Cognitive-Enhancing Effects of Bioactive Compounds and Traditional Herbal Medicines in Elderly Patients with Metabolic Syndrome

Aging is a multifactorial process that leads to progressive physiological changes char-acterized by senescence, cellular loss, and organ decline, which accelerate the devel-opment of metabolic syndrome (MetS) in elderly individuals. MetS, in turn, not only significantly increases the risk of developing cardiovascular disease (CVD) but also contributes to decreased functional and cognitive capacity due to the inability of el-derly patients to adopt with metabolic stress. While genetic predisposition has a sub-stantial influence on the risk of developing MetS, other intrinsic factors, including chronic inflammation, insulin resistance (InsR), and altered neurohormonal activation, also play crucial roles. Targeted therapies, lifestyle interventions, and pharmacother-apy can decelerate the progression of CVD, increasing the likelihood of survival with good neurologic and functional outcomes among elderly individuals with MetS. However, drug adverse reactions and the lack of adequate interventions for cognitive decline have led to the emergence of self-medications with nonprescription medicines. The anti-inflammatory, antioxidant, anti-channelopathy, antiaging, and neuroprotec-tive properties of flavonoids, alkaloids, polysaccharides, and polyphenols found in key traditional medicines showed promising data in the treatment of MetS-induced cogni-tive decline. Thus, the objective is to provide a comprehensive review of bioactive compounds and herbal medicine that show promising cognitive benefits for elderly patients with MetS.