Abstract
Aging is a multifactorial process characterized by progressive physiological changes, including cellular senescence, cellular loss, and organ decline, which collectively accelerate the development of metabolic syndrome (MetS) in older adults. MetS, in turn, not only significantly increases the risk of cardiovascular disease (CVD) but also contributes to decreased functional and cognitive capacity, partly due to diminished ability to adapt to metabolic stress. While genetic predisposition has a substantial 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 pharmacotherapy can decelerate the progression of CVD, improving the likelihood of survival with favorable neurological and functional outcomes in older individuals with MetS. However, adverse drug reactions and the lack of adequate interventions for cognitive decline have led to the emergence of self-medication with nonprescription products. The anti-inflammatory, antioxidant, anti-channelopathy, antiaging, and neuroprotective properties of flavonoids, alkaloids, polysaccharides, and polyphenols found in key traditional medicines have shown promising potential in the treatment of MetS-induced cognitive decline. This narrative review summarizes current evidence on bioactive compounds and herbal medicines that may offer cognitive benefits in elderly patients with MetS.