Dr. Keith Wollen at Washington State University, in Port Angeles, has written a review of treatment options.

Let’s focus on CAM.

HuperzineA (HupA)

  • 2 Chinese studies showed significant improvement in cognition, memory, and activities of daily living.
  • A US study in mild-to-moderate Alzheimer’s patients reported cognitive enhancement.
  • A Cochrane review concluded there are too few studies of sufficient quality to recommend its use.
  • At this point, HupA appears to be effective and better tolerated than FDA-approved drugs, but larger studies are needed.

Curcumin

  • Studies show no benefits in Alzheimer’s disease.

Resveratrol

  • Studies are ongoing.

Ginkgo biloba

  • A Cochrane review of 36 studies concluded the effect of ginkgo was inconsistent.
  • In 1 study, ginkgo and donepezil (Aricept) appeared equally effective over 24 weeks in mild-to-moderate dementia.
  • There is concern over bleed risk with ginkgo, but studies have not confirmed this.

Panax ginseng

  • There are few studies in Alzheimer’s disease.
  • In 1 study, there was short-term (12-week) benefit, which declined to the level of the control group during the 12-week follow-up.

Withania somnifera (ashwagandha or Indian ginseng)

  • No published research on Alzheimer’s disease.

Phosphatidylserine

  • There’s little research on soy-based phosphatidylserine.
  • Available data are conflicting.

alpha-Lipoic acid (ALA)

  • Poorly designed studies provide no definitive results.

Omega-3 fatty acids

  • Data suggest benefits are limited to patients with very mild cognitive impairment.

Coenzyme Q10 (CoQ10; Ubiquinione)/idebenone)

  • Studies report conflicting results.

B vitamins

  • Low levels appear to be associated with cognitive decline.
  • Studies have focused on changes in homocysteine, with the hope that lower levels will be therapeutic.
  • No apparent effects on cognition.

Vitamin E

  • 1 study reported that higher levels of vitamin A lowered the risk of Alzheimer’s disease and slowed cognitive decline.

Melatonin

  • Only a few, poorly designed study are available.

Physical exercise, cognitive training, and socialization

  • Exercise appears to have benefit on executive function (planning, coordination, working memory, abstract thinking, initiation of appropriate actions)
  • Also benefits with memory training and brain exercises in selected patients.
  • Few studies have evaluated music on cognitive function, with benefits confined to very short-term.

The bottom line?

Dr Wollen concluded, “At the present time, nutritional, botanical, and stimulatory therapies may provide more benefit and with fewer adverse consequences than conventional medications.”

12/22/10 21:34 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.