Efficacy of Yukmijihwang-tang on symptoms of Alzheimer disease: A protocol for systematic review and meta-analysis

BACKGROUND

Alzheimer disease (AD) is the most common cause of dementia, which may lead to severe memory loss and other cognitive disorders. Yukmijihwang-tang (YMJ), a type of Korean traditional herbal medicine, has been shown to be effective against neurodegenerative diseases. Although a meta-analysis on the efficacy of YMJ on AD exists, the study had some limitations, and there have been several newly published studies assessing the effect of YMJ. Therefore, the purpose of this study is to evaluate the efficacy and safety of YMJ as a treatment for AD through a meta-analysis.

METHODS

A systematic search of the following electronic databases will be conducted to identify eligible studies: MEDLINE (PubMed), Elsevier (EMBASE), The Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Korean Medical Database (KMBASE), Oriental Medicine Advanced Searching Integrated System (OASIS), Korean Traditional Knowledge Portal, Citation Information by NII (CiNii), China National Knowledge Infrastructure (CNKI). All randomized controlled trials assessing the efficacy and safety of YMJ on the symptoms of AD will be included. Two independent reviewers will perform article retrieval, deduplication, data screening, data extraction, quality evaluation, and data analyses using RevMan version 5.4. The Cochrane risk of bias tool will be used to assess the quality of the trials.

RESULTS

This study will provide synthesis of the cognitive function measured with neuropsychological tests, behavioral and psychological symptoms of dementia (BPSD), and activities of daily living (ADL) measured using validated scales. The clinical effective rate and adverse events will also be analyzed to assess the efficacy and safety of YMJ for treating AD.

CONCLUSION

This systematic review will provide evidence for the efficacy and safety of YMJ in AD.

ETHICS AND DISSEMINATION

Ethical approval is not required because individual patient data will not be included in this study. The study findings will be disseminated through conference presentations.

Chemical Composition and Anti-Alzheimer's Disease-Related Activities of a Functional Oil from the Edible Seaweed Hizikia fusiforme

Cholinergic disorder, oxidative stress, and neuroinflammation play important roles in the pathology of Alzheimer's disease. To explore the healthy potential of the edible seaweed Hizikia fusiforme on this aspect, a functional oil (HFFO) was extracted from this alga and investigated on its constituents by gas chromatography-mass spectrometry (GC/MS) in this study. Its anti-Alzheimer's related bioactivities including acetylcholinesterase (AChE) inhibition, antioxidation, and anti-neuroinflammation were evaluated, traced, and simulated by in vitro and in silico methods. GC/MS analysis indicated that HFFO mainly contained arachidonic acid (ARA), 11,14,17-eicosatrienoic acid (ETrA), palmitic acid, phytol, etc. HFFO showed moderate AChE inhibition and antioxidant activity. Bioactivity tracing using commercial standards verified that AChE inhibition of HFFO mainly originated from ARA and ETrA, whereas antioxidant activity mainly from ARA. Lineweaver-Burk plots showed that both ARA and ETrA are noncompetitive AChE inhibitors. A molecular docking study demonstrated low CDOCKER interaction energy of -26.33 kcal/mol for ARA and -43.70 kcal/mol for ETrA when interacting with AChE and multiple interactions in the ARA (or ETrA)-AChE complex. In the anti-neuroinflammatory evaluation, HFFO showed no toxicity toward BV-2 cells at 20 μg/mL and effectively inhibited the production of nitroxide and reduced the level of reactive oxygen species in lipopolysaccharide-induced BV-2 cells. The results indicated that HFFO could be used in functional foods for its anti-Alzheimer's disease-related activities.

The Relationship between Obesity and the High Probability of Dementia Based on the Body Mass Index and Waist Circumference

BACKGROUND

For an early detection and prevention of dementia, there are growing concerns about the high-risk group for dementia and mild cognitive impairment. With an increase of obesity and its complications, obesity has become a major public health problem. Therefore, the aim of this study was to investigate the relationship between obesity and the high probability of dementia.

METHODS

This study was done with subjects aged 60 to 89 years who visited a health promotion center, from April 1, 2008 to April 30, 2008. A total of 293 subjects (164 males and 129 females) were included in the evaluation of cognitive function using the Korean version of the Seven Minutes Screen test. Logistic regression models were used to analyze the association between obesity and the high-risk group for dementia.

RESULTS

Among a total of 293 subjects, 71 subjects (29 males and 42 females) had a high probability of dementia. When compared to normal body mass index (BMI) group, overweight and obesity groups had about a 2.2-fold and 2.4-fold higher probability of dementia (95% confidence interval [CI], 0.97 to 4.99 and 95% CI, 1.07 to 5.46, respectively). When compared to non-obese and non-abdominal obesity group, non-obese and abdominal obesity group and obese and abdominal obesity group had about a 1.5-fold and 2.0-fold higher probability of dementia (95% CI, 0.59 to 3.95 and 95% CI, 1.09 to 3.84, respectively).

CONCLUSION

This study shows that as the BMI increased, subjects had a higher probability of dementia; additionally, it suggests that abdominal obesity could be related to a higher probability of dementia.