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- Indian Frankincense (Boswellia serrata, Burseraceae)
- Lemon Balm (Melissa officinalis, Lamiaceae)
- Memory
- Older Adults
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Date:
03-30-2018 | HC# 031861-589
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Re: Initial Clinical Trial Finds that a Combination of Indian Frankincense and Lemon Balm May Improve Memory Function in Older Adults
Taghizadeh
M, Maghaminejad F, Aghajani M, Rahmani M, Mahboubi M. The effect of tablet containing
Boswellia serrata and Melisa [sic] officinalis extract
on older adults' memory: A randomized controlled trial. Arch Gerontol Geriatr. March-April 2018;75:146-150.
As
lifespans around the world increase, age-related health concerns become a
growing medical issue. Memory loss and dementia affect many older adults, and
prescription and non-prescription treatments for these conditions are commonly
used. Of the range of herbal remedies available, limited research has been done
on the potential of Indian frankincense (Boswellia
serrata, Burseraceae) and lemon balm (Melissa
officinalis, Lamiaceae) to improve memory. These plants have been used in
Iranian traditional medicine for centuries in the treatment of neurological
disorders, and individually have been reported to improve memory. Though an
animal study reported that the combination was more effective than either plant
individually, the authors found no human study that researched the combination for
the treatment of memory loss. They conducted a clinical trial to assess the
impact of the joint use of the 2 plants in treating memory issues among older
adults.
The
30-day, randomized, double-blind, parallel-group, placebo-controlled clinical
trial was conducted from August to September 2015 by the Kashan University of
Medical Sciences; Kashan, Iran. Seventy older adults were recruited through
multi-stage random sampling to take part in the study according to the
following criteria: between the age of 60 and 74; fully conscious; able to
speak; no history of psychological disorders or Alzheimer's disease; and no
allergies to herbal medicine. Subjects would be removed from the trial if they
missed 2 or more consecutive doses, were unable or chose not to follow-up, or
had adverse effects. Subjects completed a demographic questionnaire and the
Wechsler Memory Scale-Revised (WMS-R) before being assigned to the treatment
group or control group by block randomization.
Flowering
aerial parts of lemon balm were harvested in 2012 from the Medicinal Plant
Research Center of Barij Essence Pharmaceutical Company; Kashan, Iran. Indian
frankincense resin was purchased from Natural Remedies Pvt. Ltd.; Bangalore,
Karnataka, India. Tablets were produced by Barij Essence Pharmaceutical Company
(Kashan, Iran) and contained 290 mg of lemon balm extract and 27 mg of Indian
frankincense extract. The treatment also contained Avicel®
(cellulose binder; FMC Corporation; Philadelphia, Pennsylvania), corn (Zea mays, Poaceae) starch, lactose
monohydrate, and magnesium stearate adjuvant. The placebo (composition not
given) was formulated to look identical to the treatment tablet, and both were
packaged in the same manner. The treatment tablets and placebo were classified
and coded by the formulation unit of the Research Center of Barij Essence
Pharmaceutical Company. Subjects were instructed to take 1 tablet, twice a day
(morning and night), and received the tablets in 30-tablet packages at the
start of and halfway through the treatment. The second author conducted a
follow-up by telephone each week, and the subjects were retested on the WMS-R
at the end of the 30-day trial.
Seventeen
subjects did not complete the study—of 4 subjects from the treatment group, 2
reported adverse effects and 2 withdrew from the study for other reasons; of 13
subjects from the control group, 2 reported adverse effects and the others were
noncompliant, lost to follow-up, or hospitalized during the study. Fifty-three
subjects completed the study, but the authors followed an intention-to-treat
analysis; therefore, data for all 70 subjects were included in the analysis.
Data were analyzed with chi-square test, paired t-test, one-way analysis of
variance (ANOVA), and analysis of covariance (ANCOVA), using SPSS (Statistical
Package for the Social Sciences) v13.
There
were no significant differences in demographic characteristics (age, sex,
employment, marital status, level of education) between the treatment and
control groups (P>0.05), though the treatment group was almost significantly
older (P=0.07). Similarly, the 2 groups showed no significant difference in
their initial mean WMS-R scores, which included total memory and subscales for
auditory immediate, visual immediate, immediate memory, and working memory
(P>0.05). Within the treatment group, the mean scores for total memory and
all 4 subscales increased significantly at the end of the study (P<0.0001
for all). The control group saw a significant increase in working memory at the
end of the study (P<0.01), but small improvements in the other subscales
were nonsignificant. After treatment, there were significant differences
between the 2 groups in auditory immediate (P<0.0001), immediate memory
(P<0.002), and total memory (P<0.002) scores.
This
initial study on the joint use of Indian frankincense and lemon balm in the
treatment of memory loss among older adults indicates that these herbs may help
to increase memory function across multiple parameters. The authors acknowledge
that this trial was of limited duration, and longer-term studies would serve to
strengthen the research on the subject. The study saw almost a quarter of the
subjects drop out for various reasons, and while they followed an intention-to-treat
analysis, a larger sample size could provide a better assessment of the
effectiveness of this remedy in treating memory loss in older adults.
The
study was funded by Kashan University of Medical Sciences. One of the authors
(Mahboubi) is an employee of the Medicinal Plant Research Center of Barij
Essence Pharmaceutical Company.
—Heather B. Leach,
MSc
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