Online Promotion of "Brain Health" Supplements.

Objective: To identify the dietary supplements most commonly promoted online for brain health and to compare their major ingredients over 18 months. Mild cognitive impairment and Alzheimer's disease are increasing globally with few effective treatments available. Dietary supplements are widely promoted in the media and online for brain health and memory improvement despite minimal evidence of an actual effect. Methods: Incognito mode on Google Chrome was used to conduct four separate searches using the terms: memory supplement, brain health supplement, Alzheimer's supplement, and dementia supplement. The four separate searches for products were conducted through CVS, Walgreens, Walmart, GNC, Amazon, Yahoo, and Google. For each website, the top 10 supplement products and their ingredients were documented in August 2017 and again in January 2019. Results: Of the four terms used, "memory supplement" and "brain health supplement" provided the most results. The most common products were Prevagen®, Procera®, and Neuro Health®. Amazon had the most repeated products in 2017 and 2019, while Google and CVS had the least. Focus Factor® appeared 11 times in 2019 compared with once in 2017. At both time points, the most commonly promoted products were proprietary blends of Ginkgo biloba, vitamins, particularly vitamin B12 and folic acid, huperzine-A, Bacopa monnieri, and phosphatidylserine. Conclusions: Though the 2017 and 2019 datasets showed diverse products, the primary ingredients were similar. These supplements have insufficient evidence of efficacy and are expensive. Health professionals must be knowledgeable about dietary supplements for brain health to appropriately counsel individuals.