Systemic interventions needed in cognitive ageing research

There is a growing trend to look at more systemic interventions for cognitive ageing, the Professor of human psychopharmacology pointed out during the Active Nutrition Summit in Amsterdam last month. 

His expertise in understanding the mechanisms of cognitive impairment, enhancement, and neuroprotection, led him to discuss the pitfalls in treating cognitive health. 

“Using a pharmaceutical approach to cognitive ageing has failed spectacularly,” Scholey explained. 

“The idea that you can mess around with single neurotransmitters in the brain and not have several consequences is not a good strategy from the off."

Yet, he added that “there’s a growing consensus that how to approach cognitive enhancement and to ameliorate against cognitive decline, is to look at more systemic interventions".

“Several cardiometabolic processes​ which we know to be involved in cognitive ageing could offer realistic targets for nutrition and nutrients.”

Reliable biomarkers needed​

Formal ways to measure cognitive functions such as attention, working memory, and executive function, are imperative, noted Scholey, explaining that these measures provide insights into mental processes and mood, in turn contributing to a better understanding of cognitive health in day-to-day contexts.

The key, Scholey explained, is validated markers: “I think it's important really to remember that when you measure biomarkers, a change of the substance in the blood, you need to have a plausible mechanism for that, so you can accurately measure changes that occur in the body.

“But sometimes they are simply markers for a systemic change. So more validated markers might include things like cortisol, which is a good marker for stress if it's measured properly.”

He also explained that the enzyme monoamine oxidase offers promise in this sphere, describing that as a fluctuating enzyme, it can be inhibited by certain substances, and that “when that enzyme is inhibited, dopamine levels and other transmitters increase, so that's a really nice marker if you can measure it in living humans.”

“It's involved in things like serotonin and noradrenaline (a neurotransmitter in the peripheral and central nervous systems), which generally wake up the brain and have positive effects on mood and motivation.”

Marketing vs. scientific substantiation​

Scholey notes that a key issue in the industry is the continuous “push-pull” tension between marketing and research, explaining: “Marketing can result in improved sales much better than a study published in a perceivably obscure journal somewhere. 

“Obviously, the regulatory landscape is different from place to place, but I think it's really important that we have strict regulations around what claims can be made around different products.

“Some products simply don't have any evidence, and companies seem to me to be much more concerned around marketing rather than getting good evidence base.”

He explained that amongst all the most popular ingredients for cognitive health products, a considerable quantity do not have the scientific backing.

“There are some products out there which have good evidence and there are some which are more sometimes called image ingredients, which there's a perception that it might be good. But the high-level clinical trials just aren't there.

“Ashwagandha is a good example of something that does have research behind it, shown to have some positive effects on stress​.”