title: Herbal medicine for management of the behavioural and psychological symptoms of dementia (BPSD): A systematic review and meta-analysis.
abstract: Management of the behavioural and psychological symptoms of dementia remains a challenge worldwide. Herbal medicines may play a role in the development of new interventions. To determine effects of herbal medicines for management of the behavioural and psychological symptoms of dementia, meta-analysis was conducted of 31 controlled trials (3613 participants). Frequently tested herbal medicines were the Ginkgo biloba leaf extract EGb 761 (seven studies) and the multi-ingredient formula Yokukansan (eight studies). Sixteen studies tested other herbal medicines. Improvements were detected in Neuropsychiatric Inventory scores in EGb 761 groups compared to placebo (MD -3.46 [-5.94, -0.98]; I2= 93%; n = 1757) and Yokukansan groups compared to no treatment (SMD -0.53 [-0.86, -0.21]; I2= 0%; n = 150). Cognitive scores were improved in EGb 761 groups while Yokukansan did not appear to affect cognitive function. Of the other herbal medicines, there were improvements in the behavioural and psychological symptoms of dementia and cognitive outcomes in two of four placebo-controlled studies. EGb 761 and Yokukansan appeared safe and well tolerated. Adverse effects and dropouts were not reported consistently for the other herbal medicines. Weaknesses of these included short durations, small sample sizes, lack of blinding and other risks of bias. Well-designed studies are needed to further investigate the reported effects of these interventions on the behavioural and psychological symptoms of dementia.
authors.affiliation: 1 The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia.
authors.forename: Anna J
authors.initials: AJ
authors.lastname: Hyde
authors.affiliation: 1 The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia.
authors.forename: Brian H
authors.initials: BH
authors.lastname: May
authors.affiliation: 1 The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia.
authors.forename: Lin
authors.initials: L
authors.lastname: Dong
authors.affiliation: 2 Guangdong Provincial Academy of Chinese Medical Sciences & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Feng
authors.affiliation: 2 Guangdong Provincial Academy of Chinese Medical Sciences & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
authors.forename: Shaonan
authors.initials: S
authors.lastname: Liu
authors.affiliation: 2 Guangdong Provincial Academy of Chinese Medical Sciences & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Guo
authors.affiliation: 1 The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia.
authors.forename: Anthony Lin
authors.initials: AL
authors.lastname: Zhang
authors.affiliation: 2 Guangdong Provincial Academy of Chinese Medical Sciences & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
authors.forename: Chuanjian
authors.initials: C
authors.lastname: Lu
authors.affiliation: 1 The China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia.|2 Guangdong Provincial Academy of Chinese Medical Sciences & Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
authors.forename: Charlie Changli
authors.initials: CC
authors.lastname: Xue
mesh_terms: D001519:Behavior / Q000187:drug effects*; D003071:Cognition / Q000187:drug effects*; D003704:Dementia / Q000188:drug therapy*; D029001:Herbal Medicine / Q000379:methods; D006801:Humans; D009483:Neuropsychological Tests; D008517:Phytotherapy / Q000379:methods; D010936:Plant Extracts / Q000627:therapeutic use*
chemical_list: D010936:Plant Extracts
keywords: Alzheimer’s disease; Dementia; herbal medicine; neurocognitive disorders; systematic review