Abstract
The role of medications and supplements for brain health is a fast-changing and growing field, making it difficult for patients to receive updated and accurate information. The objective of this study was to assess patients' beliefs about the helpfulness or harmfulness of various medications and supplements on brain health. A convenience sample of adults from an integrated healthcare system completed a web-based survey. Descriptive statistics were used for this hypothesis-generating study. A total of 1661 respondents completed the survey. The majority of respondents were female (77%), between the ages of 51-70 (64%), and white (89%). Across the selected medications and supplements purported to improve a person's brain health (vitamin E, ginkgo biloba, hormones such as estrogen or testosterone, fish oil, and statins), 46-64% of respondents reported not knowing or skipped the item regarding their helpfulness to improve brain health. One out of four respondents reported benefits of vitamin E and nearly half reported benefits of fish oil on brain health; neither benefit is supported by current evidence. For the two medication classes evaluated for increasing dementia risk (proton pump inhibitors and anticholinergics used as sleep aids), 63-77% of respondents reported not knowing or skipped the item regarding their harmfulness to brain health. Survey respondents largely reported not knowing the potential benefits and harms of different medications and supplements for brain health. Improved health communication on pharmaceutical effects on dementia risk is greatly needed, and its development and dissemination should involve healthcare providers, patients, and media outlets.
Highlights
In the absence of a cure or disease-modifying treatment for late-life dementia, much of the current focus is on prevention (Larson, 2018)
One out of four respondents reported benefits of vitamin E and nearly half of respondents reported benefits of fish oil on brain health; neither benefit is supported by current evidence
This study uniquely contributes to the literature by providing some of the only data available on patient beliefs about the potential benefits and harms of different medications and supplements on brain health
Summary
In the absence of a cure or disease-modifying treatment for late-life dementia, much of the current focus is on prevention (Larson, 2018). Two recent evidence-based reviews of findings from 89 randomized controlled trials reported that evidence is insufficient to support the use of certain medications and supplements for cognitive protection in persons with normal cognition or mild cognitive impairment (Butler et al, 2018; Fink et al, 2018) This evidence was used to inform the 2017 National Academies’ landmark report, “Preventing Cognitive Decline and Dementia: A Way Forward” (Downey et al, 2017). Observational studies have reported increased risk of dementia when examining anticholinergic exposure from all medications; emerging evidence suggests that risk might be driven by certain anticholinergic sub-classes (Coupland et al., 2019; Gray et al, 2015; Richardson et al, 2018) Despite their widespread use among older adults, it is unknown what patients believe about the risks of these medications for dementia
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