17 Best Supplements for Alzheimer's Prevention 2024

By Dr. Frank Yap, MD - July 28, 2024

Dementia is the name for a group of symptoms associated with an ongoing decline of brain functioning. It can affect memory, thinking skills and other mental abilities. If you are 65 years old, you have a one in eight chance of suffering from significant cognitive decline.

What is dementia?

Dementia is a general category of brain diseases that cause long term inability to think and remember. It affects a person’s daily functioning, and usually also causes emotional problems, decreased motivation and eventual loss in language.

Alzheimer’s disease is the most common form of dementia which amounts to 50% to 70% of all cases. Vascular dementia, usually from either multiple strokes or severe atherosclerosis makes up to 25% of cases.

Other causes are Lewy body dementia (LBD), syphilis, chronic mercury, lead, cadmium, and aluminum exposure, Parkinson’s disease, Creutzfeldt-Jacob disease, hypothyroidism, vitamin B1 deficiency, vitamins B12 and folate deficiencies, MTHFR mutation and others.

In March 2023, the Alzheimer’s Association of the United States released its latest data indicating that there are about 6.7 million Americans aged 65 and above suffering from Alzheimer’s disease. Without many breakthroughs in prevention, mitigation, or treatment, it is projected that this number could reach 13.8 million by 2060.

Rates of early-onset dementia and Alzheimer’s disease among Americans younger than 65 have inexplicably doubled between 2013 and 2017, according to data from Blue Cross Blue Shield (BCBS), a health insurance provider.

The average age of someone between 30 and 64 years old living with either young-onset dementia or Alzheimer’s is 49, with women being disproportionately affected compared to men, according to the BCBS data.

Causes of Dementia

The exact cause of Alzheimer's disease is not yet fully understood, although a number of things are thought to increase your risk of developing the condition.

These include:

increasing age
a family history of the condition
untreated depression, although depression can also be one of the symptoms of Alzheimer's disease
lifestyle factors and conditions associated with cardiovascular disease
oxidative stress

Among the risk factors, oxidative stress (OS) turns out to be one of the primary causes of AD, playing a key role in its pathophysiology and progression (Buccellato 2021).

There are currently no drugs available to prevent, treat, or reverse the course of Alzheimer’s disease. The five FDA-approved medications available for Alzheimer’s are designed to relieve symptoms such as memory loss, for a limited time — Aricept®, Exelon®, Namenda®, Namzaric® and Razadyne®.

There are more than 120 potential drugs in clinical trials now designed to treat the underlying causes of Alzheimer’s, rather than its symptoms. The ADDF (Alzheimer's Drug Discovery Foundation) has supported 20% of these, and many more ADDF-funded treatments are expected to be in human trials this year.

How to Diagnose Dementia

Diagnosing dementia can be a challenge. Neurologists use cognitive testing, such as asking patients to subtract 3’s from 100, who were the last three U.S. Presidents, the mini mental examination, CT, and MRI scans with and without contrast and SPECT or PET scans.

Laboratory and history testing should include complete blood counts, full metabolic panel including a complete lipid panel, lipoprotein (a), fibrinogen, homocysteine, CRP-HS, complete thyroid hormone tests, DHEA-Sulfate, testosterone, estradiol, estrone, progesterone, FSH in women, afternoon resting oral temperatures, apo E genotype, history of diet colas (aspartame), history of MSG, the person’s diet (ratio of protein to fats to carbohydrates), history of chronic stress, alcohol history, what types of fats they consume and their cooking oils, family history of celiac disease or gluten intolerance, mold exposure, food allergies, smoking history, current or past hypertension, etc.

Best Natural Supplements for Preventing & Reversing Alzheimer’s and Dementia

Do Vitamins and Supplements Help With Alzheimer's? This practical guide on brain health supplements is based on a comprehensive review of over 500 scientific references and supporting studies. It explores the latest science-backed nutritional interventions for promoting brain health.

A March 2024 meta-analysis, published in the American Journal of Clinical Nutrition, indicates that daily MVM (MultiVitamin Mineral) significantly benefits both global cognition and episodic memory. These findings within the COSMOS (COcoa Supplement and Multivitamin Outcomes Study) trial support the benefits of a daily MVM in preventing cognitive decline among older adults.

A May 2024 study (Nature) suggests that specific nutrients abundant in the Mediterranean diet could be nature’s own anti-aging elixir for the brain, offering a potential new way, aside from medication, to combat age-related cognitive decline. Published in npj Aging in May 2024, the study combined advanced neuroscience and nutritional science techniques to pinpoint nutrient biomarkers associated with healthy brain aging. It focused on 100 cognitively healthy people aged 65 to 75 and examined the effects of fatty acids, vitamins, antioxidants, and carotenoids on brain health. The researchers identified a specific combination of nutrients linked to slower brain aging and improved cognitive performance. These included:

Fatty acids: vaccenic acid, gondoic acid, alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), eicosadienoic acid, and lignoceric acid, found in foods like fatty fish and nuts
Carotenoids: lutein, lutein, and zeaxanthin, found in fruits, vegetables, and egg yolks
Vitamin E: found in peanuts, avocado, and fish
Choline: found in eggs, meat, fish, and dairy

A 2023 scientific review published in the peer-reviewed journal Nutrients discusses the role of micronutrients in neurological disorders specifically, noting that long-term deficiencies may be involved in the cause and subsequent development of neurodegenerative processes and neurological diseases such as Alzheimer's disease, Parkinson's disease, Huntington's disease and amyotrophic lateral sclerosis (ALS).

As noted in this paper, the primary function of micronutrients is their "catalytic effect in enzyme systems, either as cofactors or as components of metalloenzymes." Other essential roles include antioxidant activity and immune modulation. When you're deficient in micronutrients, especially long term, peripheral nerve damage and/or damage to the central nervous system can result, which in turn can contribute to a variety of neurological diseases, including Alzheimer's and Parkinson's.

A 2022 review paper, retrieved a total of 4310 articles and 43 articles to be incorporated in the review. Findings revealed a trend of significant association between low levels of B vitamins (folate and vitamin B12), vitamin D, vitamin A, vitamin E, omega 3 fatty acid, and albumin, and high homocysteine levels in blood with an increased risk of mild cognitive impairment among older adults.

The antioxidant connection is a hot area in Alzheimer’s research, but everyone agrees that more still needs to be done. Researchers aren’t sure if some antioxidants are better than others, and it’s possible that it might be better to get your antioxidants from food instead of from supplements.

We have compiled a list below and categorised them with reference links. Note that this list is not exhaustive.

Methodology: The selection or short-listing of the list below is based on the available scientific evidence retrieved from scientific database such as PubMed and scientific search engine such as Google Scholar.

Here are the best natural supplements for dementia that are supported by research.

1. B Vitamins

Vitamins B3, B6, B9 (folate) and B12 may be particularly important for supporting cognitive function as you age, and have been shown to play a major role in the development of dementia, including Alzheimer's disease, which is the most serious (and lethal). (2022)

One theory is that the decline in cognition observed in people with Alzheimer’s disease is due to the disruption of typical energy production and metabolism in the brain.

A paper published in Aging Cell (Dec 2022) on the subject explores whether vitamin B could help offset this disruption. Martens and colleagues found that NR (Nicotinamide Riboside - a member of the vitamin B3 family) supplementation increases NAD+ levels and lowers biomarkers of neurodegeneration in plasma extracellular vesicles enriched for neuronal origin (NEVs). The results suggest NR, by increasing NAD+, could help ward off Alzheimer’s disease (AD).

A 2020 meta-analysis of 243 observational prospective studies and 153 randomised controlled trials concluded that homocysteine-lowering treatment seems the most promising intervention for AD prevention.

A 2016 randomized controlled trial suggests that B vitamin supplementation slows cognitive decline in select groups, including people with mild cognitive impairment and high baseline homocysteine levels.

A 2016 study found that higher concentrations of docosahexaenoic acid (DHA) alone significantly enhanced the cognitive effects of B vitamins, while eicosapentaenoic acid (EPA) appeared less effective. When omega-3 fatty acid concentrations are low, B vitamin treatment has no effect on cognitive decline in MCI, but when omega-3 levels are in the upper normal range, B vitamins interact to slow cognitive decline.

A 2014 large meta-analysis of 11 trials did show that while B vitamins lowered homocysteine levels, they did not affect cognitive function.

Homocysteine levels are commonly high in people over 65 and are linked to strokes, coronary artery disease, and dementia. (2010 paper)

The good news is your body can eliminate homocysteine naturally, provided you're getting enough B9 (folate), B6 and B12. One study confirming this was published in 2010. Participants received either a placebo or 800 micrograms (mcg) of folic acid (the synthetic form of B9), 500 mcg of B12 and 20 mg of B6.

The study was based on the presumption that by controlling homocysteine levels you might be able to reduce brain atrophy, thereby slowing the onset of Alzheimer's. Indeed, after two years those who received the vitamin-B regimen had significantly less brain shrinkage compared to the placebo group. Those who had the highest levels of homocysteine at the start of the trial experienced brain shrinkage at half the rate of those taking a placebo.

Vitamin B3 and NAD

Since age is the greatest risk factor for Alzheimer's disease and dementia, supplements that slow aging-related processes may also slow progression of these diseases. An observational study found that older adults have lower levels of the coenzyme NAD+ in their brains than younger adults (Pubmed 2015).

Related: Best NMN Supplement

Vitamin B and Omega-3

A posthoc analysis study of the OmegAD trial, published in 2019, concluded that the effect of omega-3 supplementation on MMSE and CDR (measures of cognitive dysfunction) appears to be influenced by baseline tHcy (total homocysteine level), suggesting that adequate B vitamin status is required to obtain beneficial effects of omega-3-fatty acid on cognition.

2. Vitamin D

In a March 2023 study, Vitamin D supplementation was associated with 40% lower dementia incidence versus no exposure.

People with lower vitamin D levels appear to have a higher risk of age-related diseases, including cognitive decline and Alzheimer's. While a few small studies suggest that vitamin D supplementation may improve some aspects of cognitive functions, more studies are required to confirm that it can protect against dementia. Vitamin D is usually safe when used as directed.

A 2023 study demonstrated that maintaining sufficient vitamin D levels reduced the risk of dementia and mild cognitive impairment by 25 percent and 33 percent, respectively. These findings suggest that adequate vitamin D levels can contribute to the prevention of dementia.

A vitamin D deficiency can result in insufficient neurotransmitter production, negatively affecting brain nutrition. Consequently, brain cells are more prone to degeneration or death, leading to memory decline and diminished logical thinking and computational abilities.

People with low levels or low dietary intake of vitamin D appear to be more likely to develop mild cognitive impairment (MCI) or dementia [Ref].

In a small non-randomized clinical trial (2012), elderly people receiving vitamin D3 supplements had better cognitive function compared to untreated people, with particular improvement in executive function [Ref], but the study was not controlled or designed to look at the risk of cognitive decline.

However, taking vitamin D alone is unlikely to reverse the condition for individuals with existing dementia. In other words, while maintaining adequate vitamin D levels can help prevent neurodegeneration, it cannot be used as a treatment.

Vitamin D is a fat-soluble vitamin. The best time to take vitamin D supplements is during meals, ideally paired with healthy fats such as olive, fish, nut oils, or fatty fish.

Combining calcium and vitamin K intake is recommended for stronger bones. Vitamin D boosts calcium absorption, while vitamin K aids in depositing the absorbed calcium into bone gaps, thereby improving bone density. Additionally, since vitamin D supplementation depletes magnesium in the body, consuming 500 milligrams of magnesium every day, roughly half of the calcium supplement dosage, is advised.

3. Omega-3 (DHA)

Docosahexaenoic acid (DHA) is a long-chain omega-3 polyunsaturated fatty acid found in some fish and over-the-counter supplements. It is a building block of the brain involved with numerous cellular pathways.

In preliminary reports from the MAPT (Multidomain Alzheimer Preventive Trial) study in 1680 older adults, 800 mg of DHA per day combined with physical activity, nutrition, and cognitive interventions led to improvements in cognition over 3 years. DHA alone resulted in less cognitive decline but only in people who had low levels of DHA at the start of the trial.

Some observational research studies found that people who eat fish every week (i.e., a major source of dietary DHA) or have higher DHA levels also had a lower risk of dementia or a slower rate of brain aging (R).

Increasing your omega-3 fat intake and reducing consumption of damaged omega-6 fats (i.e., processed vegetable oils) in order to balance your omega-3-to-omega-6 ratio also has a significant benefit for your brain.

4. Melatonin

Melatonin is neuro-protective. The brain consumes 20% of the body’s oxygen. All that oxygen passing through the brain makes a toxic byproduct called reactive oxygen species, which can damage nerves and blood vessels.

Is Melatonin Good For Alzheimer's?

Your brain uses many different antioxidants, including melatonin, to neutralize the reactive oxygen species before they can cause harm. Therefore, it is not surprising that studies show melatonin seems to provide some protective effect against diseases like Alzheimer’s.

Melatonin also improves sleep, which could theoretically lead to long-term protection against Alzheimer's. A review and meta-analysis on melatonin treatment in Alzheimer's published in Neuroscience & Biobehavioral Reviews (Aug 2021) showed individuals with Alzheimer's improved with more than 12 weeks of treatment.

5. Magnesium

Magnesium (Mg) is an essential mineral for the body and brain, which is needed for the proper functioning of many enzymes that carry out biochemical reactions. Sufficient levels of magnesium are usually obtained through a healthy diet.

A meta-analysis conducted in 2022 concluded that a significant Mg deficiency exists in subjects diagnosed with MCI or AD (Du 2022). These findings suggest that Mg deficiency may be either the result of low dietary intake of Mg or the consequence of disease progression.

Reduced Mg amount in the AD brain may be attributed to lower circulating Mg levels caused by its reduced dietary intake, or defective Mg transport mechanism. The findings of higher dietary Mg intake are associated with a lower risk of MCI indicating a potential neuroprotective effect of Mg intake or supplementation (Glick 2016).

Another 17-year study that followed more than 1,000 Japanese adults over the age of 60 found that those who consumed more than 200 mg of magnesium per day were 37 percent less likely to develop any type of dementia and 74 percent less likely to develop vascular dementia [Ozawa 2012].

One 2016 pilot randomized controlled trial of 44 patients reported that magnesium L-threonate improved overall cognitive ability for elderly patients with memory complaints (Liu 2016).

6. Creatine

What is creatine? Creatine, a nitrogenous organic acid naturally occurring in vertebrates, plays a critical role in the energy metabolism of brain cells. Synthesized primarily from arginine, glycine, and methionine, creatine is produced endogenously and obtained through dietary intake.

A 2024 meta-analysis of 16 randomised controlled trials (RCTs), suggests that creatine monohydrate supplementation may confer beneficial effects on cognitive function in adults, particularly in the domains of memory, attention time, and information processing speed.

7. Soy Isoflavones

Soy isoflavones are polyphenols found in soy products and other plants. They preferentially interact with a type of estrogen receptor involved in cognitive functions. Because they interact with estrogen receptors, soy isoflavones have also been studied for preventing menopausal symptoms and premenstrual syndrome.

A large meta-analysis of 10 randomized controlled trials reported that soy isoflavone supplementation significantly improved overall cognitive function and visual memory in people under 60 years old from non-US countries (Ref).

In a large double-blind randomized controlled trial of postmenopausal women, treatment with isoflavone-rich soy protein for several years improved visual memory, but not other cognitive functions compared to control (Ref). More benefits were seen in women between 5–10 years of menopause than those 10 years post-menopause.

In older men and women, soy isoflavones treatment resulted in improved spatial memory and construction, verbal fluency, and dexterity, but worse executive function (Ref).

In young healthy adults, high soy diet for 10 weeks resulted in significant improvements in short-term and long-term memory and in mental flexibility, but not in attention or category generation compared to those in the control diet (Ref). Women, but not men, on the high soy diet also improved in letter fluency and planning.

However, soybean oil is a different kettle of fish. We’ve often warned against the use of soybean oil. Soybean oil is a source of an omega-6 fat called linoleic acid (LA), which is highly susceptible to oxidation and is typically from GMO seeds. Not only is soybean oil loaded with trans fat, which has been linked to heart disease, soybean oil may also cause irreversible changes in your brain.

8. TMG and Betaine

Trimethylglycine (TMG) is a form of the amino acid glycine with three methyl groups that are attached to it. TMG is also commonly known as betaine or betaine anhydrous.

TMG functions as a methyl donor. TMG methylates homocysteine, an amino acid that can build up in the blood and raise the risk of heart disease, and converts it into methionine.

Additionally, glycine is also an essential amino acid that helps make proteins and enzymes and may lower the amount of sugar in the blood.

As a methyl donor, TMG may contribute to the facilitation of many biological reactions inside the cell that require the process of methylation and is proposed to help with health issues like oxidative stress and inflammation.

When taken in supplement form, TMG has many positive effects. As mentioned above, it is an essential component in methylation. Methylation is an important biochemical process involved in many different cellular functions, like the copying of DNA, the expression of genes, and the making of proteins. Notably, TMG is proposed to provide the following benefits: lower homocysteine levels, improve athletic performance, have a potential role in cancer and depression, aid individuals with autism, and support cognitive function.

Blood homocysteine levels may be reduced by TMG supplementation.

Caution: TMG shouldn't also be taken by those who have kidney problems.

9. Gingko Biloba

Ginkgo biloba is a tree with leaves that have been used in traditional Chinese medicine for centuries to treat ailments of the brain, heart, and lungs. While ginkgo biloba teas and tinctures are most common in Eastern medicine, it is also available as an herbal supplement.

There are two other meta-analyses in dementia patients. In one analysis, seven studies showed that patients using ginkgo had improved scores on certain cognitive performance tests. Two studies in the same analysis using different assessments, however, did not show a statistically significant difference (Ref). Another meta-analysis of patients with mild cognitive impairment and Alzheimer's disease showed that after 24 weeks of ginkgo, in combination with conventional medicine, they improved cognitive performance scores (Ref).

10. Sulforaphane (Broccoli)

Broccoli, for example, has a solid scientific foundation showing it's one of the most valuable health-promoting foods around. While it contains several health-promoting compounds, one of the most widely studied is sulforaphane.

Sulforaphane may also be useful in the treatment of Alzheimer’s disease. In a 2018 study, mice with Alzheimer's were treated with sulforaphane for four months, which significantly inhibited both the generation and accumulation of amyloid-beta, and alleviated several pathological changes associated with Alzheimer's, including oxidative stress and neuroinflammation.

The mice also demonstrated cognitive benefits, remaining normal, cognitively speaking, compared to wild-type mice at 10 months of age, which is when dementia typically begins in Alzheimer's mice. In tests of neurons themselves, pretreating cortical neurons with sulforaphane protected them against injury caused by amyloid beta.

11. Panax Ginseng

Panax ginseng is a plant used in traditional Chinese medicine (also known as Korean or Asian ginseng). Its root contains compounds called ginsenosides, which have anti-oxidative and anti-inflammatory effects. Panax ginseng is purported to enhance longevity, promote cognitive functions, and alleviate fatigue.

A meta-analysis of five double-blind randomized controlled trials in healthy subjects reported that Panax ginseng treatment for 8-12 weeks showed improvement in some aspects of cognitive function, behavior, and quality of life, though the evidence was not convincing or consistent across studies (Ref).

A 2020 double-blind randomized controlled trial of 52 healthy individuals reported that Panax ginseng treatment (1 g/day) for eight weeks significantly increased the volume of a brain region important for memory and improved scores on executive function, attention, and memory, effects that were not seen in the placebo group.

In one 2020 systematic review that included two randomized controlled trials for ginseng, both trials showed that ginseng supplementation resulted in significant improvements in cognitive outcomes; however, due to the limitations in the methodological quality of the trials, results have not been conclusive.

The longest placebo-controlled clinical trial included 61 Alzheimer’s patients and lasted two years (Ref). In the low-dose Panax ginseng group (4.5 g/day), cognitive scores (as measured by the Mini-Mental State Examination) improved after 48 weeks, then slightly decreased at 96 weeks. In the high-dose group (9.0 g/day), cognitive scores showed slight improvement at 48 and 96 weeks. In this study, maximum cognitive improvement was observed around 24 weeks, then sustained for two years.

12. Geen Tea (EGCG)

Overall, tea has about eight to 10 times more polyphenols than fruits and vegetables, but because it's the catechins that researchers believe are the keys to tea's health benefits (R), green tea is what they've focused on most in their studies.

Green tea is prepared from dried leaves of Camellia sinensis, a perennial evergreen shrub. It contains several compounds that are possibly beneficial to brain health, including caffeine, catechins (polyphenols like EGCG), and L-theanine (an amino acid derivative).

Greater green tea consumption was associated with lower risk of dementia in two studies conducted in Japan, with the larger study reporting 27% lower risk in people who drank at least 5 cups a day [R]. Tea drinking was also associated with higher verbal fluency in elderly Chinese people (i.e., 80–115 years old) [R].

Two double-blind randomized controlled trials have evaluated the effects of green tea extract on cognitive functions. One trial in 91 patients with mild cognitive impairment reported that the combination of green tea extract and L-theanine for 16 weeks resulted in significant improvements in memory and attention, particularly in patients who had relatively severe baseline impairment [R].

The second trial examined the acute effects of a drink containing 27.5 g of green tea extract and reported that the drink increased brain connectivity associated with working memory and the degree of connectivity correlated with the magnitude of improvement in working memory [R].

In a study presented at the 2015 International Conference on Alzheimer's and Parkinson's Diseases, those who drank green tea one to six days a week had less mental decline than those who didn't drink it. In addition, the researchers revealed that tea drinkers had a lower risk of dementia than non-tea drinkers. It's not the first time green tea has been linked to brain health.

In a study of 12 healthy volunteers, those who received a beverage containing 27.5 grams of green tea extract showed increased connectivity between the parietal and frontal cortex of the brain compared to those who drank a non-green tea beverage (R).

The increased activity was correlated with improved performance on working memory tasks, and the researchers believe the results suggest green tea may be useful for treating cognitive impairments, including dementia. According to the study authors (R):

"Our findings provide first evidence for the putative beneficial effect of green tea on cognitive functioning, in particular, on working memory processing at the neural system level by suggesting changes in short-term plasticity of parieto-frontal brain connections.

Modeling effective connectivity among frontal and parietal brain regions during working memory processing might help to assess the efficacy of green tea for the treatment of cognitive impairments in psychiatric disorders such as dementia."

13. Multivitamins for Brain Health

A March 2024 meta-analysis, published in the American Journal of Clinical Nutrition, indicates that daily MVM (MultiVitamin Mineral) significantly benefits both global cognition and episodic memory. These findings within the COSMOS (COcoa Supplement and Multivitamin Outcomes Study)
trial support the benefits of a daily MVM in preventing cognitive decline among older adults.

One of the studies analysed above was COSMOS-Mind. According to the COSMOS-Mind study published in the journal Alzheimer’s & Dementia (2022), findings showed improved scores in overall cognition, memory, and executive function in the people who took Centrum Silver compared to the people who took the placebo.

The researchers estimated that taking the multivitamin daily for three years translated to a 60% slowing of cognitive decline—about 1.8 years.

“Three years of multivitamin supplementation did improve cognitive function,” Laura Baker, PhD, lead author of the study and a professor of gerontology and geriatric medicine at Wake Forest University School of Medicine, told Verywell. “People with cardiovascular disease appeared to have benefited the most from the multivitamin.”

Over 2,200 adults aged 65 and older enrolled in the COSMOS-Mind trial took part in the study, which was done over three years. The average age of the participants was 73 years old, 60% were women, and 89% were White. None of the participants had a history of stroke or heart attack at the start of the trial.

Read More: Memory and Cognitive Benefits of Multivitamins (2024)

14. Quercetin

In this study published in Neuropharmacology in 2015, researchers gave quercetin to mice with Alzheimer’s, injecting them with quercetin every two days for three months. By the end of the study, the injections had reversed several markers of Alzheimer’s, and the mice performed much better on learning tests.

In a separate study published in 2018, researchers gave mice with Alzheimer’s a quercetin-rich diet. Researchers found the diet improved brain function in mice with early-middle stage Alzheimer’s, although it had no significant effect on middle-late stage Alzheimer’s.

You may have heard that coffee is linked to a reduced risk of Alzheimer’s. There’s certainly some research to back that claim up. However, a 2016 research has suggested that quercetin (not caffeine) is the primary compound in coffee responsible for protective effects against Alzheimer’s.

However, quercetin is known to have a low oral bio-availability. Quercetin will need to be formulated in a liposomal or a phytosomal formulation, or to be combined with vitamin C and bromelain for optimal absorption.

15. Choline

Choline is a precursor to acetylcholine and is an essential nutrient not only for your brain and nervous system but also your cardiovascular function. The Institute of Medicine officially recognized choline as an essential nutrient for human health in 1998.

Aided by a transporter protein, choline combines with acetyl coenzyme A at the neuron terminal to form the neurotransmitter acetylcholine. Adequate amounts of choline must be available in your brain at all times, in order for your neurons to function properly (R). In a mice study, choline has also been shown to protect against Alzheimer's by (R):

Reducing your homocysteine level, an amino acid that has been shown to cause neurodegeneration and is involved in the formation of amyloid plaques, two hallmarks of Alzheimer's. Choline converts homocysteine into methionine, which has a number of beneficial effects.
Inhibiting microglia activation. Microglia cells clear debris from your brain, and while this is a crucial function, in Alzheimer's the microglia have a tendency to become overactivated, causing inflammation in the brain that can result in the death of neurons. By reducing activation of microglia, choline can help protect Alzheimer's patients from further brain damage.

16. Lutein and Carotenoids

These antioxidant compounds are found most often in orange colored vegetables, such as sweet potatoes and carrots. Some carotenoids, such as lutein and zeaxanthin, are found in dark green vegetables, namely kale and spinach (as well as egg yolks). Lutein and zeaxanthin are best known for the role they play in vision health, but accumulating evidence suggests they play a role in cognitive health as well by enhancing neural efficiency.

While lutein is well-known for its role in eye health, its role in brain health is being increasingly explored. The connection makes sense, since as your vision worsens with age, so too may your cognitive abilities.

The Cognitive impAiRmEnt Study (CARES), was designed to examine the potential synergistic effects of a combination of omega-3 fatty acids (namely DHA and eicosapentaenoic acid [EPA]), xanthophyll carotenoids (specifically lutein, zeaxanthin and meso-zeaxanthin) and vitamin E (d-α-tocopherol) on the cognitive performance of cognitively healthy older adults.

According to CARES, cognitively healthy subjects aged over 65 years, on a diet supplemented for 2 years with a combination of fish oil, vitamin E, and macular pigments (lutein and zeaxanthin), showed improved cognitive ability, measured by working memory test performance, and increased levels of tissue carotenoids, as well as systemic xanthophylls and omega-3 fatty acid concentrations (Power 2022).

Research shows visual impairment at a distance is associated with declining cognitive function over time, while "maintaining good vision may be an important interventional strategy for mitigating age-related cognitive declines." (JAMA 2018)

Meanwhile, studies support the beneficial effects of lutein on brain health. In a trial of young, healthy adults, supplementation with lutein and zeaxanthin improved levels of these carotenoids in the central nervous system along with boosting cognitive function. (Nutrients 2017)

Among older adults with a mean age of 73.7 years, lutein and zeaxanthin supplementation also improved cognitive function, including boosts in complex attention and cognitive flexibility domains, compared to those taking a placebo. (Hammond 2017)

Men taking part in the study also had improvements in composite memory. These benefits were seen with a daily lutein and zeaxanthin dose equivalent to that found in one-half cup of cooked kale or 1 cup of cooked spinach. (NutritionFacts 2023)

A literature search involving eight clinical trials further revealed that lutein and zeaxanthin in the blood or macula are associated with cognitive performance, and "there is an inverse relationship between a higher amount of macular pigment in the blood and lower risk of mild cognitive impairments or Alzheimer's disease." (Wang 2022)

Your body cannot make lutein, so you must get it from your diet. Following are 10 foods that are particularly rich sources of lutein.

Dark leafy greens
Carrots
Broccoli
Egg yolks
Red and yellow peppers
Sweet corn
Avocados
Raspberries
Cherries
Paprika

17. Coffee and Caffeine

Caffeine, a natural component of coffee and tea, is the most commonly consumed psychoactive substance in the world. It has well-documented effects on mental alertness.

In a 2012 study, individuals with MCI (mild cognitive impairment) were less likely to progress to dementia if they had higher caffeine levels in their blood.

As mentioned above, research has also suggested that quercetin (not caffeine) is the primary compound in coffee responsible for protective effects against Alzheimer’s.

Diet To Prevent Alzheimer's and Dementia

There is evidence that a diet rich in fruits and vegetables, particularly those with high levels of antioxidants, may help to reduce the risk of cognitive decline.

A 2017 meta-analysis of 9 studies concluded that the increased consumption of fruit and vegetables is associated with a reduced risk of cognitive impairment and dementia.

Antioxidants protect the brain against oxidative stress, which can contribute to brain damage and cognitive decline.

Maintaining a healthy and balanced diet is essential to reduce the risk of developing Alzheimer’s disease.

This includes eating various nutrient-rich foods, especially those high in vitamin B12, omega-3 fatty acids, and antioxidants.

The MIND diet is associated with the preservation of cognitive function, likely through its protective effects against cardiovascular disease. The MIND diet, which is based on the established cardiovascular Mediterranean and DASH diets, includes foods and nutrients that have been associated with preserving brain health.

Dr. Nikhil Palekar, medical director of the Stony Brook Center of Excellence for Alzheimer’s Disease and director of the Division of Geriatric Psychiatry, explained that the MIND diet is a low-salt type of Mediterranean diet shown to be beneficial for brain health.

“As it contains antioxidant-rich foods, as well as omega-3 fatty acids,” he said.

A low-salt diet has also been shown to benefit brain functioning independent of its action on improving hypertension.

“Given the above benefits, [the] MIND diet is highly recommended for healthy older adults as a way to reduce risk for Alzheimer’s disease, along with daily moderate-intensity aerobic exercise, cognitive activities, and socialization,” said Palekar.

Saturated Fats

Saturated fats are mostly from animal products such as red meat, processed meat, butter, and cheese, though coconut oil is a plant source that is still high in saturated fat. High intakes of saturated fat can lead to high LDL cholesterol levels. One cohort study in the American Journal of Clinical Nutrition showed a diet high in processed meat specifically had a correlation with an increased risk of dementia.

Family history is a large contributor for the risk of developing Alzhiemer’s. Neal Barnard says in widely watched TEDx talk that avoiding the bad fat can decrease risk of Alzheimers by 80 percent. This is even if you have the APOE-epsilon4 allele, the gene that is linked with Alzheimer’s disease.

Best Brain-Boosting Foods to Include in Your Diet

Healthy fish — Small cold-water fish that are rich in animal-based omega-3 fats but have a low risk of contamination are among your best choices for healthy fish. This includes anchovies, sardines, mackerel, herring and wild-caught Alaskan salmon. The omega-3 they contain is vital to your brain, helping to fight inflammation and offer numerous protections to your brain cells.

Cruciferous veggies and leafy greens — Eating just one serving of green leafy vegetables a day may help to slow cognitive decline associated with aging, helping you to be 11 years younger, cognitively speaking, than your non-leafy green-eating peers (source). They’re a rich source of brain-protective nutrients like folate, vitamins E and K, lutein and beta-carotene (source). Cruciferous vegetables, like broccoli and cauliflower, are equally impressive, in part because they’re good sources of choline, a B vitamin known for its role in brain development.

Eggs — Pastured, organic eggs, particularly the yolks, provide valuable vitamins (A, D, E and K), omega-3 fats and antioxidants. They’re also one of the best sources of choline available. Choline helps keep your cell membranes functioning properly, plays a role in nerve communications and reduces chronic inflammation. Choline is also needed for your body to make the brain chemical acetylcholine, which is involved in storing memories.

Beneficial health-promoting fats that your body — and your brain in particular — needs for optimal function include clarified butter called ghee, organic grass fed raw butter, olives, organic virgin olive oil and coconut oil, nuts like pecans and macadamia, free-range eggs, wild Alaskan salmon and avocado, for example.

Olive oil - In a May 2024 study investigating the relationship between diet and dementia-related death, published in the Journal of the American Medical Association (JAMA), researchers analyzed the diets and health outcomes of more than 92,000 U.S. adults. The findings suggest that regardless of genetic predisposition and overall diet quality, those who included at least seven grams (half a teaspoon) of olive oil per day lowered their risk of dementia-related death by 28 percent compared to participants who reported never or rarely including olive oil in their diet. Also, replacing even one teaspoon, or 5 grams, of margarine and mayonnaise with the same amount of olive oil per day was linked to an 8 to 14 percent reduced risk of death from dementia.

Avocado oil, with a similar fat profile to extra virgin olive oil, might offer comparable benefits. A 2014 study found avocado oil improved cardiovascular risk markers in rats fed a high-sugar diet. Poor cardiovascular health has been linked to cognitive issues.

Palm oil has also shown significant health benefits, with one study highlighting its strong antioxidant effects. Antioxidants can protect brain cells from oxidative stress and prevent cell damage. Oxidative stress can impair neurogenesis, the generation of new neurons in the brain, damaging cognitive function. Like olive oil, palm oil is rich in the antioxidant oleic acid.

Coconut oil has demonstrated neuroprotective benefits, including relieving oxidative stress, reducing neuroinflammation, and improving mitochondrial function, according to research.

Coffee — Increased coffee (and tea) consumption was linked to a lower risk of glioma brain tumor, such that people in the top category of coffee consumption were 91% less likely to have glioma compared with those in the bottom category (source).

Blueberries — Blueberries are rich in phytochemicals linked to improvements in learning, thinking and memory, along with reductions in neurodegenerative oxidative stress. They’re also relatively low in fructose compared to other fruits, making them one of the healthier fruits available. Wild blueberries, which have high anthocyanin and antioxidant content, are known to guard against Alzheimer's and other neurological diseases.

Conclusion

While studies suggest that taking certain supplements may help prevent Alzheimer's, the best way to promote longevity and overall health is to engage in healthy practices like consuming a nutritious diet, engaging in regular exercise, stop smoking and reducing stress.

Although there are no guaranteed ways to avoid Alzheimer’s, The Alzheimer’s Association offers 12 healthy habits to improve brain health and reduce the risk of cognitive decline and, perhaps, Alzheimer’s and dementia as well.

Keep your brain engaged
Be a lifelong learner
Exercise regularly
Protect your head—always wear a helmet and seat belt when appropriate to protect your head from injuries
Don’t smoke
Control your blood pressure
Manage diabetes
Eat a healthy diet
Maintain a healthy weight
Manage stress
Intermittent fasting
Get good quality sleep

By making mindful choices, we empower ourselves to maintain optimal brain health now and preserve it well into the future.

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Dr Dale Bredesen's RECODE Protocol for Alzheimer's