Ginkgo biloba for Prevention of Dementia

A Randomized Controlled Trial

  • DeKosky, Steven T. MD
  • Williamson, Jeff D. MD, MHS
  • Fitzpatrick, Annette L. PhD
  • Kronmal, Richard A. PhD
  • Ives, Diane G. MPH
  • Saxton, Judith A. MD
  • Lopez, Oscar L. MD
  • Burke, Gregory MD
  • Carlson, Michelle C. PhD
  • Fried, Linda P. MD, MPH
  • Kuller, Lewis H. MD, DrPH
  • Robbins, John A. MD, MHS
  • Tracy, Russell P. PhD
  • Woolard, Nancy F.
  • Dunn, Leslie MPH
  • Snitz, Beth E. PhD
  • Nahin, Richard L. PhD, MPH
  • Furberg, Curt D. MD, PhD
JAMA: The Journal of the American Medical Association 300(19):p 2253-2262, November 19, 2008.

Context

Ginkgo biloba is widely used for its potential effects on memory and cognition. To date, adequately powered clinical trials testing the effect of G biloba on dementia incidence are lacking.

Objective

To determine effectiveness of G biloba vs placebo in reducing the incidence of all-cause dementia and Alzheimer disease (AD) in elderly individuals with normal cognition and those with mild cognitive impairment (MCI).

Design, Setting, and Participants

Randomized, double-blind, placebo-controlled clinical trial conducted in 5 academic medical centers in the United States between 2000 and 2008 with a median follow-up of 6.1 years. Three thousand sixty-nine community volunteers aged 75 years or older with normal cognition (n = 2587) or MCI (n = 482) at study entry were assessed every 6 months for incident dementia.

Intervention

Twice-daily dose of 120-mg extract of G biloba (n = 1545) or placebo (n = 1524).

Main Outcome Measures

Incident dementia and AD determined by expert panel consensus.

Results

Five hundred twenty-three individuals developed dementia (246 receiving placebo and 277 receiving G biloba) with 92% of the dementia cases classified as possible or probable AD, or AD with evidence of vascular disease of the brain. Rates of dropout and loss to follow-up were low (6.3%), and the adverse effect profiles were similar for both groups. The overall dementia rate was 3.3 per 100 person-years in participants assigned to G biloba and 2.9 per 100 person-years in the placebo group. The hazard ratio (HR) for G biloba compared with placebo for all-cause dementia was 1.12 (95% confidence interval [CI], 0.94–1.33; P = .21) and for AD, 1.16 (95% CI, 0.97–1.39; P = .11). G biloba also had no effect on the rate of progression to dementia in participants with MCI (HR, 1.13; 95% CI, 0.85–1.50; P = .39).

Conclusions

In this study, G biloba at 120 mg twice a day was not effective in reducing either the overall incidence rate of dementia or AD incidence in elderly individuals with normal cognition or those with MCI.

Trial Registration

clinicaltrials.gov Identifier: NCT00010803

Copyright © 2008 by the American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use. American Medical Association, 515 N. State St, Chicago, IL 60610.
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