Medicinal Plants of Northern Thailand for the Treatment of Cognitive Impairment in the Elderly

Dementia is a progressive neurological disease affecting memory and behavior. The diagnosis of dementia is increasing exponentially worldwide and with it the potential risk for a severe social and economic burden of caring for an increasing debilitated elderly population. Cognitive impairment, and especially memory loss, can be the first indication of dementia. This study documents the treatment of cognitive impairment in the elderly by Thai traditional healers in northern Thailand usingmedicinal plants. Interviews were conducted from 2008-2012 to investigate the etiology of dementia in Thai Traditional Medicine and identify plants used to treat memory loss in the pharmacopeia of northern Thailand. Multi-plant herbal formulas from ancient manuscripts of the Lanna Kingdom were obtained from Thai traditional healers. These formulas were analyzed through ethnobotanical inquiry for plant species with potential bioactivity against memory loss in the elderly. Crude extracts of eleven selected plant species were screened through four in vitro bioassays to measure their general antioxidant activity, total phenolic content and acetylcholinesterase inhibition activity. Of these eleven species, five plants exhibited high levels of acetylcholinesterase inhibition activity: Cinnamomum bejolghota (Buch-Ham.) Sweet, Dracaena loureiroi Gagnep., Diospyros decandra Lour., Jasminum sambac (L.) Aiton., and Eurycoma longifolia Jack. One plant, Cinnamomum bejolghota demonstrated high activity in all four in vitro bioassays. Three different doses of an ethanol extract of Cinnamomum bejolghota were evaluated for their memory enhancing ability on in vivo rat behavioral models and enzymatic marker tests on their brain tissue. Results from the Morris Water Maze navigation task showed that the two highest dosages of the extract produced significant memory improvement after two weeks of treatment. Enzymatic marker analyses in three portions of the rats’ brains associated with memory formation, the hippocampus, striatum and cortex, showed significant acetylcholinesterase inhibition activity thereby increasing acetylcholine levels in these parts of the brain. This study identified a plant with memory enhancing activity that, with further study, could help to alleviate the suffering of those afflicted with age-related memory decline. Ethnopharmacological studies support the viability of traditional medicine to treat diseases that are relevant in modern society