Traditional Ayurvedic and herbal remedies for Alzheimer’s disease: from bench to bedside

ABSTRACT

Introduction: Alzheimer’s disease (AD) is a progressive, neurodegenerative disorder prevalent worldwide among elderly populations. Owing to limited efficacy, side effects, and poor patient compliance for current rationally designed therapies, options are being searched from alternate therapies such as Indian (Ayurvedic), Chinese, or other traditional systems.

Areas covered: Following a comprehensive literature search, the authors provide a review encompassing: (1) pathophysiological changes involved in AD, (2) Ayurvedic holistic approach and herbal medicines to manage dementia and AD, and (3) traditional plants and their phytoconstituents effective in AD with description of possible mechanism of action.

Expert opinion: Traditional remedies could be adjunct therapeutic options to allay wide-ranging pathological cascades of AD. Ayurveda offers a holistic approach of treatment along with a list of nootropic herbs and formulations that are the rich sources of antioxidants, anti-amyloidogenic, neuroprotective, adaptogenic, anti-inflammatory, and immunomodulatory compounds that are found to modulate neuroendocrine-immune activities, enhance memory, intellect, rejuvenate brain functions, and improve quality of life. A strong knowledge base of traditional systems coupled with contemporary science may provide new functional leads for age-associated neurodegenerative disorders at preventive, promotive, and curative levels, and evolution of new drug therapies and development processes, though further research is needed.

KEYWORDS:

• Alzheimer’s disease
• acetylcholinesterase
• amyloid beta
• neurofibrillary tangles
• traditional medicine
• neurodegenerative disease
• Ayurveda
• herbal medicine
• dementia

Article highlights

• Owing to limited efficacy and side effects of current treatment strategies for AD, options from herbal and traditional systems viz. Ayurveda and TCM are being searched because of their natural and safer approach.

• Ayurveda and TCM systems hold long clinical experience and rich traditional knowledge to manage neurodegenerative disorders.

• Ayurveda provides a holistic approach to manage AD via unique modes: pharmacological (Rasayana and nootropic herbs, Panchakarma bio-purification) and non-pharmacological (spiritual healing/mantra therapy, psychotherapy/yoga/meditation).

• Ayurvedic nootropic herbs and formulations (polyherbal/herbo-mineral) are the rich sources of antioxidants, anti-amyloidogenic, neuroprotective, anti-inflammatory, and immunomodulatory compounds working on neuroendocrine-immune levels and rejuvenate brain functions and allay neurodegenerative cascades of AD.

• Different traditional herbs/phytoconstituents/alkaloids mediate their anti-AD activity via multidimensional and multi-targeted actions such as inhibits AChE, MAO, β-secretase enzymes, synaptic damage, tau protein hyperphosphorylation, attenuates Aβ, oxidative stress, neurodegeneration, cognitive deficits, and improves memory.

• Ayurveda and herbal therapies help to allay the morbidity and manage the AD at preventive, promotive, curative levels and improve quality of life.

• Evidences of safe synergistic interactions of traditional herbs on concomitant use with synthetic anti-AD drugs support their adjunct usage in AD. This review proposes the pressing need of paradigm shift from single-target to a multi-target drug approach and the integration of contemporary and traditional systems to develop effective treatment strategies for AD.

• Traditional medicines and therapies have limited scientific data on signal transduction processes, efficacy, and safety with poor scientific documentation and validation, hence future studies are warranted to explore their rich potential in neurotherapeutics.

Acknowledgments

The authors would also like to thank Prof. Vaidya Kartar Singh Dhiman, Director General, CCRAS, Ministry of AYUSH, Government of India for their support and guidance.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by the long-term development plan UHK. This paper was not specifically funded.