title: Ginkgo biloba extract and long-term cognitive decline: a 20-year follow-up population-based study.
abstract: BACKGROUND
  Numerous studies have looked at the potential benefits of various nootropic drugs such as Ginkgo biloba extract (EGb761®; Tanakan®) and piracetam (Nootropyl®) on age-related cognitive decline often leading to inconclusive results due to small sample sizes or insufficient follow-up duration. The present study assesses the association between intake of EGb761® and cognitive function of elderly adults over a 20-year period.
  
  
  RESULTS
  The data were gathered from the prospective community-based cohort study 'Paquid'. Within the study sample of 3612 non-demented participants aged 65 and over at baseline, three groups were compared: 589 subjects reporting use of EGb761® at at least one of the ten assessment visits, 149 subjects reporting use of piracetam at one of the assessment visits and 2874 subjects not reporting use of either EGb761® or piracetam. Decline on MMSE, verbal fluency and visual memory over the 20-year follow-up was analysed with a multivariate mixed linear effects model. A significant difference in MMSE decline over the 20-year follow-up was observed in the EGb761® and piracetam treatment groups compared to the 'neither treatment' group. These effects were in opposite directions: the EGb761® group declined less rapidly than the 'neither treatment' group, whereas the piracetam group declined more rapidly (β = -0.6). Regarding verbal fluency and visual memory, no difference was observed between the EGb761® group and the 'neither treatment' group (respectively, β = 0.21 and β = -0.03), whereas the piracetam group declined more rapidly (respectively, β = -1.40 and β = -0.44). When comparing the EGb761® and piracetam groups directly, a different decline was observed for the three tests (respectively β = -1.07, β = -1.61 and β = -0.41).
  
  
  CONCLUSIONS
  Cognitive decline in a non-demented elderly population was lower in subjects who reported using EGb761® than in those who did not. This effect may be a specific medication effect of EGb761®, since it was not observed for another nootropic medication, piracetam.
authors: University of Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France. helene.amieva@isped.u-bordeaux2.fr
authors: Hélène
authors: H
authors: Amieva
authors: Céline
authors: C
authors: Meillon
authors: Catherine
authors: C
authors: Helmer
authors: Pascale
authors: P
authors: Barberger-Gateau
authors: Jean François
authors: JF
authors: Dartigues
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D020441:Ginkgo biloba / Q000737:chemistry*; D006801:Humans; D016015:Logistic Models; D008297:Male; D018697:Nootropic Agents / Q000008:administration & dosage / Q000494:pharmacology; D010889:Piracetam / Q000008:administration & dosage / Q000494:pharmacology*; D010936:Plant Extracts / Q000008:administration & dosage / Q000494:pharmacology*; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D000096983:Ginkgo Extract
chemical_list: D018697:Nootropic Agents; D010889:Piracetam; D010936:Plant Extracts; C063170:Ginkgo biloba extract; D000096983:Ginkgo Extract