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Ginkgo and Memory
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To the Editor: Dr Solomon and colleagues1 state that the cognitive effect size for ginkgo in dementia is significantly smaller than that of cholinesterase inhibitors. Effect sizes for cholinesterase inhibitors in mild to moderate Alzheimer disease have tended to be larger than those seen with other classes of agents.2-3 However, to our knowledge, there are no adequately powered published trials that have directly compared a cholinesterase inhibitor with ginkgo for dementia. Indirect comparisons of effect sizes across dementia trials must be interpreted with caution because the rate of cognitive decline varies significantly by type of dementia, baseline dementia severity, trial duration, and dose of agents being studied.2-3
It is possible that cholinesterase inhibitors may benefit individuals with normal cognitive abilities,4-5 and both ginkgo and cholinesterase inhibitors are being studied for their effects on dementia prevention. However, as with dementia, we know of no published direct comparison trials of a cholinesterase . . . [Full Text of this Article]
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