Vasodilators and Nootropics as Predictors of Dementia and Mortality in the PAQUID Cohort

Dartigues, J.-F.; Carcaillon, Laure; Helmer, Catherine; Lechevallier, Nathalie; Lafuma, A; Khoshnood, Babak

doi:10.1111/j.1532-5415.2007.01084.x

Cited by 23 publications

(15 citation statements)

References 24 publications

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“…Therefore, regarding EGb761® exposure, expecting a protective effect on the rate of dementia incidence in a delay of 3 to 6 years before dementia diagnosis would imply a direct effect of EGb761® on the neurodegenerative process itself during the more aggressive period of the pre-clinical phase, which is probably an over-optimistic hypothesis for the mechanism of action of this drug. In addition, a previous analysis of the PAQUID study has shown that EGb761® may increase the probability of survival in the elderly population [53]. Since age is the strongest risk factor for developing dementia demonstrated to date, the increased risk of developing dementia due to longer survival could also offset any possible beneficial effects of EGb761® on cognitive function.…”

Section: Discussionmentioning

confidence: 99%

Ginkgo Biloba Extract and Long-Term Cognitive Decline: A 20-Year Follow-Up Population-Based Study

et al. 2013

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BackgroundNumerous 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.Methods and FindingsThe 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).ConclusionCognitive 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.

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Section: Discussionmentioning

confidence: 99%

Ginkgo Biloba Extract and Long-Term Cognitive Decline: A 20-Year Follow-Up Population-Based Study

et al. 2013

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“…Poor performance on executive tests such as the Mini-Mental State Exam (Bassuk, Wypij, & Berkman, 2000;Dartigues et al, 2007) or the Short Portable Mental Status Questionnaire (Blazer, Sachs-Ericsson, & Hybels, 2005;Liang, Bennett, Sugisawa, Kobayashi, & Fukaya, 2003) tends to be associated with higher mortality risk, however the relationship has not always been found to be significant (Ganguli, Dodge, & Mulsant, 2002;Ostbye et al, 2006) and may be dependent on the length of the followup period (Ganguli et al, 2002; van Gelder, Tijhuis, Kalmijn, Giampaoli, & Kromhout, 2007). Performance on tests of crystallized intelligence, such as the National Adult Reading Test (Abas, Hotopf, & Prince, 2002;Anstey, Luszcz, Giles, & Andrews, 2001) or Raven's Mill Hill Vocabulary Scale (Rabbitt et al, 2002) tends to be robust to the effects of aging and is less likely to exhibit an association with mortality after health and social status are taken into account.…”

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confidence: 96%

Fluid intelligence is independently associated with all-cause mortality over 17 years in an elderly community sample: An investigation of potential mechanisms

2009

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“…Separating EGb 761 users from the other vasodilators gave similar odds ratios but did not reach statistical significance [70] . More recently, the analyses of the PAQUID Study concluded that EGb 761 (but not vasodilators) increases the survival time without dementia [71] .…”

Section: Treatment Effectiveness Of Antioxidantsmentioning

confidence: 99%

Is Antioxidant Therapy a Viable Alternative for Mild Cognitive Impairment? Examination of the Evidence

Ancelin

Christen

Ritchie

2007

Dement Geriatr Cogn Disord

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Therapeutic interventions for the prodromal stages of dementia are currently being sought with a view to delaying if not preventing disease onset. Uncertainty as to whether cognitive disorder in a given individual will progress towards dementia and adverse drug side effects has led to hesitancy on the part of drug regulators to instigate preventive pharmacotherapies. In this context, antioxidant therapies may provide a low-risk alternative, targeting very early biological changes. While a growing body of knowledge demonstrates both the importance of oxidative stress in the aetiology of dementia and the efficacy of antioxidant treatment in animal and cellular models, studies in humans are presently inconclusive. While some antioxidants, notably flavonoid- or vitamin-rich diets, appear to lower the relative risk for Alzheimer’s disease in humans in observational studies, these results must be interpreted in the light of the biological complexity of the relationship between oxidative stress and neurodegeneration, and the methodological and theoretical shortcomings of studies conducted to date. A clearer understanding of these factors will assist in the interpretation of the results of the intervention studies which are now being undertaken; these studies being the only current means of establishing efficacy for preventive drug treatment of Alzheimer’s disease.

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Vasodilators and Nootropics as Predictors of Dementia and Mortality in the PAQUID Cohort

Abstract: These results suggest that treatment with EGb 761 may increase the probability of survival in the elderly population. These findings need to be corroborated and further assessed using randomized, controlled trials.

Cited by 23 publications

References 24 publications

Ginkgo Biloba Extract and Long-Term Cognitive Decline: A 20-Year Follow-Up Population-Based Study

Ginkgo Biloba Extract and Long-Term Cognitive Decline: A 20-Year Follow-Up Population-Based Study

Fluid intelligence is independently associated with all-cause mortality over 17 years in an elderly community sample: An investigation of potential mechanisms

Is Antioxidant Therapy a Viable Alternative for Mild Cognitive Impairment? Examination of the Evidence

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