Management of Cognitive Determinants in Senile Dementia of Alzheimer’s Type: Therapeutic Potential of a Novel Polyherbal Drug Product

Sadhu, Ananya; Upadhyay, Prabhat; Agrawal, Aruna; Ilango, K.; Karmakar, Dipankar; Singh, G.P.I.; Dubey, Govind Prasad

doi:10.1007/s40261-014-0235-9

Cited by 46 publications

(64 citation statements)

References 40 publications

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“…Treatment durations were 6 to 64 weeks. Two studies were conducted in Iran, one in India, and the remainder in China (Table ). In 29 studies, the control was donepezil.…”

Section: Resultsmentioning

confidence: 99%

Comparisons between traditional medicines and pharmacotherapies for Alzheimer disease: A systematic review and meta‐analysis of cognitive outcomes

May

Feng

Hyde

et al. 2017

Int J Geriat Psychiatry

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“…Treatment durations were 6 to 64 weeks. Two studies were conducted in Iran, one in India, and the remainder in China (Table ). In 29 studies, the control was donepezil.…”

Section: Resultsmentioning

confidence: 99%

Comparisons between traditional medicines and pharmacotherapies for Alzheimer disease: A systematic review and meta‐analysis of cognitive outcomes

May

Feng

Hyde

et al. 2017

Int J Geriat Psychiatry

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“…45 Several preclinical analysis and clinical trials have proven the efficacy of these plants in management of cognitive deficits in aged population. 16,43,[46][47][48][49][50] Subsequently, metformin in addition to its antidiabtic properties has been also recently recognized as a potential treatment for neurodegenerative disorders such as AD. Studies have shown that metformin prevents apoptotic cascade in endothelial cell type by inhibiting Permeability Transition Pore (PTP) and blocking the release of cytochrome-c that will lead to cell death.…”

Section: Discussionmentioning

confidence: 99%

“…The polyherbal formulation has demonstrated a potential role in treatment and prevention of neurodegenerative disorders in the elderly by significantly improving cognitive and neuropsychiatric measures, reducing oxidative stress and neuroinflammation. 16 Whereas, metformin is the first line pharmacologic treatment for T2DM, as it decreases hepatic glucose production and improves insulin sensitivity by augmenting glucose uptake in the peripheral tissues, mainly muscles. 17,18 Metformin's efficacy, security profile, beneficial cardiovascular and metabolic effects and its ability to be associated with other antidiabetic or neuroprotective agents provided the basis to use the combination therapy in the present study.…”

Section: 13mentioning

confidence: 99%

“…Only 120 patients were randomized into two groups of 60 participants each; Group I: elderly subjects with diabetes who were given metformin and placebo, Group II: elderly patients with diabetes who were given metformin and test drug (polyherbal formulation). 16 A random list of numbers was determined by a computer-generated series with the proper sequence applied to container labels and supplied to participants in the order enrolled after being randomly assigned to the various treatment groups. This computer generated randomization scheme was developed and kept by the study sponsor.…”

Section: Study Design Participants and Treatmentmentioning

confidence: 99%

“…The placebo tablets were prepared using dibasic calcium phosphate and microcrystalline cellulose and were identical in appearance to the test drug. 16 Follow up of the patients was performed by monitoring them weekly by phone to control them from nonconsumption of capsules, prevent sample loss and record response to relevant questions. Compliance was determined by calculating the rate of tablet consumption before they received medication for next two weeks.…”

Section: Study Design Participants and Treatmentmentioning

confidence: 99%

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Combination Treatment with a Novel Polyherbal Formulation and Metformin: A Single Blind Placebo-Controlled Study in Patients with T2DM and Cognitive Impairments

Dubey¹,

Sadhu²,

Upadhyay³

et al. 2015

Diabetes Res Open J

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CitationDubey GP, Sadhu A, Upadhyay P, et al. Combination treatment with a novel polyherbal formulation and metformin: a single blind placebocontrolled study in patients with T2DM and cognitive impairments. ABSTRACTBackground: Older people suffering from Type 2 Diabetes Mellitus (T2DM) are at major risk for age related cognitive dysfunction and dementia, mainly due to vascular complications. Studies have shown that T2DM is also associated with Alzheimer's Disease (AD) and is responsible for accelerating the pathology through insulin resistance. A polyherbal drug containing Bacopa Monnieri, Hippophae rhamnoides and Dioscorea bulbifera has shown a potent neuroprotective effect in management of cognitive deficits in elderly; and metformin a well-accepted antidiabetic agent responsible for lowering blood glucose in T2DM, can together provide an intriguing potential combination therapy for prevention and amelioration of cognitive impairments in T2DM patients. Objective: The present study is aimed to evaluate the combined effect of a polyherbal drug and metformin on improving cognitive functions in patients suffering from T2DM. Method: Elderly patients with an age range of 60-75 years diagnosed for T2DM were enrolled in the study and randomized into two groups; Group I=T2DM patients given metformin and placebo, Group II=T2DM patients given metformin and polyherbal drug. The subjects received the combination therapy of metformin (500 mg) and placebo or metformin (500 mg) and polyherbal drug (500 mg) twice daily for a period of 24 weeks. Estimation of Mini Mental State Examination (MMSE) score, blood glucose, HbA1c, insulin, lipid profile (total cholesterol, LDL-c, HDL-c, triglycerides), homocysteine, Interleukin-6 (IL-6), TNF-α and C-reactive protein (CRP) were measured at baseline and were repeated at three months and six months. The primary end point was a change from baseline to week 24 in MMSE score. Key secondary end points included change from baseline to week 24 in Digital Symbol Substitution (DSS); subtest of the Wechsler Adult Intelligence Scale-Revised), word recall (digital memory apparatusMedicaid systems, Chandigarh, India), attention span (Attention Span Apparatus -Medicaid systems, Chandigarh, India), Functional Activity Questionnaire (FAQ) and Hamilton Depression Scale (HDS) score. Further inflammatory markers and level of oxidative stress were analysed using standard biochemical tests. Result: The trial was performed in 120 elderly diabetic patients out of whom 112 patients

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Diagnosis and Management of Dementia: Review

Arvanitakis

Shah

Bennett

2019

JAMA

852

604

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ementia is a common public health problem. 1 Worldwide, approximately 47 million people have dementia, and this number is expected to increase to 131 million by 2050. 1 Reductions in age-adjusted incidence of dementia have occurred in the United States and other developed countries over the last 20 years, perhaps associated with increasing formal educational attainment. However, without improved treatments or preventive therapy, the adverse consequences of dementia will continue to increase. 2 In the United States, the prevalence of dementia is 15% in people older than 68 years. 3 Alzheimer disease (AD) affects 5.8 million people, and 13.8 million are projected to have the diagno-sis of AD by the year 2050. 4 AD is the sixth leading cause of death and the fifth leading cause among people older than 65 years. 5,6 This review summarizes diagnosis and management of dementia, defined as significant cognitive impairment in 2 or more cognitive domains. MethodsWe conducted a literature search in PubMed, using the search terms "dementia and (diagnosis or management)" in the title field. The following inclusion criteria were applied: publication date from IMPORTANCE Worldwide, 47 million people live with dementia and, by 2050, the number is expected to increase to 131 million.OBSERVATIONS Dementia is an acquired loss of cognition in multiple cognitive domains sufficiently severe to affect social or occupational function. In the United States, Alzheimer disease, one cause of dementia, affects 5.8 million people. Dementia is commonly associated with more than 1 neuropathology, usually Alzheimer disease with cerebrovascular pathology. Diagnosing dementia requires a history evaluating for cognitive decline and impairment in daily activities, with corroboration from a close friend or family member, in addition to a thorough mental status examination by a clinician to delineate impairments in memory, language, attention, visuospatial cognition such as spatial orientation, executive function, and mood. Brief cognitive impairment screening questionnaires can assist in initiating and organizing the cognitive assessment. However, if the assessment is inconclusive (eg, symptoms present, but normal examination findings), neuropsychological testing can help determine whether dementia is present. Physical examination may help identify the etiology of dementia. For example, focal neurologic abnormalities suggest stroke. Brain neuroimaging may demonstrate structural changes including, but not limited to, focal atrophy, infarcts, and tumor, that may not be identified on physical examination. Additional evaluation with cerebrospinal fluid assays or genetic testing may be considered in atypical dementia cases, such as age of onset younger than 65 years, rapid symptom onset, and/or impairment in multiple cognitive domains but not episodic memory. For treatment, patients may benefit from nonpharmacologic approaches, including cognitively engaging activities such as reading, physical exercise such as walking, and socialization such as fa...

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Management of Cognitive Determinants in Senile Dementia of Alzheimer’s Type: Therapeutic Potential of a Novel Polyherbal Drug Product

Abstract: The results of this study demonstrate the therapeutic potential of this novel polyherbal formulation for the management and treatment of SDAT.

Cited by 46 publications

References 40 publications

Comparisons between traditional medicines and pharmacotherapies for Alzheimer disease: A systematic review and meta‐analysis of cognitive outcomes

Comparisons between traditional medicines and pharmacotherapies for Alzheimer disease: A systematic review and meta‐analysis of cognitive outcomes

Combination Treatment with a Novel Polyherbal Formulation and Metformin: A Single Blind Placebo-Controlled Study in Patients with T2DM and Cognitive Impairments

Diagnosis and Management of Dementia: Review

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