Plant-Based Nutraceutical Interventions against Cognitive Impairment and Dementia: Meta-Analytic Evidence of Efficacy of a Standardized Gingko biloba Extract

Article type: Research Article

Authors: Solfrizzi, Vincenzo^{a; b; c; d; 1; *} | Panza, Francesco^{a; b; c; d; 1; *}

Affiliations: [a] Geriatric Medicine-Memory Unit and Rare Diseases Centre, University of Bari Aldo Moro, Bari, Italy | [b] Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy | [c] Department of Clinical Research in Neurology of the University of Bari Aldo Moro at “Pia Fondazione Card G. Panico”, Tricase, Lecce, Italy | [d] Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy

Correspondence: [*] Correspondence to: Francesco Panza, MD, PhD, Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology of the University of Bari Aldo Moro at “Pia Fondazione Card G. Panico“, Tricase, Lecce, Italy; and Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS “Casa Sollievo della Sofferenza”, San Giovanni Rotondo, Foggia, Italy. E-mail: geriat.dot@geriatria.uniba.it and Vincenzo Solfrizzi, MD, PhD, Geriatric Medicine-Memory Unit and Rare Diseases Centre, University of Bari Aldo Moro, Bari, Italy. E-mail: v.solfrizzi@geriatria.uniba.it.

Note: [1] These authors contributed equally to this work.

Abstract: Among nutraceuticals and nutritional bioactive compounds, the standardized Ginkgo biloba extract EGb 761 is the most extensively clinically tested herbal-based substance for cognitive impairment, dementia, and Alzheimer's disease (AD). In the last three years, notwithstanding negative meta-analytic findings and the discouraging results of preventive trials against AD, some randomized controlled trials focusing particularly on dementia, AD, and mild cognitive impairment (MCI) subgroups with neuropsychiatric symptoms (NPS) and some recent meta-analyses have suggested a renowned role for EGb 761 for cognitive impairment and dementia. Meta-analytic findings suggested overall benefits of EGb 761 for stabilizing or slowing decline in cognition of subjects with cognitive impairment and dementia. The safety and tolerability of EGb 761 appeared to be excellent at different doses. Subgroup analyses showed that these clinical benefits of EGb 761 were mainly associated with the 240 mg/day dose, and also confirmed in the AD subgroup. More importantly, one of these meta-analyses showed clinical benefits in cognition, behavior, functional status, and global clinical change of EGb 761 at a dose of 240 mg/day in the treatment of patients with dementia, AD, and MCI with NPS. The inclusion of the recent randomized controlled trials focusing on dementia, AD, and MCI subgroups with NPS may partly explain the conflicting results of these recent meta-analyses and previous pooled findings.

Keywords: Alzheimer's disease, cognitive impairment, dementia, EGb 761, Gingko biloba extract, meta-analysis, mild cognitive impairment, nutraceuticals, systematic review

DOI: 10.3233/JAD-141887

Journal: Journal of Alzheimer's Disease, vol. 43, no. 2, pp. 605-611, 2015