Ginkgo Biloba Might Not Preserve Memory in Octogenarians

(HealthDay News) -- Ginkgo biloba, the popular herbal supplement widely promoted as a memory enhancer, offered no clear-cut protection against memory loss in octogenarians, a new study shows.

And a small but disturbing pattern showed up in those who took the herb extract during the three-year study, the researchers added.

"Seven had TIAs (transient ischemic attacks, or mini-strokes) or stroke," said study author Dr. Hiroko Dodge, an assistant professor of public health at Oregon State University. Exactly why this happened requires further study, she added.

Ginkgo biloba is believed to have antioxidant and anti-inflammatory properties, protecting cell membranes and helping govern the workings of the brain's chemical messengers, or neurotransmitters. Some studies have found that the herb may help some people with Alzheimer's disease.

Dodge's team evaluated 118 men and women aged 85 and older who were all free of memory complaints at the start of the study. They scored normally on a memory function test before being admitted to the study. Half were assigned to take 240 milligrams of ginkgo biloba extract daily; half got a placebo.

Overall, Dodge found that 21 people developed mild memory problems during the study -- 14 took placebo, and 7 took the ginkgo supplement. "There was a clear tendency that ginkgo prevents memory decline," but the differences in the preservation of memory between the two groups were not statistically significant, she said.

But when the researchers did a secondary analysis, taking into account the level of medication adherence, those who actually remembered to take the extract did show some benefit. "Those taking the ginkgo extract [on a regular basis] had a 70 percent lower risk of developing mild memory problems than those taking placebo," she said.

It is not clear whether the difference is a chance occurrence or not.

"We have to wait for larger studies," Dodge said.

More research is also needed, she said, on why the 7 participants who had strokes or mini-strokes were all on the extract and what that association might be.

Another expert agreed, calling the findings inconclusive.

"The study was really too small to provide conclusive results on the benefits and risks of ginkgo supplement," said Dr. Paul Aisen, director of the Alzheimer's Disease Cooperative Study at the University of California, San Diego.

"Without a larger study, I would certainly not recommend the use of ginkgo biloba extract in those 85 and over," he said. Overall, he added, the bulk of studies published in the medical literature do not provide enough proof to recommend the herb for preserving memory and cognitive function.

Likewise, the Alzheimer's Association says on its Web site that while the herb may help some people with Alzheimer's disease, further research is needed to find the exact way in which it works. Experts are awaiting the results of a much larger, multi-center trial based at the University of Pittsburgh. That trial compared the effects of the herb with a placebo in 3,000 people to see if ginkgo biloba helped prevent or delay the onset of Alzheimer's disease. The trial ran through 2007, and the results will not be available until some time later.

Dodge's study is published in the Feb. 27 online issue of Neurology.

More information
To learn more about alternative treatments for Alzheimer's, visit the Alzheimer's Association.

CDC Panel Urges Extending Flu Vaccine Coverage for Kids

(HealthDay News) -- U.S. health advisers recommended Wednesday that all children 6 months to 18 years of age receive annual flu shots.

Currently, the recommendation is that children 6 months to 5 years of age get vaccinated.
The recommendation by the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices would cover an additional 30 million children, making it one of the largest expansions of flu vaccination coverage in U.S. history.

The committee is recommending that the new guidelines take effect no later than the 2009-10 flu season, noting that many doctors have already ordered their vaccine for the 2008-09 season. The panel's recommendations are typically followed by the CDC, which issues vaccination guidelines to doctors and hospitals.

"Each season, many children remain vulnerable to the consequences of not being vaccinated against influenza," U.S. Surgeon General Dr. Richard H. Carmona said in a prepared statement. "We hope this expanded vaccination recommendation will strongly encourage Americans to get an annual influenza vaccination as soon as vaccine becomes available in their communities. This will help in reducing the number of childhood hospitalizations and deaths from influenza each season."

The flu kills dozens of U.S. children annually, part of the estimated 36,000 Americans who die each year from the disease. So far this season, there have been more than 10 reported deaths of children. During the 2006-07 flu season, 68 children died.

Children tend to come down with the flu at higher rates than adults but usually don't get as sick. Health officials hope that extending vaccine coverage will also benefit adults, making them less likely to be infected by children.

"Influenza is a serious, deadly illness that needs to have a vaccination each and every year," said Richard Kanowitz, president of Families Fighting Flu, who lost a 4-year-old daughter to influenza in 2004.

Kanowitz's group was one of those supporting expanding the age range for flu vaccination.
In 2006, the CDC expanded the recommendation to include children up to 5 years old.

"We want the recommendation expanded, because we hear even to this day people say, 'The recommendation doesn't apply to me. I don't have to get vaccinated.' It's completely the opposite," Kanowitz said. "You need to get vaccinated. The CDC just puts out a recommendation, and the confusion over whether people need to get vaccinated needs to be dispelled by having a clear message -- everyone should get vaccinated. The more people who get vaccinated, the more lives get saved."

This year's flu season has hit many areas of the country hard. Adding to the severity of the flu outbreak, this year's vaccine is not well matched to the current strains of flu most prevalent in the United States.

The virus strain most common in the United States right now is the influenza A H3N2 strain, and it's a strain not included in this year's vaccine. Also, this year's vaccine is not well-matched against influenza type B.

Complicating matters, some of this year's influenza type A virus is showing resistance to the antiviral drug Tamiflu. Overall, 8.1 percent of the influenza type A viruses tested by the CDC were resistant to Tamiflu. In past years, less than 1 percent of the viruses have been resistant to the drug.

Last week, the U.S. Food and Drug Administration selected the influenza strains that will make up the 2008-09 flu vaccine. Following the lead of the World Health Organization, the FDA is including the new flu strains Brisbane/10, a version of the H3N2 flu; a second new Type A strain known as H1N1/Brisbane/59; and a newer Type B/Florida strain.

But according to one expert, even the best planning may not result in a perfect vaccine.
"You have to make a decision about what will be in the vaccine in advance," said Dr. John Treanor, a professor of medicine, microbiology and immunology at the University of Rochester Medical Center in Rochester, N.Y. "It takes six to eight months to make the vaccine after you've chosen the strains.

"But the reality is that new strains emerge after that decision is made. So, you could be wrong," Treanor said.

More information
For more on flu vaccine, visit the CDC.