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by Glickman-Simon R

Alzheimer’s Disease and Non-Alzheimer’s Dementia

Alzheimer disease is the most common cause of dementia. Dementia is a loss in mental function that impacts daily life. The ability to learn, remember, and function is slowly lost. It is related to abnormal deposits of protein and twisted fibers in nerve cells in the brain. The cause of this is not known. Less common disease forms include those associated with heart disease and Parkinson disease.
There is no cure. Some medications can treat symptoms and may slow cognitive loss. Some patients and caregivers look to natural treatments to help manage changes related to dementia. They may ease anxiety, improve sleep, or improve clarity in thought process.

Natural Therapies

Likely Effective

Dementia is serious and requires standard medical treatment and close supervision. The following alternative treatments may favorably effect cognitive function:
  • Ginkgo biloba —may improve cognition and activities of daily living. (Note: Ginkgo biloba may interact harmfully with other medications.) A1-A8
  • Huperzine A —may improve cognitive function and activities of daily living. (Note: Huperzine A may interact harmfully with other medications. It is not advised for patients with certain health condition, such as asthma. It may also cause nausea, sweating, and blurred vision. B2, B14

Possibly Effective

Supplements that may improve symptoms include:
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about all herbs or supplements you are taking. Some may interact with your treatment plan or health conditions. Some supplements discussed here have certain concerns such as:
  • Ginkgo biloba may interact harmfully with a number of commonly prescribed medications. Talk to your doctor about the medications you are taking.
  • Huperzine A may interact with other medications used to treat dementia.

References


Herbs
A1
Le Bars P. Conflicting results on ginkgo research. Forsch Komplementarmed Klass Naturheilkd. 2002;9:19-20.
A2
Napryeyenko O, Borzenko I. Ginkgo biloba special extract in dementia with neuropsychiatric features: a randomised, placebo-controlled, double-blind clinical trial. Arzneimittelforschung. 2007;57:4-11.
A3
Scripnikov A, Khomenko A, Napryeyenko O. Effects of Ginkgo biloba extract EGb 761® on neuropsychiatric symptoms of dementia: findings from a randomised controlled trial. Wien Med Wochenschr. 2007;157:295-300.
A4
Dodge HH, Zitzelberger T, Oken BS, et al. A randomized placebo-controlled trial of ginkgo biloba for the prevention of cognitive decline. Neurology. 2008 Feb 27.
A5
Bornhoft G, Maxion-Bergemann S, Matthiessen PF. External validity of clinical trials for treatment of dementia with ginkgo biloba extracts.] Z Gerontol Geriatr. 2008 Mar 11.
A6
McCarney R, Fisher P, Iliffe S, et al. Ginkgo biloba for mild to moderate dementia in a community setting: a pragmatic, randomised, parallel-group, double-blind, placebo-controlled trial. Int J Geriatr Psychiatry. 2008 Jun 9.
A7
Birks J, Evans JG. Ginkgo biloba for cognitive impairment and dementia. Cochrane Database of Systematic Reviews. 2009;(1):CD003120.
A8
Weinmann S, Roll S, Schwarzbach C, Vauth C, Willich SN. Effects of Ginkgo biloba in dementia: systematic review and meta-analysis. BMC Geriatr. 2010;10:14.

Supplements
B1
Thal LJ, Calvani M, Amato A, et al. A 1-year controlled trial of acetyl-l-carnitine in early-onset AD. Neurology. 2000;55:805-810.
B2
Zhang Z, Wang X, Chen Q, et al. Clinical efficacy and safety of huperzine Alpha in treatment of mild to moderate Alzheimer disease, a placebo-controlled, double-blind, randomized trial. Zhonghua Yi Xue Za Zhi. 2002;82:941-944.
B3
Hudson S, Tabet N. Acetyl-l-carnitine for dementia. Cochrane Database Syst Rev. 2003;CD003158.
B4
Lip GY, Lane DA, et al. Cochrane Database Syst Rev. 2003;(3):CD004394.
B5
Malouf R, Grimley Evans J. The effect of vitamin B6 on cognition. Cochrane Database Syst Rev. 2003;(4):CD004393.
B6
Montgomery SA, Thal LJ, Amrein R. Meta-analysis of double blind randomized controlled clinical trials of acetyl-L-carnitine versus placebo in the treatment of mild cognitive impairment and mild Alzheimer's disease. Int Clin Psychopharmacol. 2003;18:61-71.
B7
Szatmari SZ, Whitehouse PJ. Vinpocetine for cognitive impairment and dementia [review]. Cochrane Database Syst Rev. 2003;CD003119.
B8
Freund-Levi YF, Eriksdotter-Jonhagen M, Cederholm T, et al. Omega-3 fatty acid treatment in 174 patients with mild to moderate Alzheimer disease: OmegAD Study. Arch Neurol. 2006;63:1402-1408.
B9
Jansen SL, Forbes DA, et al. Melatonin for cognitive impairment. Cochrane Database Syst Rev. 2006 Jan 25;(1).
B10
Freund-Levi Y, Basun H, Cederholm T, et al. Omega-3 supplementation in mild to moderate Alzheimer's disease: effects on neuropsychiatric symptoms. Int J Geriatr Psychiatry. 2007 Jun 21. [Epub ahead of print]
B12
Aisen PS, Schneider LS, et al. High-dose B vitamin supplementation and cognitive decline in Alzheimer disease: a randomized controlled trial. JAMA. 2008 Oct 15;300(15):1774-1783.
B13
Jia X, McNeill G, Avenell A. Does taking vitamin, mineral and fatty acid supplements prevent cognitive decline? A systematic review of randomized controlled trials. J Hum Nutr Diet. 2008;21:317-336.
B14
Li J, Wu HM, Zhou RL, Liu GJ, Dong BR. Huperzine A for Alzheimer's disease. Cochrane Database of Systematic Reviews. 2008;(2):CD005592.
B15
Riemersma-van der Lek RF, Swaab DF, Twisk J, et al. Effect of bright light and melatonin on cognitive and noncognitive function in elderly residents of group care facilities: a randomized controlled trial. JAMA. 2008;299:2642-2655.
B16
Ford AH, Flicker L, Alfonso H, et al. Vitamins B(12), B(6), and folic acid for cognition in older men. Neurology. 2010;75(17):1540-1547.
B17
Andreeva VA, Kesse-Guyot E, et al. Cognitive function after supplementation with B vitamins and long-chain omega-3 fatty acids: ancillary findings from the SU.FOL.OM3 randomized trial. Am J Clin Nutr. 2011 Jul;94(1):278-286.
B18
Jansen S, Forbes D, Duncan V, Morgan D, Malouf R. Melatonin for the treatment of dementia. Cochrane Database Syst Rev. 2011;(1):CD003802.
B19
Rodriguez-Martin JL, Qizilbash N, et al. Thiamine for Alzheimer’s disease. Cochrane Database Syst Rev. 2011;(2):CD001498.
B20
Farina N, Isaac MG, et al. Vitamin E for Alzheimer’s dementia and mild cognitive impairment. Cochrane Database Syst Rev. 2012 Nov 14;11:CD002854.
B21
Sydenham E, Dangour AD, et al. Omega 3 fatty acid for the prevention of cognitive decline and dementia. Cochrane Database Syst Rev. 2012 Jun 13;(6): CD005379.
B22
Dysken MW, Sano M, et al. Effect of vitamin E and memantine on functional decline in Alzheimer disease: the TEAM-AD VA cooperative randomized trial. JAMA. 2014 Jan 1;311(1)33-44.
B23
Van der Zwaluw NL, Dhonukshe-Rutten RA, et al. Results of a 2-year vitamin B treatment of cognitive performance: secondary data from an RCT. Neurology. 2014 Dec 2;83(23):2158-2166.

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