Caffeine in Aging Brains: Cognitive Enhancement, Neurodegeneration, and Emerging Concerns About Addiction

Manuel Glauco Carbone, Giovanni Pagni, Claudia Tagliarini, Icro Maremmani () and Angelo Giovanni Icro Maremmani
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Manuel Glauco Carbone: Division of Psychiatry, Department of Medicine and Surgery, University of Insubria, Viale Luigi Borri 57, 21100 Varese, Italy
Giovanni Pagni: Department of Psychiatry, North-Western Tuscany Local Health Unit, Tuscany NHS, Lunigiana Socio-Sanitary Area, Piazza Craxi 22, 54011 Aulla, Italy
Claudia Tagliarini: Psychiatric Diagnosis and Treatment Service (S.P.D.C.), Sant’Elia Hospital, Provincial Health Authority 2, Via Luigi Russo 6, 93100 Caltanissetta, Italy
Icro Maremmani: VP Dole Research Group, G. De Lisio Institute of Behavioural Sciences, Via di Pratale 3, 56121 Pisa, Italy
Angelo Giovanni Icro Maremmani: VP Dole Research Group, G. De Lisio Institute of Behavioural Sciences, Via di Pratale 3, 56121 Pisa, Italy

IJERPH, 2025, vol. 22, issue 8, 1-27

Abstract: This narrative review examines the effects of caffeine on brain health in older adults, with particular attention to its potential for dependence—an often-overlooked issue in geriatric care. Caffeine acts on central adenosine, dopamine, and glutamate systems, producing both stimulating and rewarding effects that can foster tolerance and habitual use. Age-related pharmacokinetic and pharmacodynamic changes prolong caffeine’s half-life and increase physiological sensitivity in the elderly. While moderate consumption may enhance alertness, attention, and possibly offer neuroprotective effects—especially in Parkinson’s disease and Lewy body dementia—excessive or prolonged use may lead to anxiety, sleep disturbances, and cognitive or motor impairment. Chronic exposure induces neuroadaptive changes, such as adenosine receptor down-regulation, resulting in tolerance and withdrawal symptoms, including headache, irritability, and fatigue. These symptoms, often mistaken for typical aging complaints, may reflect a substance use disorder yet remain under-recognized due to caffeine’s cultural acceptance. The review explores caffeine’s mixed role in neurological disorders, being beneficial in some and potentially harmful in others, such as restless legs syndrome and frontotemporal dementia. Given the variability in individual responses and the underestimated risk of dependence, personalized caffeine intake guidelines are warranted. Future research should focus on the long-term cognitive effects and the clinical significance of caffeine use disorder in older populations.

Keywords: caffeine dependence; neurodegenerative diseases; cognitive impairment; elderly (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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