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Cochrane review questions cognitive benefits of ginkgo biloba for early memory problems
A large systematic review of randomised controlled trials (RCTs) suggests the herbal supplement Ginkgo biloba may offer modest benefits for people with established dementia but provides little or no benefit for those with earlier cognitive decline.
However, the findings, published in Cochrane Database of Systematic Reviews, highlight the limited and variable evidence supporting Ginkgo use and underscore the need for more rigorous studies to clarify its role in managing MCI and dementia.
“As the population ages and rates of cognitive impairment and dementia continue to rise, rigorous evaluation of widely marketed and commonly used supplements such as Ginkgo biloba is essential to guide informed decisions,” said Lisa S. Wieland, PhD, Georgetown University Medical Center, Washington, DC.
The researchers analysed 82 RCTs involving 10,613 participants to evaluate the benefits and harms of the herbal supplement Ginkgo biloba in people with cognitive complaints, MCI, or dementia. Databases, including MEDLINE and Embase, were searched through November 2024, and 72 trials with 9,783 participants contributed extractable data. Investigators assessed outcomes such as global clinical status, cognitive performance, activities of daily living, and adverse events at roughly 6 months, pooling results using random-effects meta-analysis when appropriate.
Across 12 trials involving 1,913 participants with MCI, ginkgo showed little or no benefit versus placebo for global clinical status (mean difference [MD], -0.03 on the Clinical Dementia Rating scale), cognition measured by the Alzheimer’s Disease Assessment Scale-Cognition (MD, -0.07), or daily functioning at 6 months.
In contrast, among 13 trials including 3,288 participants with dementia, Ginkgo was associated with modest improvements in global clinical status (MD, -0.06), cognitive performance on the Syndrom-Kurztest (MD, -1.86), and activities of daily living (MD, -0.19).
Rates of adverse events were similar to placebo in most analyses and no meaningful differences were observed for serious adverse events.
“This review provides clarity for clinicians and patients navigating decisions about widely used herbal supplements,” said Hakima Amri, Georgetown University Medical Center. “Future studies in this field should expand to include the emerging novel clinical trial designs in order to answer targeted questions of efficacy and effectiveness. ”
The last Cochrane review on Ginkgo biloba for cognitive impairment and dementia was published in 2009.
Reference: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013661.pub2/full
SOURCE: Georgetown University Medical Center
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