Senile Dementia & Alzheimer’s Disease
Senile Dementia includes a range of disorders associated with deterioration of the Brain function. It may include personality changes, amnesia, impaired reasoning etc. Its cause is generally age-related deterioration of the Brain, but these symptoms may occur as a result of earlier brain trauma or mini-strokes.Alzheimer’s Disease is the most common form of Senile Dementia. It is marked by progressive mental deterioration due to Brain degeneration. It is seen in middle and old age, and is the most common form of premature Senility.
In Traditional Medicine, it falls under several categories. It is usually caused by Deficiency of Essence. Medicines that strengthen the Head and Nerves can be used with benefit. From the TCM point of View, deficiency in old age is associated with Yin and/or Yang deficiency, and so Tonics of that nature may be beneficial too.
According to Unani sources, Dementia can be categorised as Cold and Moist (Phlegm) or Cold and Dry (Melancholy/Yin deficiency).
Obstruction of Brain activity may occur from Phlegm or Damp (Cold and Moist), in which case medicines like Calamus, Indian Spikenard, Polygala Yuan Zhi and/or Phlegm–clearing medicines like Pinellia Ban Xia, Arisaema Tian Nan Xing and Agaric.
In Melancholic dispositions (Cold and Dry), medicines that clear Melancholy should be used. This includes Dodder, Fumitory, Agaric, Senna, with prepared Black Hellebore being applicable in experienced hands. Yin tonic are also indicated.
Medicines that nourish and strengthen the Brain and Nerves are most important. This includes seeds and nuts, especially Sesame or Cannabis seeds, and Walnuts, 5 per day taken on a long-term basis. Tonic medicines include Withania, Ginseng, Astragalus, Chebula, Centella, Lycium Gou Qi Zi, Shilajit etc.
Medicines that enhances Blood flow to the brain include Frankincense, Turmeric, Saffron and Ginkgo leaf.
According to modern research, certain groups of Herbs have been indicated in the treatment of Alzheimer’s and Dementia.
Brain-Derived Neurotrophic Factor (BDNF)
Modern medicine has studied some of the neurochemical brain changes that occur with degenerative brain diseases like Parksinon’s Disease and Alzheimer’s Disease. Brain-Derived Neurotrophic Factor (BDNF) has been implicated in various brain and central nervous system diseases. Medicines that modulate BDNF can have significant benefit in chronic brain disease. Various herbal medicines were studied and the following were found to have positive effects:
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Bacopa monnieri Eleutherococcus Gingko Salvia Dan Shen |
Withania Ginseng Rhodiola |
Saffron St. John’s wort Perilla |
Coffee Green Tea Grape, Grape seed Olive oil |
A number of herbs have shown neuroprotective effects. These prevent brain degeneration from various causes. In addition, Herbs with potent antioxidant effects may have Neuroprotective effects by relieving oxidative stress.
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Mucuna Centella Cassia Fistula Rhubarb Aloeswood Clove |
Emblic Myrobalan Withania Lycium Gou Qi Zi (‘Goji’) Notoginseng San Qi Atractylodes Bai Zhu Madder |
Nigella Cyperus rotundus Saffron Safflower Myrrh |
Rosemary Lavender Vervain Valerian Black Nightshade |
The following have been shown to have beneficial effects in animal models, or else have compounds which have demonstrated positive effects in Brain degeneration.
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Ginseng Notoginseng San Qi Polygonum He Shou Wu Dang Gui Rhodiola Emblic Myroabalan |
Clove Celery seed Safflower Periwinle Schisandra Wu Wei Zi |
Gingko leaf Centella Bacopa Calamus Polygala Yuan Zhi |
Andrographis Wild Rue Lavender Frankincense Shilajit |
Medicines that inhibit Acetylcholinesterase are commonly used in early to moderate Alzheimer’s disease.
Adhatoda vasica and Wild Rue are particularly strong inhibitors of Acetylcholinesterase, Clove and Black Pepper also being relatively strong.
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Coptis Huang Lian Phellodendron Huang Bai Barberry bark |
Lemon Balm Rue Adhatoda vasica |
Calendula Basil Sage |
Green tea Resveratrol Curcumin |
- Blood-moving Medicines: Calendula, Safflower, Saffron, Rue, St. John’s wort, Frankincense, Myrrh, Notoginseng San Qi
- Aromatics (move Qi and open Brain Orifices): Calamus, Clove, Aloeswood, Frankincense
- Clear Heat & Inflammation: Coptis, Rhubarb, Andrographis, Black Nightshade
- Tonics: Withania, Ginseng, Rhodiola, Notoginseng San Qi, Polygonum He Shou Wu, Dang Gui, Centella, Emblic Myroabalan, Shilajit
Most Used TCM Formulas
In a study of Taiwanese databases, the following formulas were most commonly used in descending order:
- Qi Ju Di Huang Wan–Liver and Kidney Yin deficiency
- Jia Wei Xiao Yao San–Qi stagnation with Liver Heat
- Ban Xia Bai Zhu Tian Ma Tang–Wind-Phlegm obstruction
In the first 3 years of diagnosis, the following formulas were most commonly prescribed:
- Jia Wei Xiao Yao San–Qi stagnation with Liver Heat
- Ban Xia Bai Zhu Tian Ma Tang–Wind-Phlegm obstruction
- Gan Mai Da Zao Tang
- Bu Zhong Yi Qi Tang–Qi deficiency
- Chai Hu Jia Long Gu Mu Li Tang
In later stages of Dementia, the following formulas are most commonly used:
- Suan Zao Ren Tang
- Gui Pi Tang
- Jia Wei Xiao Yao San
Other TCM formulas commonly used include Tian Ma Gou Teng Yin and Tian Wan Bu Xin Dan,
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Western Tradition Simples:
Formulas: Powder of Rosemary Compound Restorative of Nicholas (Pleres Arconticon) (Nicholas) Electuarium Alcharif (Mesue) Diacameron Magna (Diathamaron) (Nicholas) Safoof e Jawahar Mohra (Precious Defender Powder) Brahmi Ghirta |
Chinese Classification Simples:
Heart and Spleen Deficiency Gui Pi Tang Yang Xin Tang Heart or Liver Fire Tian Ma Gou Teng Yin Chai Hu Jia Long Gu Mu Li Tang Huang Lian Xie Xin Tang Blood and Qi deficiency Yi Gan San Dang Gui Shao Yao San Gou Teng San Phlegm Obstruction / Wind-Phlegm Ban Xia Bai Zhu Tian Ma Tang –can add Calamus (Shi Chang Pu) and Curcuma Yu Jin Er Chen Tang (add Calamus) Su He Xiang Wan Blood Stasis Tong Qiao Huo Xue Tang Tao Hong Si Wu Tang Yin/ Essence Deficiency Qi Ju Di Huang Tang Zuo Gui Wan Sheng Mai San Kidney Deficiency with Phlegm obstruction Di Huang Yin Zi Yang Deficiency Gui Fu Li Zhong Wan Shen Qi Wan |
Other Formulas:
1. Vascular Dementia: Ginseng, Ginkgo, Saffron (this has been studied)
2. Centella, Costus, Calamus, Convolvulus Shankhpushpi in Aged Ghee
3. Schisandra Wu Wei Zi, Ginseng (Ren Shen), Notoginseng San Qi and Lycium Gou Qi Zi
This combination was found to prevent learning and memory disorders in Mice. (Read the research here)
4. Ginseng, Poria Fu Ling, Calamus (Shi Chang Pu), Polygala Yuan Zhi (Kai Xin San)
5. Ginseng, Poria Fu Ling, Calamus (Shi Chang Pu), Polygala Yuan Zhi, Schisandra Wu Wei Zi, Ophiopogon Mai Men Dong, Curcuma Yu Jin and Gardenia Zhi Zi (Jia Wei Kai Xin San) (This has been studied)
6. Senile Dementia (Qi Fu Yin)
Polygala Yuan Zhi
Atractylodes Bai Zhu
Ginseng
Rehmannia Shu Di Huang
Dang Gui
Licorice
7. Senile Dementia, Alzheimer’s:
Withania
Indian Spikenard
Rauwolfia
Convolvulus Shankhapushpi
Asparagus Shatavari
Emblic Myrobalan
Mucuna pruriens
Hyoscyamus niger
Shilajit
Pearl
Red Coral
This has been studied (see here)
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Decoction for Nourishing the Kidney, Eliminating Blood Stasis and Dispelling Phlegm: Cornus Shan Zhu Yu Cuscuta Tu Si Zi Fructus Alpinia Yi Zhi Ren Curcuma Yu Jin Arisaema cum Bile Dan Nan Xing Polygala Yuan Zhi Calamus Shi chang pu Placenta (Zi He Che) Leech (Shui Zhi), Hawthorn fruit (Shan Zha). In a trial, 48 cases were treated, 21 had remarkable effect, 23 good effect, 4 had no effect. Effective rate was 91%. Tian Di Jing Wan Gastrodia Tian Ma Earthworm (Di Long) Polygonatum Huang Jing Leech (Shui Zhi), Calamus (Shi Chang Pu) Ligustrum Nu Zhen Zi In animal experiments it showed effectiveness in an Alzheimer’s disease model. (See research here) |
Decoction for Nourishing Kidney and Brain: Polygonum He Shou Wu Cornus Shan Zhu Yu Dioscorea Shan Yao Lycium Gou Qi Zi Cuscuta Tu Si Zi Paeonia Chi Shao Salvia Dan Shen Curcuma Yu Jin This was studied in the treatment of 20 cases, Of those treated, 13 had marked effect with a total effective rate of 95%. Long Sheng Zhi Capsule Leech (Shui Zhi) Astagalus Huang Qi Safflower Hong Hua Peach kernel (Tao Ren) Calamus (Shi Chang Pu) Acanthopanax Ci Wu Jia This has been approved by the China Food and Drug Administration for treatment of patients with cardio-vascular and cerebrovascular disease. It has proven effective in Alzaheimer’s models and reduces neuronal oxidative stress and inflammation. (see here) |
Research:
GENERAL/REVIEW:–Network pharmacology implicates traditional Chinese medicine in regulating systemic homeostasis to benefit Alzheimer’s disease
–The core pattern of Chinese herbal formulae and drug–herb concurrent usage in patients with dementia
–Retrospect and prospect of active principles from Chinese herbs in the treatment of dementia
–Medicinal Plants and Dementia Therapy: Herbal Hopes for Brain Aging?
–Ayurvedic Medicine for the Treatment of Dementia: Mechanistic Aspects.
–Medicinal Herbs in Iranian Traditional Medicine for Learning and Memory.
–Treatment of Alzheimer’s Disease in Iranian Traditional Medicine
–Botanicals and phytochemicals active on cognitive decline: The clinical evidence.
–The psychopharmacology of European herbs with cognition-enhancing properties.
–Potential Natural Products for Alzheimer’s Disease: Targeted Search Using the Internal Ribosome Entry Site of Tau and Amyloid-β Precursor Protein
–Traditional Chinese herbal medicine for vascular dementia
–Neuroprotective Herbs and Foods from Different Traditional Medicines and Diets
–Neuroprotective Natural Products for Alzheimer’s Disease
–Effects of medicinal plants on Alzheimer’s disease and memory deficits
–Traditional Oriental Medicines and Alzheimer’s Disease
–Neuroprotective Natural Products for Alzheimer’s Disease
–Ayurvedic medicinal plants for Alzheimer’s disease: a review
–Indian Medicinal Herbs and Formulations for Alzheimer’s Disease, from Traditional Knowledge to Scientific Assessment
–The Use of Herbal Medicine in Alzheimer’s Disease—A Systematic Review
–Effect of plant extracts on Alzheimer’s disease: An insight into therapeutic avenues
–Herbal therapy: a new pathway for the treatment of Alzheimer’s disease
–Possible Role of Common Spices as a Preventive and Therapeutic Agent for Alzheimer’s Disease
–An exploration of the potential mechanisms and translational potential of five medicinal plants for applications in Alzheimer’s disease.
–Determination of Anti-Alzheimer’s Disease Activity of Selected Plant Ingredients
–Ameliorative Effects of Phytomedicines on Alzheimer’s Patients.
–Ethnobotanical treatment strategies against Alzheimer’s disease.
DIET
Diet therapy for the treatment of Alzheimer’s disease in view of traditional Persian medicine: A review.
SPECIFIC HERBS:
Bacopa:
–Brahmi (Bacopa monnieri): An ayurvedic herb against the Alzheimer’s disease.
–Use of Bacopa monnieri in the Treatment of Dementia Due to Alzheimer Disease: Systematic Review of Randomized Controlled Trials.
–Bacopa monnieri, a Neuroprotective Lead in Alzheimer Disease: A Review on Its Properties, Mechanisms of Action, and Preclinical and Clinical Studies.
–Bacopa monnieri as an Antioxidant Therapy to Reduce Oxidative Stress in the Aging Brain.
–Neurocognitive Effect of Nootropic Drug Brahmi (Bacopa monnieri) in Alzheimer’s Disease.
–Bacopa monnieri prevents colchicine-induced dementia by anti-inflammatory action.
–Synergistic neuroprotection by phytocompounds of Bacopa monnieri in scopolamine-induced Alzheimer’s disease mice model.
–Cognitive enhancement and neuroprotective effects of Bacopa monnieri in Alzheimer’s disease model.
–Efficacy of Bacopa Monnieri (Brahmi) and Donepezil in Alzheimer’s Disease and Mild Cognitive Impairment: A Randomized Double-Blind Parallel Phase 2b Study.
–Amelioration of Amyloid-β Induced Alzheimer’s Disease by Bacopa monnieri through Modulation of Mitochondrial Dysfunction and GSK-3β/Wnt/β-Catenin Signaling.
–A Computational Study of Natural Compounds from Bacopa monnieri in the Treatment of Alzheimer’s Disease.
–Neuroprotective effects of Bacopa monnieri in experimental model of dementia.
Other:
–PROTECTIVE EFFECT OF IRIS GERMANICA L. IN Β-AMYLOID-INDUCED ANIMAL MODEL OF ALZHEIMER’S DISEASE.
–Aqueous extract of lavender (Lavandula angustifolia) improves the spatial performance of a rat model of Alzheimer’s disease.
–Ameliorative effects of Matricaria chamomilla L. hydroalcoholic extract on scopolamine-induced memory impairment in rats: A behavioral and molecular study
–The Mechanisms of Action of Curcumin in Alzheimer’s Disease.
–Memory-improving activity of Melissa officinalis extract in naïve and scopolamine-treated rats.
–Paeoniflorin attenuates Aβ25-35-induced neurotoxicity in PC12 cells by preventing mitochondrial dysfunction.
–Tanshinone IIA reduces the risk of Alzheimer’s disease by inhibiting iNOS, MMP‑2 and NF‑κBp65 transcription and translation in the temporal lobes of rat models of Alzheimer’s disease.
–Centella asiatica Extract Improves Behavioral Deficits in a Mouse Model of Alzheimer’s Disease: Investigation of a Possible Mechanism of Action.
–Silymarin attenuated the amyloid β plaque burden and improved behavioral abnormalities in an Alzheimer’s disease mouse model.
–Ginkgo biloba extract in Alzheimer’s disease: from action mechanisms to medical practice.
–A traditional medicinal herb Paeonia suffruticosa and its active constituent 1,2,3,4,6-penta-O-galloyl-beta-D-glucopyranose have potent anti-aggregation effects on Alzheimer’s amyloid beta proteins in vitro and in vivo.
SPECIFIC FORMULA:
–Repeated administration of Sailuotong, a fixed combination of Panax ginseng, Ginkgo biloba, and Crocus sativus extracts for vascular dementia, alters CYP450 activities in rats
–A herbal medicine for Alzheimer’s disease and its active constituents promote neural progenitor proliferation.
–The effects of the combination of Cyperus rotundus, Crocus sativus, Piper nigrum, and Boswellia serrata on learning and memory deficit and oxidative damage in brain tissue of hypothyroid rats.
–Tibetan medicine “RNSP” [Ratna Sampel] in treatment of Alzheimer disease