brain health · Nov 14, 2025

Can Nootropics and Cognitive Performance Enhancers Help Prevent Dementia?

Written by Natalie Falshaw, MSc

In recent years, brain health has moved into the mainstream and is now recognized as central to longevity and preventive medicine.

This rising popularity is evident both in research and development. Academic publications mentioning “brain health” or “cognitive health” have grown from fewer than ten per year in the 1990s and early 2000s to nearly 2,000 in 2021 [1]. Meanwhile, the commercial appetite for cognitive enhancement is increasing — even with many products still lacking robust proof, the nootropics category alone is projected to reach $30 billion by 2028 [2, 3].

At the same time, dementia has become one of America’s most urgent health challenges. In 2025, an estimated 7.2 million Americans aged 65 and older are living with Alzheimer’s or dementia, affecting roughly one in nine people in this age group [4]. By 2060, that figure is expected to nearly double, reaching 13.8 million [5].

The central question is simple: can a single product sharpen your mind today and also safeguard your brain for decades to come, bridging the gap between those proactively investing in long-term health and those already at risk?

Understanding Nootropics and Cognitive Performance Enhancers

Nootropics, often referred to as smart drugs, are a broad group of compounds designed to support memory, enhance learning, and boost everyday mental clarity [6]. They are primarily championed within the biohacking community, but their use extends well beyond to athletes, first responders, high-performing professionals, and individuals who are recovering from brain injuries such as multiple concussions. In therapeutic contexts, nootropics may also play a role when cognitive functions are impaired or compromised.

These compounds range from over-the-counter supplements such as omega-3 fatty acids, bacopa monnieri, and ginkgo biloba, to prescription medicines including modafinil, methylphenidate (Adderall), and the Alzheimer’s drug donepezil. While some are aimed at fine-tuning cognitive performance in healthy individuals above baseline, others are designed to restore suboptimal function in clinical contexts. With neurological and psychiatric disorders accounting for an estimated $3 trillion in lost productivity worldwide each year, the urgency of finding effective and sustainable solutions is clear [7].

How do they work?

Nootropics influence the brain through a variety of mechanisms, depending on the specific compound [8]. Some are synthetically derived drugs that act on targeted neural pathways, while others are naturally occurring plant extracts or nutrients that support cognitive function through multiple overlapping effects.

The most common mechanisms include:

Neurotransmitter modulation: Stimulant medicines such as modafinil or methylphenidate boost the activity of brain chemicals like dopamine and noradrenaline in the prefrontal cortex, sharpening attention, increasing alertness, and strengthening working memory, especially in people with conditions like ADHD or narcolepsy. Similarly, prescription drugs like donepezil, a class of cholinesterase inhibitors used in Alzheimer’s treatment, stop the breakdown of acetylcholine, a key messenger for memory and learning, which may provide short-term improvements in thinking and daily function.
Enhancement of brain blood flow: Herbal extracts such as ginkgo biloba support circulation in small blood vessels in the brain and add antioxidant protection, which may result in improved cognitive function and clarity [9].
Stimulation of brain growth factors: Compounds like lion’s mane mushroom (Hericium erinaceus) appear to stimulate brain-derived neurotrophic factor (BDNF), a protein that helps neurons grow new connections, adapt, and stay resilient over time.
Neuroprotection and inflammation control: Nutrients such as omega-3 fatty acids play a supporting role by calming inflammation and strengthening neuronal membranes, which may ease symptoms like brain fog, support mood, and stabilize memory.

Together, these approaches can make the brain work more efficiently in the short term by boosting cell signalling, blood flow, and function. However, short-term gains do not guarantee long-term protection. Cognitive decline develops gradually over many years, driven by various factors. So while a nootropic may help you feel sharper today, that does not automatically mean it will alter the underlying biology that determines neurodegenerative risk.

The Science Behind Dementia and Alzheimer’s Prevention

Dementia is best understood as a collection of symptoms such as memory loss, language problems, and changes in behaviour and daily function which arise from different underlying diseases, with Alzheimer’s disease being the most common cause [10].

The biological changes that drive dementia develop slowly, often over decades. They involve several overlapping processes rather than a single cause, which is why treating Alzheimer’s and related conditions with a single drug has proven so difficult [11]. Key pathological processes include:

Amyloid plaques: sticky clumps of amyloid beta protein that disrupt cell-to-cell communication and trigger damaging immune responses.
Tau tangles: twisted fibers of tau protein that accumulate inside neurons and impair their ability to function and survive.
Neuroinflammation: chronic activation of immune cells in the brain, which amplifies injury and accelerates degeneration [12].
Metabolic dysfunction: reduced brain insulin sensitivity, which impairs energy use and is linked to amyloid and tau changes. This also offers a plausible route by which mid-life metabolic health shapes later cognitive risk [13].
Vascular injury: damage to small blood vessels and reduced cerebral blood flow, often coexisting with Alzheimer’s pathology [14].

Current licensed Alzheimer’s treatments may temporarily boost neurotransmitters and provide modest improvements in cognition and daily functioning. However, they do not halt or reverse disease progression. More recent disease-modifying therapies, such as anti-amyloid antibodies, may slow decline in early Alzheimer’s, but they are treatments given after pathology has begun, not true prevention.

Conversely, prevention requires reshaping brain structure and function over many years. It means building resilience across multiple pathways at once, rather than simply enhancing short-term performance. Genetics influence risk, but addressing modifiable factors may offer the most powerful opportunity to support healthy brain ageing.

The Role of Lifestyle in Long-Term Cognitive Health

Most studies examine short-term performance rather than prevention, because dementia develops over decades, making prevention trials difficult to control or complete. That is beginning to change, but testing prevention directly is inherently difficult. Dementia develops over decades, making it almost impossible to control every variable or wait long enough for definitive outcomes in clinical trials. This is why most nootropic research remains centered on immediate cognitive effects rather than long-term protection.

What is already clear, however, is that lifestyle is the most powerful lever we have for safeguarding brain health across the lifespan [15]. A Lancet report estimates that addressing modifiable risk factors could delay or prevent up to 40-45% of dementia cases worldwide [16]. Unlike a single pill, lifestyle interventions act on many biological pathways at once, strengthening resilience against the processes that drive cognitive decline [17].

Evidence-based strategies include:

Regular physical activity: boosts blood flow, insulin sensitivity, and neuroplasticity [18].
Mediterranean or DASH-style diet: rich in plants, whole grains, and healthy fats, associated with slower cognitive decline [19].
Adequate sleep: clears toxic proteins such as amyloid and supports memory consolidation [20].
Social and mental engagement: builds “cognitive reserve,” allowing the brain to withstand underlying pathology [21].
Stress management: protects hippocampal function and reduces chronic inflammation [22].

Supplements can play a supporting role here. While no single nutrient has yet proven to prevent dementia in healthy adults, compounds that reduce inflammation or support neuronal function may complement the broader foundations of lifestyle, enhancing day-to-day cognition and reinforcing long-term resilience.

So while there is no silver bullet, a strategic combination of evidence-based lifestyle practices working in tandem with nootropic or neuroprotective nutrients can support both performance today and a reduced risk of Alzheimer’s tomorrow.

Using Nouro to Support Cognitive Performance and Prevent Dementia

Through Tonum’s research program, Nouro has been clinically developed in collaboration with Duke Health for nearly a decade, with the aim of bridging the gap between short-term cognitive performance and long-term brain health. Its proprietary blend targets several key pathways implicated in dementia simultaneously, including amyloid build-up, neurotrophic signalling, and neuroinflammation.

Key ingredients include:

Alpha-lipoic acid (ALA): a natural antioxidant that reduces oxidative stress, supports mitochondrial energy production, and has been shown in animal models to improve memory function [23].
Alpha-GPC (alpha-glycerylphosphorylcholine): a choline-containing compound that boosts acetylcholine, a neurotransmitter critical for memory, learning, and attention [24].
Paraxanthine: the primary metabolite of caffeine, shown to enhance short-term memory, attention, reasoning, and reaction time, often with fewer side effects than caffeine itself [25].

Clinical results of Nouro have demonstrated:

46% reduction in amyloid beta plaque accumulation
>50% reduction in glial fibrillary acidic protein (GFAP), a key marker of brain inflammation
35% increase in brain-derived neurotrophic factor (BDNF) compared to placebo

Together, these findings suggest that Nouro sharpens cognitive performance now while also engaging the biological processes most relevant to reducing long-term dementia risk

Take a proactive approach and consider incorporating Nouro into your brain health routine.

Takeaways

Most nootropics enhance focus, memory, or clarity in the short term, but this does not guarantee protection against dementia.
Dementia develops over decades through multiple interacting processes, making single-target treatments difficult to sustain as prevention.
Lifestyle factors — e.g., exercise, diet, sleep, stress management, and social engagement — remain the strongest, evidence-based strategies for long-term brain health.
Supplements can play a complementary role, especially when they target mechanisms like inflammation, mitochondrial function, or neurotrophic signalling.
Nouro, clinically developed with Duke Health, shows promise in bridging performance and prevention by addressing key pathways involved in dementia.

References:

Natalie Falshaw is a health researcher, consultant, and coach dedicated to empowering individuals with evidence-based insights into their unique biology. With a BSc in Neuroscience (University of Leeds) and an MSc in Microbiome Research (King’s College London), she specializes in metabolic health, longevity, and the microbiome, translating complex research into actionable knowledge for disease prevention.

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