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What scientists found about various methods of fighting dementia.

• Physical exercise. Researchers reviewed data from 16 trials comparing a physical activity intervention with an inactive control. They found insufficient evidence to draw conclusions about the effectiveness of aerobic training, resistance training or tai chi for improving cognition. The researchers did find low-strength evidence that combining different types of interventions at the same time, such as physical activity, diet, and cognitive training, improved cognitive test performance.

• Prescription medications. Researchers reviewed data from 51 trials comparing the effect of prescription medication with placebo, usual care or active control on cognitive outcomes. The evidence did not support use of any of the studied pharmacologic treatments (dementia medications, antihypertensives, diabetes medications, NSAIDs or aspirin, hormones, and lipid-lowering agents) for cognitive protection in persons with normal cognition or mild cognitive impairment.

• Cognitive training. A review of 11 trials of adults with either normal cognition or mild cognitive impairment at the time of enrollment found insufficient evidence that cognitive training exercises could prevent dementia. Group cognitive training was found to improve performance only in the cognitive domain trained. For example, memory training improved memory but did not improve any other aspects of cognition. • Over-the-counter vitamins and supplements. The study’s authors reviewed 38 trials comparing over-thecounter (OTC) supplements, including omega-3 fatty acids, soy, ginkgo biloba, B vitamins, vitamin D plus calcium, vitamin C or beta carotene, multi-ingredient supplements, with placebo or other OTC interventions for preventing or delaying cognitive decline, mild cognitive impairment, or clinical Alzheimer-type dementia. They found insufficient evidence to suggest that any of the supplements worked to reduce the risk for cognitive decline.