Ginkgo biloba

Tier 3 — weak evidence · Cognitive / Dementia prevention

Despite decades of popularity, ginkgo has not proven effective at preventing dementia or cognitive decline. The GEM trial (DeKosky 2008, JAMA — 3,069 older adults, mean 6.1 years) found no reduction in all-cause dementia. The 2009 Cochrane review (Birks & Grimley Evans) also found no reliable prevention benefit. Evidence for modest symptomatic improvement in existing dementia is stronger for the pharmaceutical-grade EGb 761 extract. Warning: ginkgo has mild antiplatelet activity and can interact with warfarin, aspirin, and other anticoagulants.

Dose: 120–240 mg/day standardised extract (EGb 761); no evidence it prevents dementia in healthy adults