Mental training offers best chance of halting cognitive decline, finds review

BMJ 2013; 346 doi: (Published 22 April 2013) Cite this as: BMJ 2013;346:f2567
  1. Lilian Anekwe
  1. 1BMJ

Despite some manufacturers’ claims to the contrary, there is no evidence that drugs or supplements help prevent cognitive decline in healthy older adults, a review of the research has found. The most promising evidence was for “formal cognitive training,” usually involving the use of computer programmes, although the likely benefit is probably small, it concluded.

Researchers from the University of Toronto conducted a review of the literature to assess the evidence behind claims that a number of drugs, vitamins, supplements, exercise, and cognitive training could help to prevent cognitive decline in healthy adults. Altogether they found 32 randomised controlled trials of 38 000 adults and reported their findings in the journal of the Canadian Medical Association.1

The review found that none of the drugs in the trials helped to prevent cognitive decline. These drugs included donepezil, memantine, testosterone, and dehydroepiandrosterone, while oestrogen and anti-inflammatory drugs were found to worsen memory. There was also no evidence that the herbal supplement ginkgo, a range of vitamins and fatty acids, losing weight, or stopping smoking had any effect on preventing cognitive decline.

The researchers found some evidence that people who followed a programme of moderate and high intensity resistance training (lifting weights) with a professional trainer showed more improvement in their memory than people who just did gentle stretching, but overall they described the evidence for physical exercise as “inconsistent.”

The strongest evidence was found for mental training and exercises, most often using computer programmes. These involved more than the mental challenges offered by crosswords and Sudoku puzzles and seemed to involve the level of cognition needed in learning a second language. Altogether the researchers found three trials involving 3321 people that lasted for between three and five years. All three trials showed improvement in memory scores, but the researchers concluded that the clinical significance of these results was not clear, because the changes in the cognitive scales used were small.


Cite this as: BMJ 2013;346:f2567


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