Gingko Biloba and Dementia

by Carrington Carrington, RN

Dementia is a syndrome who signs and symptoms may be the result of several acquired, progressive, life-limiting disorders that erase memory and the person’s usual way of being in the world. (Tabloski, 2010, p. 740) The person with dementia has both a chronic illness and a terminal illness. Person’s with dementia losses the ability to perform activities of daily living and progressively become completely dependent in all aspects of care. There is no predictability of how or when the disease will progress. The greatest risk for developing dementia is older age even though a younger person may develop dementia as well. Although it is more common in older adults than in younger persons, dementia is not considered a normal part of aging.(Mauk, 2010, p. 531)

There is no cure available at the present time for dementia. Treatments for dementia are directed towards improving functioning and slowing down the progression of the disease. There are a number of pharmacological agents that are used to treat cognitive impairment but I will be focusing on a complementary and alternative therapy (CAM) form to treat dementia.
Complementary and alternative therapy according to Mauk is a group of diverse medical and healthcare systems, practices, and products that are not presently considered part of the conventional medicine in the United States. However there are many people who use herbal therapies they hear about along with their regular routine prescribed medications. Gingko Biloba will be our herbal therapy of choice for dementia.

Gingko biloba is one of the oldest living tree species and its leaves are among the most extensively studied herbs in use today. In Europe and the United States, ginkgo supplements are among the best-selling herbal medications. It consistently ranks as a top medicine prescribed in France and Germany. (University of Maryland Medical Center). Ginkgo has been used in traditional medicine to treat blood disorders and enhance memory. Scientific studies throughout the years have found evidence that supports these claims. Although not all studies agree, ginkgo may help prevent or treat dementia (including Alzheimer's disease). It also shows promise for enhancing memory in older adults. Because ginkgo inhibits platelets activation factor it is presumed to improve blood flow to the brain as well. (Tabloski, 2010, p. 747) Further studies suggest it may directly protect nerve cells that are damaged in dementia. (University of Maryland Medical Center)
Ginkgo biloba comes in tablets, capsules, and in liquid extracts. Dosages range from 120 to 240 mg daily.

Positive benefits of Ginkgo in a person with dementia are:
· Improvement in thinking, learning, and memory (cognitive function)
· Improvement in activities of daily living
· Improvement in social behavior
· Fewer feelings of depression
Negative benefits are:
· Inhibits platelet activation factor and can cause bleeding
· Increased blood pressure with thiazide diuretic
· Increased sedation with trazadone
· Can increase blood sugar
· Can cause headaches, dizziness, GI disturbances
Contraindicated in people who are:
· Diabetic
· Pregnant or breast feeding
· Have epilepsy
· Bleeding disorders

If you take gingkgo, you should stop taking it at least 36 hours before surgery or dental procedures due to the risk of bleeding. Tell your doctor or dentist that you take ginkgo.

Nursing considerations for Dementia
Dementia is a chronic illness and may require 20 years or more of home care, assisted living, or long term institutional care. The demented person will need acute care services to maintain independence, prevent excess disability, ensure safety, and manage medical complications. The family should be informed that even with the finest efforts of caregivers, the dieses will progress and create dependency in activities in daily living and ultimately result in death.

References
Mauk, K.L. (2010). Gerontological Nursing Competencies for Care, (2nd edition). Sudbury, MA:Jones and Barlett Publishers.
Tabloski, P. A. (2010). Gerontological Nursing, (2nd edition). Upper Saddle River, NJ: Pearson Education INC.
University of Maryland Medical Center. (2011). Ginkgo biloba. Retrieved from
http://www.umm.edu/altmed/articles/ginkgo-biloba-000247.htm

NOTE: This blog post reflects the work of a Registered Nurse with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.