ACP Journal Club. Ginkgo biloba extract did not reduce risk for Alzheimer disease in elderly patients with memory complaints.

Vellas B, Coley N, Ousset PJ, et al; GuidAge Study Group. Long-term use of standardised ginkgo biloba extract for the prevention of Alzheimers disease (GuidAge): a randomised placebo-controlled trial. Question In elderly patients who report memory complaints to their primary care physicians, does ginkgo biloba extract reduce risk for Alzheimer disease (AD)? Methods Design: Randomized placebo-controlled trial (GuidAge). ClinicalTrials.gov NCT00276510. Setting: 712 primary care physicians at clinical research networks, and 25 memory centers in France. Patients: 2854 community-living adults ≥ 70 years of age (mean age 76 y, 67% women) who consulted their primary care physicians or a memory center for memory problems, had an identified proxy, and scored > 25 on the Mini-Mental State Examination, < 6 on the Covi Anxiety Scale, and < 15 on a geriatric depression scale. Exclusion criteria included major objective memory impairment ; diagnosis of dementia, major depression, or generalized anxiety; or Clinical Dementia Rating > 0.5. Intervention: Standardized ginkgo biloba extract, 120 mg twice per day (n = 1419), or placebo (n = 1435). Outcomes: Probable AD (Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and National Institute of Neurological and Communicative Disorders and Stroke—Alzheimer's Diseases and Related Disorders Association criteria). Secondary outcomes included adverse events. Patient follow-up: 85% at 2 years.