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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:


Bacopa monnieri
Eleutherococcus
Gingko
Salvia Dan Shen
Withania
Ginseng
Rhodiola
Saffron
St. John's wort
Perilla
Coffee
Green Tea
Grape, Grape seed
Olive oil

Neuroprotective Herbs
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.

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

Herbs proven beneficial in Alzhemier's:
The following have been shown to have beneficial effects in animal models, or else have compounds which have demonstrated positive effects in Brain degeneration.

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


Herbs that Inhibit Acetylcholinesterase (AChE)
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.

Coptis Huang Lian
Phellodendron Huang Bai
Barberry bark

Lemon Balm
Rue
Adhatoda vasica

Calendula
Basil
Sage

Green tea
Resveratrol
Curcumin

As can be seen from the above lists of medicines, the herbs generally fit into one of several categories:
  • 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
  • Wen Dan Tang
  • Chai Hu Jia Long Gu Mu Li Tang

Other TCM formulas commonly used include Tian Ma Gou Teng Yin and Tian Wan Bu Xin Dan,

Western Tradition

Simples:
Sage
Balm
Turmeric
Orris
Camomile
Calamus
Withania
Centella / Bacopa
Nigella
Rosemary
Saffron
Frankincense
Lavender
Walnut
Costus
Chebulic Myrobalan
Convolvulus Shankhpushpi
Aged Ghee


Formulas:

Powder of Rosemary Compound

Restorative of Nicholas (Pleres Arconticon) (Nicholas)
Electuarium Alcharif (Mesue)
Diacameron Magna (Diathamaron) (Nicholas)
Brahmi Ghirta




Chinese Classification

Simples:
Ginseng
Lycium Gou Qi Zi
Paeonia Bai Shao
Notoginseng San Qi
Achyranthes Niu Xi
Cyperus Xiang Fu
Polygonum He Shou Wu
Schisandra Wu Wei Zi
Paeonia Mu Dan Pi
Salvia Dan Shen
Acorus Shi Chang Pu
Polygala Yuan Zhi


Heart and Spleen Deficiency
Gui Pi Tang
Yang Xin Tang

Excess Heart or Liver Fire
Tian Ma Gou Teng Yin
Huang Lian Xie Xin Tang

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)

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

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 Gadenia 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)

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 giving 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 ahs proven effective in Alzaheimer's models and reduces neuronal oxidative stress and inflammation. (see here)

Research:
GENERAL/REVIEW:
–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

DIET
Diet therapy for the treatment of Alzheimer's disease in view of traditional Persian medicine: A review.

SPECIFIC HERBS:
–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

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