What interventions improve memory?

What Sharpens Memory

Physical exercise, particularly aerobic activity at moderate intensity for at least 150 minutes per week, combined with a Mediterranean diet pattern, represents the strongest evidence-based approach to improving and maintaining memory function.

Exercise Interventions

Aerobic exercise is the most robustly supported intervention for memory enhancement. 1

• The 2020 Canadian Consensus Conference on Dementia recommends physical activity interventions of at least moderate intensity to improve cognitive outcomes, including memory (Level 1B evidence). 1
• Specifically, aerobic exercise and/or resistance training of at least moderate intensity are recommended to improve cognition in older adults. 1
• For individuals with mild cognitive impairment, aerobic exercise is specifically recommended to improve cognitive outcomes (Level 2B evidence). 1

The American Heart Association/American Stroke Association guidelines recommend exercise as adjunctive therapy to improve cognition and memory, though the evidence quality is moderate (Class IIb, Level C). 1

• Exercise shows reasonably consistent positive effects on memory, though effect sizes are relatively small. 1
• Recent meta-analyses demonstrate that exercise improves global cognition and executive function, with neuroimaging studies showing increased metabolic activity, cerebrovascular improvements, and neuroplasticity throughout the brain. 2

Important caveat: While observational studies strongly support exercise for cognitive health, intervention trials show more modest and inconsistent effects. 1 The 2011 JAGS systematic review found insufficient evidence that physical activity improved cognition in older adults when rigorously evaluated, highlighting methodological limitations in many studies. 1

Dietary Approaches

The Mediterranean diet is the dietary pattern with the strongest evidence for memory protection. 1

• The Canadian Consensus Conference recommends adherence to a Mediterranean diet to decrease risk of cognitive decline (Level 1B evidence). 1
• High consumption of mono- and polyunsaturated fatty acids with low saturated fat intake is recommended. 1
• Increased fruit and vegetable intake is recommended. 1

A healthy lifestyle combining multiple factors shows stronger effects than single interventions. 3, 4

• A 10-year prospective cohort study of 29,072 older adults found that those with favorable lifestyles (4-6 healthy factors including diet, exercise, social contact, cognitive activity, not smoking, and no alcohol) had significantly slower memory decline than those with unfavorable lifestyles. 3
• This protective effect occurred even in carriers of the APOE ε4 allele, a genetic risk factor for dementia. 3

Cognitive Rehabilitation Strategies

Specific memory training techniques are reasonable interventions, though effects may not generalize broadly. 1

• Cognitive rehabilitation to improve attention, memory, visual neglect, and executive functioning is reasonable. 1
• Compensatory strategies may be considered, including internalized strategies (visual imagery, semantic organization, spaced practice) and external memory aids (notebooks, paging systems, computers). 1
• Specific memory training such as promoting global processing in visual-spatial memory and constructing semantic frameworks for language-based memory is reasonable. 1

Critical limitation: Working memory training programs produce short-term, specific training effects that do not generalize to "real-world" cognitive skills. 1 A 2016 meta-analysis of 87 publications found no convincing evidence of reliable improvements in far-transfer measures (nonverbal ability, verbal ability, reading, arithmetic) when compared with treated controls. 1

What Does NOT Work

"Brain-training" computerized programs lack evidence for meaningful memory improvement. 1

• These programs show no evidential value when compared with treated controls. 1
• Training effects are short-term and specific, without generalization to practical cognitive skills. 1

Dietary supplements are not recommended unless documented deficiency exists. 5, 6

• Do not use omega-3 supplements in persons with established dementia, as high-quality evidence shows no benefit. 5
• Do not recommend B vitamin supplementation unless documented deficiency exists. 5
• Do not recommend vitamin E supplementation for cognitive protection (no effect shown in large trial with 2000 IU daily over 3 years). 5
• Do not recommend routine supplementation with vitamin D, vitamin C, selenium, or copper for cognitive enhancement. 5

Additional Supportive Interventions

Enriched environments and social engagement support memory function. 1

• Enriched environments to increase engagement with cognitive activities are recommended. 1
• Active social contact (≥twice per week) is associated with slower memory decline. 3

Sleep optimization should be assessed. 1

• A careful sleep history should be included in assessments, as sleep abnormalities are associated with dementia risk. 1

Hearing correction may indirectly support memory. 1

• Persons with cognitive complaints should be questioned about hearing loss symptoms. 1
• If confirmed by audiometry, audiologic rehabilitation including hearing aids may be recommended. 1

Practical Implementation

The most effective approach combines multiple lifestyle factors rather than focusing on single interventions. 3, 4

• A composite lifestyle index shows stronger relationships with memory than single factors. 4
• Even a short-term (14-day) program combining mental and physical exercise, stress reduction, and healthy diet showed significant effects on cognitive function and brain metabolism. 7

Common pitfall: Expecting dramatic improvements from single interventions. The evidence consistently shows that comprehensive lifestyle modification produces more robust and sustained benefits than isolated interventions. 3, 4