title: Association of Alzheimer's disease onset with ginkgo biloba and other symptomatic cognitive treatments in a population of women aged 75 years and older from the EPIDOS study.
abstract: BACKGROUND
  Peripheral C4A treatment (cerebral and peripheral vasotherapeutics) and especially Ginkgo biloba extracts are prescribed for a number of symptoms, particularly memory impairment, in elderly patients. It is postulated that because of its pharmacological actions, this treatment could prevent the decline of cognitive function, but no studies have been published to date to test its efficacy in prevention of Alzheimer's disease. The potential association between use of C4A treatments, in particular EGb 761 (standardized Ginkgo biloba extracts), and dementia of the Alzheimer type was investigated.
  
  
  METHODS
  A case-control study was nested in a cohort of 1462 community-dwelling elderly women aged over 75 years. Sixty-nine women with Alzheimer-type dementia were compared with 345 paired women whose cognitive function remained normal. This study involved women whose cognitive function was evaluated at baseline by use of Pfeiffer's test and whose medication history was taken. The onset of cognitive impairment was investigated over a 7-year follow-up period. In order to study the factors associated with the onset of dementia, the data concerning women with a score of > or = 8 on Pfeiffer's test at inclusion, indicating normal cognitive function, were analyzed.
  
  
  RESULTS
  A multivariate analysis including potential confounding factors showed that fewer women who developed Alzheimer's dementia had been prescribed C4A treatment (including EGb 761) for at least 2 years (odds ratio = 0.31, 95% confidence interval = 0.12-0.82, p =.018). Figures for EGb 761 alone were similar but did not reach statistical significance (odds ratio = 0.38, 95% confidence interval = 0.08-1.76, p =.22).
  
  
  CONCLUSIONS
  These results suggest that C4A treatment may reduce the risk of developing Alzheimer's dementia in elderly women. The potential preventive effect of C4A treatments, including EGb 761, requires further examination. To establish a causal relationship, these findings have to be confirmed with prospective studies.
authors.affiliation: Department of Internal Medicine and Clinical Gerontology, Acute Unit for Alzheimer's Patients, Toulouse, France. sandrieu@cict.fr
authors.forename: Sandrine
authors.initials: S
authors.lastname: Andrieu
authors.forename: Sophie
authors.initials: S
authors.lastname: Gillette
authors.forename: Karine
authors.initials: K
authors.lastname: Amouyal
authors.forename: Fati
authors.initials: F
authors.lastname: Nourhashemi
authors.forename: Emma
authors.initials: E
authors.lastname: Reynish
authors.forename: Pierre Jean
authors.initials: PJ
authors.lastname: Ousset
authors.forename: Jean Louis
authors.initials: JL
authors.lastname: Albarede
authors.forename: Bruno
authors.initials: B
authors.lastname: Vellas
authors.forename: Hélène
authors.initials: H
authors.lastname: Grandjean
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000517:prevention & control*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000517:prevention & control; D005260:Female; D020441:Ginkgo biloba; D006801:Humans; D016015:Logistic Models; D010936:Plant Extracts / Q000627:therapeutic use*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D000096983:Ginkgo Extract
chemical_list: D010936:Plant Extracts; C063170:Ginkgo biloba extract; D000096983:Ginkgo Extract