Introduction: Cognitive decline and dementia are key features of brain aging that substantially affect individuals’ health and quality of life. Existing treatments for dementia mainly focus on individuals with mild-to-moderate cognitive impairment. Ginseng, known for its anti-aging properties, has shown potential benefits for cognitive function. This study aimed to systematically review clinical evidence from randomized controlled trials (RCTs) regarding the potential of ginseng to prevent or slow cognitive decline and to explore the most effective dosing strategies. Methods: A comprehensive search was performed across 10 databases, including PubMed, Embase, Cochrane Library, Web of Science, Scopus, Ovid, CNKI, Wanfang Data, VIP database, and Chinese Biomedical Literature Database (CBM), covering studies from their inception to October 15, 2024. Two independent reviewers screened the studies for eligibility and assessed their quality. Data extraction and meta-analysis were conducted using Review Manager 5.4 and Stata 15.1, while Trial Sequential Analysis (TSA) was conducted using TSA 0.9.5.10 beta. The analysis focused on older adults diagnosed with mild cognitive impairment (MCI), Alzheimer’s disease (AD), or other types of dementia. Results: Nine studies involving 617 patients were included. The results revealed that (1) compared with the control group, the ginseng group exhibited higher scores on the Mini-Mental State Examination (MMSE) (MD = 0.38, 95%CI (0.03, 0.74), P = 0.03) and lower scores on the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) (MD = -2.21, 95%CI (-3.97, -0.44), P = 0.014), indicating improved cognitive function. (2) Subgroup analysis of MMSE outcomes indicated that a ginseng dose of 4.5g/d provided cognitive benefits. (3) TSA results confirmed the reliability of these meta-analysis results. Discussion: Ginseng may provide modest cognitive benefits for older adults with MCI, AD, or dementia. The observed effects are biologically plausible given ginseng's antioxidant and neuroprotective properties; however, the improvements did not reach the threshold for clinical significance. The limited number of included studies and moderate heterogeneity underscore the need for larger, high-quality RCTs to confirm these results and determine the most effective dosing strategies. Conclusions: Current evidence indicates that ginseng can improve cognitive function in older adults with MCI, AD or dementia. However, the extent of improvement is modest and not statistically significant, and its clinical relevance remains uncertain. Nevertheless, ginseng could still be considered as a potential therapy for age-related cognitive decline.
Chen et al. (Mon,) studied this question.