In my book How Not to Age, I discussed the role of drugs and supplements and focus

on diet and lifestyle approaches to the prevention and treatment of cognitive decline.

But there are a few common non-drug, non-supplement, non-lifestyle approaches to dementia treatment.

For example, cognitive stimulation therapy, which typically involves group activities and social interaction.

There have been at least 44 randomized controlled trials of cognitive stimulation, including thousands of participants.

ADAS COG, short for Alzheimer's disease assessment scale, cognitive subscale,

is the most commonly used measure of cognition in clinical trials of dementia treatment,

a clinically relevant improvement,

is often defined as a reduction of four more points on the ADAS COG measure.

Regrettably, the attenuation of cognitive decline for most of the cognitive

stimulation studies averaged only about two points. Now, you could argue, look, any improvement

is better than nothing, but unfortunately the cognitive effects don't appear to generalize

to helping with everyday life situations. You can train people to get better at a computerized brain game,

but that doesn't necessarily translate to other arenas. Also, the marginal improvements

are temporary. They don't seem to persist once the intervention period is over. While cognitive

stimulation therapy may have no significant overall effect on quality of life.

Any kind of group therapy has been shown to improve psychological well-being.

As social creatures, social participation is important for mental health throughout the life course,

but there's insufficient evidence that it can improve or prevent cognitive dysfunction.

Dementia is associated with

social isolation, but this may be reverse causation, where the dementia leads to social

withdrawal instead of the other way around. The same issue comes up all the time with those advocating

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