Franke AG, Heinrich I, Lieb K, Fellgiebel A. The use of Ginkgo biloba in healthy elderly. Age (Dordr). June 5, 2013; [epub ahead of print]. doi: 10.1007/s11357-013-9550-y.

Higher levels of education are associated with a decreased risk for dementia and higher rates of health-conscious behavior. Health-conscious behavior involves choosing behaviors that lead to successful aging. It is unclear how the behaviors are chosen. One concept of healthy aging involves using dietary supplements. Ginkgo (Ginkgo biloba) is used to treat cognitive decline. The purpose of this survey study was to evaluate highly educated people to determine the prevalence of ginkgo use and sources of information about successful aging strategies.

All public universities offering specialized university lectures for elderly people throughout Germany (n = 64) were contacted for participation. A total of 22 public universities participated. The study included elderly students > 60 years of age. A total of 1,672 questionnaires were distributed, and 530 were returned and met the age inclusion criteria. Data were collected from July to December 2011. Subjects completed an extensive self-report paper-and-pencil questionnaire. The questionnaire obtained information on demographics, health insurance, and educational background, as well as standardized questionnaires: Anxiety about Aging Scale (AAS), General Health Questionnaire (GHQ-12) to screen for psychiatric symptoms, Symptom Check List (SCL-90-R) about physical and mental symptoms, Subjective Memory Complaints Questionnaire (SMCQ) to assess subjective memory deficits, Health Locus of Control Scale (KKG) to evaluate beliefs of health control, and a questionnaire to assess the frequency of health-conscious behavior (FEG).

The population of respondents included 61.7% women; subjects ranging from 60-94 years of age (mean age = 69.74 years); 88.3% retired persons; 63.8% with a college degree; 19.4% who had completed professional training; 2.5% with a master's degree; and 59.1% who were married. In general, vitamin and supplement use was significantly higher among women (P = 0.01), those who exhibited health-conscious behavior (P < 0.001), and those who self-reported memory complaints (P = 0.003). When queried about ginkgo, 90.4% knew about it; 66.7% knew it could be used for cognitive enhancement; and 15.3% used ginkgo supplements. Significantly more subjects using ginkgo were older-aged (P = 0.006); 73.3% of all had heard about ginkgo from a physician or pharmacist; 57.3% had a physician recommend the use of ginkgo; and the majority of subjects were convinced that the efficacy of ginkgo was scientifically proven. There was no significant difference in ginkgo use with respect to education, profession, family status, or health insurance. Compared to non-users, ginkgo users had significantly higher values for health-conscious behavior (P < 0.001); used natural remedies and vitamins significantly more often (P = 0.001); were significantly more concerned about aging (P = 0.036); self-reported a significantly larger number of subjective memory complaints (P = 0.022); evaluated their memory to be significantly worse (P = 0.022); and thought their memory capacity to be so poor that they possibly had dementia, although it was not diagnosed (P = 0.001). However, there was no between-group significant difference in physical and mental symptoms according to the SCL-90-R. According to the GHQ-12, ginkgo users considered their general health to be significantly worse than non-users. A total of 15% of ginkgo users did not report ginkgo use to their physician.

Based on this data and other studies, the authors conclude that the frequency of ginkgo use increases as people get older and that the use of ginkgo is greater among subjects with higher education. It should be noted that the high frequency of ginkgo use (15.4%) in this population had to do, in part, with the finding that > 50% of the subjects had a physician recommend ginkgo use. In the United States, studies demonstrate ginkgo use frequency rates of ≤ 4%, and fewer physicians recommend ginkgo use. The limitations of the study are that the subjects may be more acutely aware of cognitive decline because they are students, and the data only relate to highly educated and motivated older people.