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Alzheimer's and Dementia Studies

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Ginkgo biloba has been the focus of recent media reports as a potential treatment for Alzheimer's disease. The National Institute on Aging reports that a 1997 ginkgo biloba study suggests that a ginkgo biloba extract may be of some help in treating the symptoms of Alzheimer's disease and vascular dementia (stroke). The study provides no evidence that ginkgo biloba will cure or prevent Alzheimer's disease, but says that ginkgo biloba treats the symptoms.

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JAMA study announces positive results in Alzheimer disease with Ginkgo Biloba

October 22, 1997 Results of a multicenter study published in the Journal of the American Medical Association (JAMA) indicate that Ginkgo biloba extract can be of significant benefit in the treatment of dementia associated with Alzheimer disease and multi-infarct dementia.  The authors asserted that the improvement seen in patients with Alzheimer could be equated with "a six-month delay in the progression of the disease." These results are particularly promising in light of the fact that no satisfactory treatments currently exist for the management Alzheimers Disease or Dementia.

The placebo-controlled, double-blind Alzheimer study was designed to investigate the effects of standardized Ginkgo extract in 309 patients with mild-to-severe dementia associated with either Alzheimer disease or multi-infarct dementia. Alzheimer patients were randomized to receive 52 weeks of treatment with placebo or Ginkgo extract at a dose of 40 mg three times a day, a total daily dose of 120 mg Ginkgo Biloba. At 52 weeks, 202 Alzheimer dementia patients were included in the endpoint analysis, which was based on standard tests of cognitive impairment, daily living and social behavior, and general psychopathology.

The researchers reported that 27% of Alzheimer patients who received 26 or more weeks of treatment with Ginkgo extract experienced at least a four-point improvement on the 70-point Alzheimer Disease Assessment Scale-Cognitive subscale (ADAS-Cog), compared to 14% of Alzheimer patients in the placebo group. Daily living and social behavior were deemed improved in 37% of Ginkgo patients, compared to 23% of those taking Alzheimer patients taking placebo, as measured by the Geriatric Evaluation by Relative's Rating Instrument (GERRI). In contrast, the GERRI showed that 40% of Alzheimer patients taking placebo experienced a worsening of their Alzheimer condition, while worsening was seen in only 19% of those taking Ginkgo.

The authors concluded that "EGb appears to stabilize and, in an additional 20 percent of cases (vs. placebo), improves the Alzheimer patient's functioning for periods of six months to one year. Regarding its safety, adverse events associated with EGb were no different from those associated with placebo."

The Ginkgo preparation used in the study (EGb 761) was a concentrated ginkgo biloba leaf extract standardized to 24% ginkgo flavone glycosides and 6% terpenelactones, the same extract widely used in Europe for the treatment of cognitive disorders and other conditions.

LeBars PL, Katz MM, Berman N, et al. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. JAMA 1997;278:1327-1332.

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Phytomedicine study supports positive results in Alzheimer disease with Ginkgo Biloba

Similar encouraging results for Alzheimer patients were also reported in the journal Phytomedicine. This double-blind, placebo-controlled, randomized study investigated the effects of Ginkgo biloba extract in 156 patients with either Alzheimer disease or multi-infarct dementia. An Alzheimer patient responder rate of 28% for multiple therapeutic effects (p<0.01) was observed in patients taking Ginkgo extract, as compared to 10% in the placebo group. A separate analysis of the two different diagnostic subgroups (Alzheimer or multi-infarct dementia) showed that the differences in improvements between Ginkgo and placebo after 24 weeks were consistently slightly higher in patients with Alzheimer disease. The researchers reported that the Ginkgo extract was well tolerated.

Kanowski S, Herrmann WM, Stephan K, et al. Proof of efficacy of the Ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Phytomed 1997;4(1):3-13.)

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Ginkgo Biloba compares favorably to drug used in Alzheimer's treatment.

EGb-761, a standardized extract of Ginkgo biloba, is approved by German authorities as an effective treatment for primary degenerative dementia and vascular dementia. In 1996, Tacrine® (tetrahydroaminoacrine) was the only drug approved in the U.S. for the treatment of Alzheimer's disease. An open, uncontrolled trial was conducted to compare the pharmacological activity of ginkgo and Tacrine in elderly patients with mild-to-moderate dementia. Results showed that both substances exhibit "cognitive activator" type effects, characterized by CEEG profiles demonstrating an increase of 7.5 to 13 cps activity and decreased slow frequencies. Ginkgo biloba (240 mg) exhibited "cognitive activator" profiles in more subjects than Tacrine (40 mg), and subjects who showed more cognitive-activator responses to the first dose of ginkgo also demonstrated better therapeutic effects with chronic administration of ginkgo.

Itil T, Ahmed I, Le Bars P, et al. "The pharmacological effects of ginkgo biloba (GB), a plant extract, on the brain in comparison to Tacrine." Psychopharmacology Bulletin 1996;32(3):459.

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Ginkgo Biloba's Effect on Alzheimer Reduced Short-term Memory and Concentration
In at least 10 controlled clinical studies in elderly people with declining brain function due to cerebral insufficiency or Alzheimer disease, those taking ginkgo biloba experienced significant improvements in mental performance, including short-term memory and concentration. Researchers also noted benefits to mood, attention, and sociability.

Limited, but promising research suggests that ginkgo biloba may also help maintain and improve brain function in young, healthy people. In several small studies in healthy people, short-term memory, attention, and response time were significantly improved after single doses of ginkgo biloba extract.

Hindmarch I. Activity of ginkgo biloba extract on short-term memory. In: Fungeld EW, ed. Rokan (ginkgo biloba). Recent Results in Pharmacology and Clinic. Berlin, Heidelberg, and New York: Springer Verlag, 1988; 321-326.

Allard M. Effects of ginkgo biloba extract on normal or altered memory function in man. In: Christey Y, Costentin J, Lacour M, eds. Effects of Ginkgo biloba extract on the central nervous system. Paris: Elsevier, 1992.

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Photo courtesy of NIEHS News: Environmental Health Perspectives Volume 107, Number 12, December 1999