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- Ginkgo (Ginkgo biloba)
- Asian Ginseng (Panax ginseng)
- Cognition
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Date:
03-31-2014 | HC# 101354-493
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Re: Ginkgo, Ginseng, and Royal Jelly Combination Improves Memory in Patients with Mild Cognitive Impairment
Yakoot M, Salem A, Helmy S. Effect of Memo®,
a natural formula combination, on Mini-Mental State Examination scores in
patients with mild cognitive impairment. Clin
Interv Aging. 2013;8:975-981.
Ginkgo (Ginkgo
biloba) and Asian ginseng (Panax
ginseng) are used for memory loss. Ginkgo has antioxidant, free radical
scavenging, neuroprotective, and antiplatelet aggregation effects; beneficial
effects in
ischemia-reperfusion injury, hypoxia, cerebrovascular
disease, cognitive deficits, and
dementia have also been shown. Human and animal studies
show that Asian ginseng improves abstract thinking, mental abilities, stamina,
and endurance. Royal jelly is a honey bee secretion with high nutritional value
that is rich in health-promoting substances such as sterols, phosphorus
compounds, fatty acids, and acetylcholine. Royal jelly contains 2 unique
substances – (1) the fatty acid 10-hydroxy-trans-2-decenoic acid which has been
reported to promote neurogenesis, and (2) adenosine monophosphate (AMP)
N1-oxide which induces neural cell proliferation and has been shown to improve
cognitive impairment in mice.
It is hypothesized that a combination of
ginkgo, ginseng, and royal jelly may have additive and complementary effects.
The purpose of this randomized, double-blind, placebo-controlled multicenter study
was to evaluate the effect of a proprietary supplement called Memo®
(Pharco Pharmaceuticals; Alexandria, Egypt) on mild cognitive impairment. One
capsule of Memo contains 750 mg lyophilized royal jelly standardized to at least 6% 10-hydroxy-2-decenoic acid, 120
mg ginkgo extract standardized to contain 24% flavonoid glycosides and 6% terpenoids,
and 150 mg of P. ginseng alcohol root extract (containing 40%–80% ginsenosides).
Patients
(n = 66, aged 50-80 years) were recruited from 2 outpatient clinics in
Alexandria, Egypt. Included patients complained of memory impairment or
forgetfulness and were diagnosed with mild cognitive impairment according to
the Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Patients were excluded if they had an established
diagnosis of dementia or a baseline Mini-Mental State Examination (MMSE) score <
21; current treatment for dementia (except those with only mild impairment who
stopped treatment at least 1 month prior to enrollment); a recent history or
current treatment for any specific acute acquired brain injury; a history or
current treatment for major depressive or psychotic illnesses; were critically
ill; had severe anemia; or had vital organ dysfunction. Patients were randomly
assigned to receive either 1 capsule of Memo or placebo for 4 weeks. The
outcome measure was a change in the MMSE score from baseline to 4 weeks.
At
baseline, both groups had similar MMSE scores and demographic characteristics. After
4 weeks of treatment, the Memo-treated group had a mean 2.1-point improvement
in the MMSE score compared with baseline, which was a statistically significant
improvement (P < 0.0001). Also, the Memo-treated group had a statistically
significant improvement in MMSE score compared to the placebo group at 4 weeks
(P < 0.0001). The placebo group did not significantly improve compared with
baseline. All of the data remained constant even after adjusting for age and
educational level. There was no effect of gender on the change from baseline.
It is unclear whether a 2.1-point increase in MMSE score translates to
meaningful improvements in cognitive function; the authors do not discuss
clinical relevance of these findings.
No
serious adverse events were reported in either group; mild nausea, dyspepsia,
and transient headache were reported in 3 patients in each group. Improved
sexual performance and libido was reported by men treated with Memo; however, this
result did not reach statistical significance.
According
to the authors, this is the first study that evaluated the addition of royal
jelly to a combination of ginkgo and Asian ginseng for the improvement of mild
cognitive impairment. The authors conclude that the combination of these 3
ingredients may be beneficial in the treatment of cognitive decline during
aging, as well as in the early phases of dementia and Alzheimer's disease. They
acknowledge that financial constraints limited this study to the use of MMSE
scores only for inclusion criteria and outcome measure. Larger studies of longer
duration employing additional measures of cognitive function are needed to
confirm these findings.
—Heather S. Oliff,
PhD
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