Brahmi has been used by Ayurvedic
practitioners in India for thousands of
years, but only now is Western medicine
discovering its potential.
Image: iStockphoto

For thousands of years Ayurvedic practitioners in India have used an aquatic plant known as brahmi (Bacopa monniera) to enhance intelligence and mental functioning. Now, Western medicine is examining the herb’s potential to delay or treat dementia.

Brahmi, pine bark and lemon balm are among the herbal preparations showing therapeutic effects that may help treat various symptoms related to Alzheimer’s dementia, including loss of memory, capacity to learn, depression and anxiety.

Trials under way at Swinburne University of Technology’s Brain Sciences Institute (BSI) are part of a collaborative project through the National Institute of Complementary Medicine (NICM). This Australian Government-funded initiative was established in 2007 to seek out scientifically valid evidence for alternative therapies, allowing them to become part of mainstream treatments, particularly for priority health issues such as the prevention and early treatment of dementia.

The incidence of dementia is expected to rise rapidly in coming years, with Alzheimer’s Australia predicting the number of sufferers in Australia will quadruple from 245,000 in 2009 to 1.1 million by 2050, as a result of our ageing population.

Research Fellow with Alzheimer’s Australia Dr Maree Farrow says the disease is fast becoming one of the most feared health issues worldwide. Surveys in Australia and overseas place it second only to cancer on the list of health concerns. The older the respondents the greater their anxiety about dementia, as age is the biggest predictor of the disease.

Dr Farrow says Alzheimer’s Australia supports research into both pharmaceutical and natural treatments to develop products that prove safe and effective. She says people with Alzheimer’s and their families are desperate for effective treatments.

Despite claims on some products about the benefits of vitamin E and Ginkgo biloba, she says clinical trials have not shown conclusive results in treating already established Alzheimer’s disease, although some research suggests these supplements may have a role in delaying its onset.

Swinburne’s Professor Con Stough is director of the NICM Collaborative Centre for Natural Medicines and Neurocognition, which is responsible for a range of trials to improve the research behind alternative medicines. Other collaborators in the neurocognition research are the University of Western Australia, Melbourne’s Alfred Hospital and CDR Australia.

Professor Stough says a number of studies indicate that memory tests can predict the later development of dementia as much as 10 years before it can be formally diagnosed.

“If we can treat cognitive decline in the early stages then we may be able to prevent or delay more serious cognitive impairment. Intelligence does slow and decay over time as a natural part of the ageing process,” Professor Stough says.

He says not every forgotten name or misplaced item is a sign of Alzheimer’s disease. As people age their brains shrink and become less efficient. It does take longer to process new information and certain aspects of memory do fail. But Alzheimer’s dementia is a specific disease of the brain, although science has not yet determined the exact cause; most of what is known comes from autopsy examinations of sufferers.

The findings include inflammation of the brain, deposits of beta amyloid, traces of heavy metals and signs of oxidative stress. Professor Stough says research suggests that brahmi’s mechanism of action acts on all of these. It has an anti-inflammatory effect, is an antioxidant and collates and removes heavy metals and beta amyloid.

Professor Andrew Scholey, head of the BSI’s Herbal and Nutritional Medicine Research Unit at Swinburne and who oversees many of the clinical trials, says that historically the field has struggled to gain scientific credibility. However, Swinburne’s trials are performed to standards that provide acceptance within the mainstream scientific community. Being able to capture the therapeutic cognitive benefits of a product in healthy adults provides ‘proof of concept’ and provides a gateway for full-blown clinical trials in other, less healthy populations.

Two brahmi trials have been done over 90  days with double-blind, randomised control techniques using a special brahmi containing product marketed as KeenMind. The results have shown improvements in working memory, particularly spatial memory accuracy.

A 50-day trial of a particular pine bark extract supplement for men aged 50 to 65 years has also shown improved speed in spatial working memory and immediate recognition tasks, along with a trend towards lower systolic blood pressure.

Another trial is investigating the short-term calmative effects of a special lemon balm product, because anxiety and agitation are major symptoms that Alzheimer sufferers experience. Different preparations trialled included a tea and yoghurt, with some positive results. Participants were less stressed while taking part in testing, although their performance in the testing did not necessarily improve.

Both Professors Scholey and Stough stress the importance of the specific preparations used in trials, and that the therapeutic effects demonstrated do not necessarily translate to all products containing the relevant herbs.

Nigel Pollard, managing director of Flordis Natural Medicine, which produces KeenMind, says the lack of sound evidence for the therapeutic effects of many herbal products is a significant problem for consumers looking for real health benefits from the products they buy.

He says while Flordis products are backed by clinical trials, regulations in Australia allow herbal products to make generalised claims about ingredients such as “helps improve memory”, without the need for any evidence supporting the specific preparation on sale.

The alternative medicine industry is “relatively immature” in Australia, Mr Pollard says, with a lack of consumer awareness about the variables that can influence the effectiveness of a product. These include where plants are grown, how the active ingredients are extracted, prepared and produced – for example, a liquid, a coated or uncoated tablet, a powder – and even whether or not products are taken with food.

“Consumers don’t treat these products like medicines, which they should, because they can have powerful therapeutic effects or interactions with other medications. Of course people should tell their doctor about anything they’re taking, although most probably don’t.”

Consumer research indicates that more than 60 per cent of Australians already use some form of alternative health product as part of a proactive, preventative health strategy. All the more reason, Mr Pollard says, why the research being conducted at Swinburne, and through the NICM in general, is so important; to provide the medical profession and consumers with information and evidence that will allow them to safely incorporate alternative medicines into more effective healthcare programs.