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on the notion that a smaller dose is sufficient after the neuronal cell membranes have been saturated with phosphatidylserine. Its lack of side effects, together with its established success in several studies of age-associated memory impairment, helped to get it into the first-level category.

Donepezil (Aricept)

Although donepezil (Aricept) has not been tested in people with mild memory loss, the strength of the data in Alzheimer's disease, which includes FDA approval, as well as clinical experience, led me to elevate it to the A list. You need to be alert to its side effects of nausea and diarrhea, which means that if you are taking another medication that can cause such side effects, such as aspirin, be prepared for stomach discomfort. If this becomes severe, you may need to stop Aricept. Your physician will prescribe Aricept 5 to 10 mg as a single daily dose. Rivastigmine (Exelon) and galantamine (Reminyl) are very similar to Aricept and can substitute for Aricept in the Memory Program.

Estrogen (for Women Only)

Estrogen is only now being directly tested as both a preventive and treatment strategy for mild memory loss due to aging. Even though the results are not yet out, the weight of the evidence supporting its promemory properties is strong. Also, estrogen has broad antiaging properties that include actions against osteoporosis and heart disease, which helped it get top billing. Gynecologic monitoring is essential because of the potential risk of uterine and breast cancer, though using an estrogen-progesterone combination virtually eliminates the increased risk of cancer of the uterus. You need a prescription from your doctor for Premarin 0.625 mg daily (or equivalent), or estrogen-progesterone combinations such as Prempro (over a dozen such combination medications exist).

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