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Background: Dementia affects over 55 million people worldwide, with Alzheimer’s disease the most common cause. India has an estimated 8.8 million older adults living with dementia. Disease-modifying treatments remain limited, and prevention through modifiable risk factors is increasingly emphasised. Ayurveda describes loss of memory (Smritibhramsha or Smritinasha) and its relation to ageing, and offers Medhya Rasayana and other rejuvenative therapies for preserving intellect and memory. Objective: To review the Ayurvedic understanding of memory and its decline, and the experimental and clinical evidence for Rasayana interventions relevant to Alzheimer’s disease and cognitive ageing. Methods: Narrative review of classical texts and of preclinical and clinical studies identified through PubMed and Google Scholar, with emphasis on randomised controlled trials and meta-analyses. Results: Ayurveda attributes decline of memory to ageing (Vriddhavastha) with Vata predominance, depletion of Dhatus and Ojas, and mental factors, and prescribes Medhya Rasayanas such as Mandukaparni, Yashtimadhu, Guduchi and Shankhapushpi. In healthy adults, a meta-analysis of randomised trials found that Bacopa improved attention and some cognitive measures. Ashwagandha improved memory and executive function in a small trial in mild cognitive impairment and reversed amyloid pathology in an Alzheimer’s mouse model. A bioavailable curcumin improved memory and reduced brain amyloid and tau signals in non-demented adults over 18 months. No Rasayana has been shown to slow progression of established Alzheimer’s dementia. Conclusion: Rasayana herbs show promise for cognitive ageing and mild cognitive impairment, consistent with Ayurveda’s preventive emphasis. Rigorous long-term trials with clinical and biomarker outcomes are needed in people at risk of, or in early stages of, Alzheimer’s disease.

Keywords: Smritibhramsha; dementia; Alzheimer’s disease; Medhya Rasayana; Bacopa; Ashwagandha; curcumin; cognitive ageing