Abstract
To promote health-conscious behavior in the aging society and gain insight into the sources of knowledge on which preventive strategies are based, analyzing the behavior of elderly people who are recognized as highly health conscious may be useful. We focused on the use of Ginkgo biloba, which is commonly considered to be effective in preventing cognitive decline and dementia, among elderly adults. A total of 1,672 questionnaires were distributed among geriatric participants (60–94 years) who attended university lectures at 22 universities throughout Germany. Response rate was 36.1 %. We collected data on demographic characteristics, preventive strategies (use of Ginkgo and other supplements), health-conscious behavior, sources of knowledge concerning health behavior, and factors associated with the participants’ concept of aging. The prevalence of Ginkgo use was 15.3 %. Ginkgo was assumed to be effective for cognitive enhancement and the treatment of cognitive decline by two thirds of the surveyed participants and one third believed Ginkgo to be effective for preventing dementia. Ginkgo use was significantly higher among participants using natural remedies and herbal and food supplements. The use of Ginkgo was recommended by physicians (57.3 %), chemists (16 %), and healthcare magazines (10.7 %). Food supplements were taken by 65.8 % of the sample: this percentage was significantly higher among subjects who exhibited health-conscious behavior. “Knowledge” about strategies to enhance cognition or prevent cognitive decline among the elderly do not appear to be evidence based. Thus, there is a need to establish reliable and independent sources of scientific information for healthcare professionals and the general public.
Similar content being viewed by others
References
Abebe W, Herman W, Konzelman J (2011) Herbal supplement use among adult dental patients in a USA dental school clinic: prevalence, patient demographics, and clinical implications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111(3):320–325
Adusumilli PS, Ben-Porat L, Pereira M, Roesler D, Leitman IM (2004) The prevalence and predictors of herbal medicine use in surgical patients. J Am Coll Surg 198(4):583–590
Ahlemeyer B, Krieglstein J (2003) Neuroprotective effects of Ginkgo biloba extract. Cell Mol Life Sci 60(9):1779–1792
Baltes PB (1997) On the incomplete architecture of human ontogeny. Selection, optimization, and compensation as foundation of developmental theory. Am Psychol 52(4):366–380
Barnes PM, Bloom B, Nahin RL (2008) Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report 12:1–23
Bastianetto S, Zheng WH, Quirion R (2000) The Ginkgo biloba extract (EGb 761) protects and rescues hippocampal cells against nitric oxide-induced toxicity: involvement of its flavonoid constituents and protein kinase C. J Neurochem 74(6):2268–2277
Birks J, Grimley Evans J (2007) Ginkgo biloba for cognitive impairment and dementia. Cochrane Database Syst Rev (2):CD003120
Birks J, Grimley Evans J (2009) Ginkgo biloba for cognitive impairment and dementia. Cochrane Database Syst Rev (1):CD003120
Birks J, Grimley EV, Van Dongen M (2002) Ginkgo biloba for cognitive impairment and dementia. Cochrane Database Syst Rev (4):CD003120
Blumenthal M (1997) Herbal market levels after five years of boom. HerbalGram 47:64–5
Bradley CP (1992) Uncomfortable prescribing decisions: a critical incident study. BMJ 304(6822):294–296
Brayne C (2007) The elephant in the room - healthy brains in later life, epidemiology and public health. Nat Rev Neurosci 8(3):233–239
de Jongh R, Bolt I, Schermer M, Olivier B (2008) Botox for the brain: enhancement of cognition, mood and pro-social behavior and blunting of unwanted memories. Neurosci Biobehav Rev 32(4):760–776
DeFeudis FV, Drieu K (2000) Ginkgo biloba extract (EGb 761) and CNS functions: basic studies and clinical applications. Curr Drug Targets 1(1):25–58
Dietz P, Striegel H, Franke AG, Lieb K, Simon P, Ulrich R (2013): Randomized Response Estimates for the One-Year Prevalence of Cognitive Enhancement in University Students. Pharmacotherapy, (in press)
Dlugosch G, Krieger W (1995) Fragebogen zur Erfassung des Gesundheitsverhaltens: FEG. Swets Test Services, Frankfurt
Fowler JS, Wang GJ, Volkow ND, Logan J, Franceschi D, Franceschi M, MacGregor R, Shea C, Garza V, Liu N, Ding YS (2000) Evidence that gingko biloba extract does not inhibit MAO A and B in living human brain. Life Sci 66(9):PL141–PL146
Franke AG, Lieb K (2010) Pharmacological neuroenhancement and brain doping : Chances and risks. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 53(8):853–859
Franke AG, Lieb K, Fellgiebel A (2009) From symptomatic to disease modifying therapy? Recent developments in the pharmacotherapy of Alzheimer’s disease. Fortschr Neurol Psychiatr 77(6):326–333
Franke AG, Bonertz C, Christmann M, Lieb K (2012) Attitudes Toward Cognitive Enhancement in Users and Nonusers of Stimulants for Cognitive Enhancement: A Pilot Study. AJOB Prim Res 3(1):48–57
Franke GH (2002) SCL-90-R: Die symptom checkliste von L. R. Derogatis. Göttingen: Beltz Test GmbH
Goldberg DP, Blackwell B (1970) Psychiatric illness in general practice. A detailed study using a new method of case identification. Br Med J 1(5707):439–443
Hui EK, Rubenstein LZ (2006) Promoting physical activity and exercise in older adults. J Am Med Dir Assoc 7(5):310–314
Jeste DV, Depp CA, Vahia IV (2010) Successful cognitive and emotional aging. World Psychiatry 9(2):78–84
Kanowski S, Herrmann WM, Stephan K, Wierich W, Horr R (1996) Proof of efficacy of the Ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Pharmacopsychiatry 29(2):47–56
Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA (2002) Recent patterns of medication use in the ambulatory adult population of the United States: the Slone survey. Jama 287(3):337–344
Kelly JP, Kaufman DW, Kelley K, Rosenberg L, Anderson TE, Mitchell AA (2005) Recent trends in use of herbal and other natural products. Arch Intern Med 165(3):281–286
Lasher KP, Faulkender PJ (1993) Measurement of aging anxiety: development of the Anxiety about Aging Scale. Int J Aging Hum Dev 37(4):247–259
Le Bars PL, Katz MM, Berman N, Itil TM, Freedman AM, Schatzberg AF (1997) A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group Jama 278(16):1327–1332
Lewis PJ, Tully MP (2011) The discomfort caused by patient pressure on the prescribing decisions of hospital prescribers. Res Social Adm Pharm 7(1):4–15
Lohaus A, Schmitt GM (1998) Fragebogen zur Erhebung von Kontrollüberzeugungen zu Krankheit und Gesundheit (KKG). Hogrefe, Göttingen
Maclennan KM, Darlington CL, Smith PF (2002) The CNS effects of Ginkgo biloba extracts and ginkgolide B. Prog Neurobiol 67(3):235–257
Maher B (2008) Poll results: look who’s doping. Nature 452(7188):674–675
Maier W (2010) Diagnose- und Behandlungsleitlinie Demenz: Interdisziplinäre S3-Praxisleitlinien. Springer, Berlin
Morris CA, Avorn J (2003) Internet marketing of herbal products. Jama 290(11):1505–1509
Oyama Y, Chikahisa L, Ueha T, Kanemaru K, Noda K (1996) Ginkgo biloba extract protects brain neurons against oxidative stress induced by hydrogen peroxide. Brain Res 712(2):349–352
Pearson N, Biddle SJ, Gorely T (2009) Family correlates of fruit and vegetable consumption in children and adolescents: a systematic review. Public Health Nutr 12(2):267–283
Rhodes RE, Martin AD, Taunton JE, Rhodes EC, Donnelly M, Elliot J (1999) Factors associated with exercise adherence among older adults. An individual perspective. Sports Med 28:397–411
Rimbach G, Wolffram S, Watanabe C, Packer L, Gohil K (2003) Effect of Ginkgo biloba (EGb 761) on differential gene expression. Pharmacopsychiatry 36(Suppl 1):S95–S99
Rowe JW, Kahn RL (1987) Human aging: usual and successful. Science 237(4811):143–149
Schneider LS (2012) Ginkgo and AD: key negatives and lessons from GuidAge. Lancet Neurol 11(10):836–837
Schuler H (2006) Lehrbuch der Personalpsychologie. Göttingen: Hogrefe
Smith ME, Farah MJ (2011) Are prescription stimulants "smart pills"? The epidemiology and cognitive neuroscience of prescription stimulant use by normal healthy individuals. Psychol Bull 137(5):717–741
Solomon PR, Adams F, Silver A, Zimmer J, DeVeaux R (2002) Ginkgo for memory enhancement: a randomized controlled trial. Jama 288(7):835–840
Stern Y, Gurland B, Tatemichi TK, Tang MX, Wilder D, Mayeux R (1994) Influence of education and occupation on the incidence of Alzheimer’s disease. Jama 271(13):1004–1010
van der Bij AK, Laurant MG, Wensing M (2002) Effectiveness of physical activity interventions for older adults: a review. Am J Prev Med 22(2):120–133
Vellas B, Coley N, Ousset PJ, Berrut G, Dartigues JF, Dubois B, Grandjean H, Pasquier F, Piette F, Robert P, Touchon J, Garnier P, Mathiex-Fortunet H, Andrieu S (2012) Long-term use of standardised Ginkgo biloba extract for the prevention of Alzheimer’s disease (GuidAge): a randomised placebo-controlled trial. Lancet Neurol 11(10):851–859
Vollmar HC, Mand P, Butzlaff ME (2008) DEGAM-Leitlinie Nr. 12: Demenz. Stand: 2008. Omikron Publ, Düsseldorf
Walley T (2002) Lifestyle medicines and the elderly. Drugs Aging 19(3):163–168
Watkins RE, Coates R, Ferroni P (1998) Measurement of aging anxiety in an elderly Australian population. Int J Aging Hum Dev 46(4):319–332
Watts D, Damasco-Ty E, Ryan F, Goodman B (2001) Geriatricians health survey 2000. J Am Geriatr Soc 49(11):1535–1538
Weinmann S, Roll S, Schwarzbach C, Vauth C, Willich SN (2010) Effects of Ginkgo biloba in dementia: systematic review and meta-analysis. BMC Geriatr 10:14
Youn JC, Kim KW, Lee DY, Jhoo JH, Lee SB, Park JH, Choi EA, Choe JY, Jeong JW, Choo IH, Woo JI (2009) Development of the Subjective Memory Complaints Questionnaire. Dement Geriatr Cogn Disord 27(4):310–317
Acknowledgments
The project was funded by the BMBF (German Ministry of Education and Research; no. 01GP0807); statistical analyses were supported by the Institute for Medical Biometry, Epidemiology and Informatics (IMBEI) of the University Medical Centre of the Johannes Gutenberg-University Mainz.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Franke, A.G., Heinrich, I., Lieb, K. et al. The use of Ginkgo biloba in healthy elderly. AGE 36, 435–444 (2014). https://doi.org/10.1007/s11357-013-9550-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11357-013-9550-y