam and oxiracetam have been tested for their ability to improve cognitive function. They have a beneficial effect that protects the brain from trauma and reduces cognitive dysfunction, but not all racetams have yet been shown to help with dementia. Generally speaking, racetams are most helpful when dementia is mild.
- Piracetam. Piracetam is the most effective nootropic for human dementia studied to date, and shows the most improvement when dementia is paired with depression.
- Cholinergics. These nootropics are compounds of choline, essential for synthesizing neurotransmitters and brain cells.
- Choline. Of all the cholinergics, choline is the most widely researched, and several studies show it has a beneficial effect on cognition in patients with dementia and Alzheimer’s disease.
- Citicoline, choline alfoscerate. Citicoline and the choline precursor choline alfoscerate have been proven effective in treating vascular dementia.
- Nutrients. Many essential nutrients have been found to have a nootropic effect, improving brain function, even in cases of dementia. Antioxidants, famous for their beneficial effects on the body, can also improve brain health and function.
- Acetyl-carnitine. Acetyl-carnitine is a derivative of the nutrient carnitine, naturally formed in the body. Several studies have shown promising effects of acetyl-carnitine on dementia, but results have been inconsistent, and more research is needed.
- Peptides. Peptides are short chains of amino acids, essential for a wide range of functions in the body. Research has shown that elevated levels of amyloid ß-peptide may impair circulation in the brain and contribute to Alzheimer’s, so research is being performed with D-enantiomeric and other peptides that bind to amyloid ß and help prevent neurodegnerative diseases. Nootropic peptide Cerebrolysin improves cognitive and overall functioning in elderly patients with dementia, as well as improving recovery after a stroke.
- Vincamine. Vincamine is a nootropic drug found in the leaves of the Vinca minor (lesser periwinkle) plant. In Europe, vincamine is a prescription medication used to treat degenerative and vascular dementia. A synthetic derivative of vincamine, vinpocetine, is more controversial: it is ineligible to be marketed in the US, banned in Australia and New Zealand, licensed by Health Canada, and used widely in Europe and Asia to treat dementia and improve memory and cognition.
Nootropics and Cholinesterase Inhibitors
Many of the most potent nootropics are based on a greater understanding of choline’s role in cognition. For example, many compounds slow down the rate of absorption of acetyl- and butyryl-cholinesterase, allowing the related neurotransmitters to reach a higher level in the brain.
While you may not be familiar with the term, some of the most ancient memory and cognition enhancers, like caffeine and rosemary, are effective cholinesterase inhibitors. In addition, the prescription drug donepezil is an acetylcholinesterase inhibitor and is the most common treatment for Alzheimer’s disease.
It may also improve memory after brain trauma, enhance cognition in people with dementia, and improve understanding and executive function in people with Parkinson’s disease. Researchers are also comparing nootropics with cholinesterase inhibitors to find more effective treatments for people with dementia.
- Nootropics vs. donepezil in dementia: A study of 510 Alzheimer’s patients compared the use of racetam nootropics with donepezil and tacrine, and found that the racetams appear to be more effective for moderate dementia, but less effective for treating moderate dementia.
- Nootropics with acetylcholinesterase inhibitors in dementia: Several studies suggest that combining nootropics with cholinesterase inhibitors is more effective in treating dementia than using the inhibitors alone.
In other words, many of these nootropic compounds seem to have a synergistic effect and work better together than they do alone.
Can Nootropics Help with Dementia?
Yes. Unfortunately, “dementia” is not a disease. Instead, it is a collection of symptoms caused by a wide range of physical and mental conditions.
Because dementia varies so much in its causes, effects, and severity, and because there are such a large number of nootropics with different mechanisms of action, it is impossible to make a blanket statement that all nootropics help with dementia.
However, some specific nootropics have been scientifically proven to benefit some dementia symptoms. While nootropics are still poorly understood, they can ease many of the symptoms of dementia by:
- Improving circulation in the brain
- Positively affecting dopamine levels in the brain
- Positively affecting choline compounds in the brain
Nootropics have different effects on different brains, so some may help with severe dementia, while some are more effective with mild dementia. Some nootropics are beneficial for healthy people and offer few benefits to older adults already experiencing cognitive decline.
So far, the best nootropics for dementia are racetams and either choline-enhancing supplements or cholinesterase inhibitors.
As mentioned, many nootropics seem to be most potent and effective when combined. Still, the possibility and variety of these combinations make scientific study with rigorous controls even more difficult. Future research will help identify the optimal nootropics for different types of dementia, with the best dosage and delivery mechanisms.