Green tea study

Lane Simonian

This interesting study suggests that epigallogatechin (EGGC) in green tea can help breakup tau tangles, which would improve neurotransmissions.  

https://www.nia.nih.gov/news/study-green-tea-and-other-molecules-uncovers-new-therapeutic-strategy-alzheimers

Hyperphosphorylation and nitration can cause tau to aggregate, both of which can mediated by peroxynitrite.  

https://pubmed.ncbi.nlm.nih.gov/16816118/

When peroxynitrite is scavenged, water is produced and water helps to de-nitrate proteins such as tau.

https://pubmed.ncbi.nlm.nih.gov/10630617

De-nitration of other proteins improves blood flow in the brain, increases the regeneration of neurons, synapses, and axons, and decreases the death of neurons.

One of the keys to treating Alzheimer's disease is the following:

The inflammatory mediator peroxynitrite, when generated in excess, may damage cells by oxidizing and nitrating cellular components. Defense against this reactive species may be at the level of prevention of the formation of peroxynitrite, at the level of interception, or at the level of repair of damage caused by peroxynitrite. Several selenocompounds serve this purpose and include selenoproteins such as glutathione peroxidase (GPx), selenoprotein P and thioredoxin reductase, or low-molecular-weight substances such as ebselen. Further, flavonoids, such as (-)-epicatechin, which occurs in green tea or cocoa as monomer or in the form of oligomers, can contribute to cellular defense against peroxynitrite.

https://pubmed.ncbi.nlm.nih.gov/12676458/

 The compounds in panax ginseng are particularly good at doing this:

Our analysis revealed that KRGE not only inhibited tau aggregation but also promoted the dissociation of tau aggregates.

https://pubmed.ncbi.nlm.nih.gov/32685100/

Saponins have long been recognized as key ingredients in traditional Chinese medicine. Accumulated evidence suggests that saponins have significant neuroprotective effects on attenuation of central nervous system disorders, such as stroke, Alzheimer's disease, Parkinson's disease, and Huntington's disease. However, our understanding of the mechanisms underlying the observed effects remains incomplete. Based on recently reported data from basic and clinical studies, this review highlights the proposed mechanisms of their neuroprotective function including antioxidant, modulation of neurotransmitters, anti-apoptosis, anti-inflammation, attenuating Ca(2+) influx, modulating neurotrophic factors, inhibiting tau phosphorylation, and regeneration of neural networks.

https://pubmed.ncbi.nlm.nih.gov/25408503/#:~:text=Saponins%20have%20long%20been%20recognized,Parkinson's%20disease%2C%20and%20Huntington's%20disease.

 For mild Alzheimer's disease, Korean Red Ginseng (panax ginseng) led to improvements in cognition that were maintained for two years.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659550/

Over the short term at least, heat processed ginseng (panax ginseng steamed at higer temperatures) led to cognitive improvements in participants with moderately severe Alzheimer's disease.

https://pubmed.ncbi.nlm.nih.gov/22780999/

Among the potential side effects of panax ginseng are insomnia, stomach upset, jitteriness, and higher blood pressure (although longer term use may reduce blood presssure).

As a whole, though, panax ginseng is safer and more effective than any currently prescribed Alzheimer's medication.  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729264/

dancsfo

This is good to know. Certainly, drinking green tea can't hurt, and while further research is needed, it's always nice that there may be some way to stave off decline.

Marta

Has there been a head to head between panax ginseng and currently prescribed Alzheimer’s meds?As a whole, though, panax ginseng is safer and more effective than ——————-

AlzWife2023

Curious if societies where green tea and ginseng are regularly consumed have lower rates of Alzheimer's.

dancsfo

https://alzconnected.org/discussion/comment/186801#Comment_186801

@AlzWife2023 Rates of Alzheimers and dementia happens to be low in Japan where green tea is consumed regularly, but I don't want to draw any conclusions as to the cause and effect. I am not sure about where people consume ginseng regularly. If you enjoy consuming it, I'd say "why not drink it? (in moderation, of course)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095986/

ButterflyWings

And cocoa?!! =)

kamilawal

what about coffee?

harshedbuzz

@dancsfo

I wonder if the lower numbers represent under-reporting and are related to a culture in which elders are revered and care of frail elderly by adult children is baked in.

HB

Lane Simonian

@Marta

The closest there is to a direct comparison between panax ginseng and other Alzheimer's disease treatments is this study in which the effects of Chinese herbs (including panax ginseng) combined with conventional medicines (mainly Aricept but in some cases Namenda) were compared to conventional medicines alone. For mild Alzheimer's disease at 18 months, those taking Chinese herbs plus conventional medicines declined by about one point in terms of MMSE scores (Mini-Mental State Examination) whereas those taking just conventional medicines declined by 2.5 points. For moderate Alzheimer's disease, those taking Chinese herbs plus conventional medicine declined by slightly less than two points whereas those taking just conventional medicines declined by 3.5 points. It is not clear wether taking panax ginseng alone would have produced better or worse results, although there is one clinical trial discussed below that suggests the former.

Adding Chinese herbal medicine to conventional therapy brings cognitive benefits to patients with Alzheimer’s disease: a retrospective analysis

The comparison with lecanemab/Leqembi is made more difficult because this trial used a different cognitive test (Clinical Dementia Rating-Sum of Boxes) and because at 18 months Biogen compared APOE4 carriers and non-carriers against a combined placebo group instead of the placebo group for carriers and the placebo group for non-carriers. The 12 month results though in which the latter was done suggests that Leqembi has almost no impact on non-carriers and only modestly slows down the decline in carriers (the first number is the decline in the placebo group).

Carriers: .180 to .139

Non-Carriers: .146 to .143

The most positive clinical trial for panax ginseng for Alzheimer's disease found about a 2 point improvement in MMSE scores at 18 months (most of the trial participants had mild Alzheimer's disease).

Lane Simonian

All sorts of confounding factors, but here is an interesting chart regarding death rates from Alzheimer's disease by country.

https://www.worldlifeexpectancy.com/cause-of-death/alzheimers-dementia/by-country/

dancsfo

https://alzconnected.org/discussion/comment/187036#Comment_187036

The study stated: "However, even after considering these potential sources of bias, differences in age-adjusted dementia prevalence still exist among regions of the world." so perhaps they did take into account some of the factors you mentioned. The point about cultural difference in reverence for elders is interesting though. A country like Japan with a larger elderly population (by proportion) seems to take aging issues seriously. I don't know if that results in under-reporting, more studies, etc. but I'd like to know as well.

Lane Simonian

The studies on coffee in terms of reducing the risk for Alzheimer's disease are mixed--although more positive than negative ones. Some of the polyphenols in coffee may be beneficial; the effects of caffeine are open to more debate.

AlzWife2023

https://alzconnected.org/discussion/comment/187043#Comment_187043

Very interesting--the differences are staggering, but there are so many variables, it's impossible to draw any conclusions from this raw data. For instance, the red (high rate) countries could have higher rates of diagnosis and more aggressive treatments of other causes of death in the aged.