<b>PHARMACOLOGICAL PROPERTIES AND CLINICAL EFFICACY OF </b><b><i>Ginkgo biloba</i></b><b> IN COGNITIVE DECLINE AND ALZHEIMER'S DISEASE</b>

Alzheimer's disease is a progressive neurodegenerative disease in patients aged 60-65 years. It is defined by memory impairment, cognitive change, and disturbances in behavior. It is the leading cause of dementia, with increasing global prevalence, and has become a serious public health issue. Ginkgo biloba, a plant used as an herbal medicine for a long time, has been extensively researched for its neuroprotective effects. Its pharmacologically active compounds, flavonoids, and terpenoids exhibit antioxidant, anti-inflammatory, and anti-amyloid activities that may play a role in treating AD. Various studies have shown that GB extract can improve cognitive function, inhibit neuroinflammation, and induce neuronal survival. Furthermore, GB combined with acetylcholinesterase inhibitors has improved treatment efficacy in AD patients. Nevertheless, conflicting results and heterogeneity of clinical trials complicate the conclusion of its effectiveness. A systematic search of English and Chinese databases was performed to search for relevant literature on GB and AD. The current review presents the results of 30-plus studies, including clinical trials, meta-analyses, and preclinical studies. The dosage, treatment duration, and patient characteristics affect GB's efficacy. Due to promising results, various limitations of current evidence must be overcome. Most studies have small sample sizes, short follow-up periods, and methodological heterogeneity. The lack of large-scale, high-quality, randomized controlled trials restricts the validity of current evidence. Future research needs to perform long-term clinical trials on standardized dosages to establish the optimal application of GB in treating AD. Further investigation of the mechanisms of GB, especially its interaction with AD-related genetic factors and potential combination with current therapies, is also needed. Correcting these shortcomings will assist in presenting a better picture of GB's place in AD management and its promise as an adjunctive treatment.