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One of the major causes is the lack of chromium in the diet

Mol Neurobiol (2022) 59(3):185061

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Acetyl-l-carnitine plus propionyl-l-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy

While overall decline rates were similar between groups, post-hoc subgroup analysis indicated slower cognitive decline in early-onset patients (aged 65 or younger) compared to placebo, as measured by the Alzheimer's Disease Assessment Scale cognitive subscale and Clinical Dementia Rating Scale [5][18]

Data availability The authors declare that all data supporting the findings of this study are available in the article and supporting information