As the years pile up, a forgotten birthday, a story retold accidentally, or a temporarily misplaced wallet may spark some worry about your memory—and how to keep it sharp. 

Such run-of-the-mill forgetfulness may increase over the years but is usually not—as you may fear—a sign that you’re on the road to a condition that can seriously impair memory and thinking, such as Alz­heimer’s disease.

Still, small thinking slipups are inconvenient and can sometimes be early warning signs of a more significant problem. So it’s natural to want to take steps to protect your mind and memory.

But which strategies may help us maintain or improve memory or even reduce the risk of dementia down the line?

Scientists are still trying to confirm early evidence from a number of observational studies, but recent research has found that some things are quite promising. Here, what may help and what’s not supported by the science.

6 Steps That May Keep Your Memory Sharp

1. Rule out other factors. Memory and thinking problems are sometimes related to concerns that your doctor can help you resolve, such as depression, some medications (such as sleeping pills), a vitamin deficiency, excess alcohol consumption, hearing loss, and thyroid, kidney, or liver-related illnesses.
What to do: Talk with your doctor. Sometimes, simply switching prescriptions or treating an underlying problem will normalize your thinking.

2. Control your blood pressure. Untreated high blood pressure has repeatedly been linked to cognitive impairment later in life, according to a 2016 report from the American Heart Association. This may be because high blood pressure can, over time, contribute to insufficient blood flow to the brain.
What to do: Avoid smoking, consume alcohol only in moderation, and aim for 7 to 9 hours of sleep at night. And if you have high blood pressure, take your hypertension medications as recommended. A 2016 study published in The Lancet found that older adults with hypertension who followed such lifestyle and medication advice had a lower risk of dementia after six years than those who didn’t take such steps.

3. Get regular exercise. People who are mostly sedentary are at a higher risk of cognitive problems as they age. Anything that elevates your heart rate and increases blood flow to the brain may help reduce that risk and keep your memory sharp.
What to do: Get about 30 minutes of aerobic activity, such as a brisk walk, most days. And because research has been mixed on whether aerobic activity alone is enough, add a few strength training exercises a couple of times per week (go here to get started). Also consider trying tai chi, which involves a series of slow and careful movements. It appears to have some brain-protective effects, according to a 2015 review published in the American Journal of Preventive Medicine.

4. Eat for your heart. Diets that promote heart health may, in turn, help your brain. For example, the well-known Mediterranean diet may help stave off cognitive decline, according to a study of more than 300 older adults that was published in JAMA Internal Medicine.
What to do: To follow the Mediterranean diet, swap the red meat on your plate for fish (preferably fatty varieties such as salmon and mackerel), and eat leafy greens such as kale and spinach daily. Work small amounts of healthy fats such as olive oil and nuts into your diet, and include beans and whole grains such as oatmeal in more of your meals. (The MIND diet has also been linked to a reduced risk of dementia.)

5. Challenge your brain. Activities that stimulate the mind might also help preserve it—what scientists call “use it or lose it.” A study from the University of Pittsburgh found that older adults who devoted at least an hour each day to a range of intellectually engaging hobbies—including bridge, board games, and playing musical instruments—were less likely to develop dementia than those who devoted less time to such pursuits.
What to do: Try learning a new language or skill, or sign up for a continuing education course on a subject you’re unfamiliar with. (The jury is still out on whether computer-based brain-training games such as Lumosity can improve thinking and memory outside of the games themselves.) “It might not matter what you do as long as it’s difficult, as long as you’re pushing yourself,” says Pam Greenwood, Ph.D., an associate professor of psychology at George Mason University in Virginia.

6. Be social. Loneliness and infrequent social contact are both associated with an elevated risk of dementia, a 2015 research summary in Ageing Research Reviews concluded.
What to do: Make time for face-to-face socializing. Strong relationships, partygoing, and visiting with friends and family have all been linked to a healthier aging brain. And try to fill up your calendar with activities you enjoy. In a 2016 study published in Frontiers in Aging Neuroscience, older adults with a busy schedule scored better on tests of memory, reasoning, and processing speed.

But Don't Bother With These

Supplements. Though a variety of nutrients, including vitamin E, beta-carotene, vitamins B6 and B12, folate, vitamin D, and fish oil, may play a role in preventing cognitive decline when part of a balanced diet, the same evidence just isn’t there for supplements of these substances, says Martha Clare Morris, Sc.D., director of nutrition and nutritional epidemiology at the Rush University Medical Center in Chicago.

The same goes for herbal supplements, such as Ginkgo biloba, which is often touted to improve memory and cognition. Our experts also recommend avoiding the many supplements, such as FocusFactor and Prevagen, whose labels may claim they can boost brainpower.

Furthermore, as with all dietary supplements, these are only loosely regulated, so you can’t know for sure what's in any given pill. Supplements can also interfere with prescription medications and, in some cases, even make you sick.

Drugs and hormones. A variety of pharmaceutical substances have been studied as possible hedges against cognitive decline or dementia, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen and the so-called "smart" drugs (such as Ritalin).

Estrogen has also been suggested as a potential brain booster, and trials are underway to test the potential of drugs such as pioglitazone and solanezumab for dementia prevention. But the evidence so far is thin to nonexistent that any of these can keep your memory sharp.

According to Consumer Reports’ Best Buy Drugs team, Alzheimer’s drugs are not even very effective for slowing mental decline in people who already have dementia. The search for an effective treatment has been largely fruitless despite years of research.

In addition, it’s important to know that some of these experimental approaches may cause harm. Taking estrogen, for example, might actually make cognitive problems worse.

Could It Be More Than Forgetfulness?

How can you tell when memory slips may signal something more serious?

It may have to do with whether the forgetfulness is temporary or permanent and how much cognitive glitches affect your daily life.

For example, it's annoying to forget why you walked into a room. But if you remember afterward, even hours later, it’s probably just a normal memory hiccup, says Lon Schneider, M.D., a professor of psychiatry and behavioral sciences at the Keck School of Medicine at the University of Southern California.

But tell your doctor if you find yourself struggling to retain information you’ve just learned. Do the same if memory lapses are permanent or paired with profound inattention—you leave the stove on all day or get lost in a familiar place.

What can you expect? After ruling out other potential health problems, your doctor will interview you and a family member to check for changes in behavior or personality.

She may order imaging tests of your brain and assess your memory, language, and attention, too.

Your results are most likely to be normal. In some cases, however, they may suggest mild cognitive impairment (marked by memory problems that are worse than expected for your age but don’t disrupt daily life) or full-blown dementia (which does affect day-to-day functioning).

Alzheimer’s disease is the leading cause of dementia, but there are many others, including some that are reversible.

Editor's Note: This article also appeared in the March 2017 issue of Consumer Reports on Health.