Health management and drugs
The health of your body often affects your brain. Many chronic diseases impair your brain's function and even raise your risk of Alzheimer's disease or other causes of dementia. Moreover, many drugs affect the brain as well as the body, for better or for worse.
Here we rank the scientific evidence and give you the info on how the choices you make to manage your health may or may not protect your brain.
* See the Evidence guide for color legend and more information.
Statins for Management of High Cholesterol
Despite promising evidence from observational studies, existing clinical trials suggest that statins are not useful for preventing or treating dementia. However, statins continue to be a relatively safe and effective method to maintain healthy cholesterol levels for many people. Statins carry some risks and the choice to take statins or not should be done in consultation with your doctor.
Lithium Drug Treatments
Lithium is a mineral prescribed in high doses to treat mania and depression, with a risk of serious side effects. Drug doses of lithium are unlikely to help patients with Alzheimer’s disease or ALS but, in elderly people with mild memory impairment, a low drug dose was reported in one trial to improve cognition and protect against a biological marker of Alzheimer’s. The safety of even low drug doses of lithium is uncertain for elderly people.
PDE5 Inhibitors for Erectile Dysfunction
Laboratory experiments in animals have reported potential protective properties of PDE5 inhibitors like Viagra and Cialis, but no human research has yet confirmed any of these potential benefits. People who use nitrate drugs should not take PDE5 inhibitors due to safety concerns.
Tobacco use likely raises the risk of dementia. However, nicotine delivered separately from tobacco can improve cognitive function and might protect against Alzheimer’s and cognitive decline although the evidence is mixed and weak. Nicotine is not as dangerous as tobacco but still has some safety concerns, such as addiction, reduced sleep quality, gastrointestinal side effects and headaches.
Systemic Chelation Therapies for Heavy Metal Disorders
Chelation therapies chemically bind metals to accelerate their removal from the body. Here we discuss both "systemic" and "brain-targeted" chelation therapies, but because targeted therapies are still in development, we rate the efficacy and safety for "systemic" therapies. Although there are theories that improper distribution of metals contributes to the dementia and brain aging, there is no evidence that chelation therapies currently on the market can slow or prevent age-related cognitive decline, dementia, or aging. Chelation therapies also carry risks.
Estrogen-containing Hormone Therapy
In women over 65 years, estrogen-containing hormone therapy may raise the risk of dementia. In younger menopausal women, it might protect long-term brain health but the evidence is inconsistent and controversial. However, most women can safely treat menopausal symptoms for a few years using physician-guided hormone therapy. Many types of hormone therapies are available but the evidence is limited that one versus the other is better for long-term health.
Bisphosphonates for Bone Density
Bisphosphonates are drugs used to treat the loss of bone strength and density in conditions such as osteoporosis. Their effects on brain health have not been examined, but one small observational study of healthy older adults found that taking bisphosphonates was associated with about 5 years longer lifespan. However, long-term bisphosphonate use is linked to severe side effects, including unusual bone fractures and doubling the risk of esophageal cancer.
The lifestyle choices that you make to protect yourself from heart attack and stroke will likely protect the health of your brain as well. Some treatment options for hypertension may protect your brain in ways beyond blood pressure.