The Use Of Herbal Products In Dementia: Experience Of Kippo In Four Nigerians

Modern neuroimaging and other investigative techniques have provided a lot of new information on the neurobiology of the dementias. Unfortunately no permanent cure has been found for this debilitating disease, giving rise to continuing trial of various products. Alternative and herbal medicines have become popular in neuropsychiatric disorders including dementia. In this report, we present our experience with Kippo – a Japanese herbal product – in 4 Nigerians with dementia. Two of the patients fully completed the study. The ten word list learning test, community screening interview for dementia (CSI –D), structured dementia interview (SIDAM) and the Geriatric Mental State schedule (GMS) were used to identify dementia according to ICD – 10 diagnostic criteria. Dementia behaviour disturbance scale (DBD) and modified 22 – item mini – mental state examination (MMSE) were used to evaluate the product efficacy over 8 weeks. One patient showed some initial improvement on the DBD without effect on the MMSE and the other patient showed some initial improvement on the MMSE without effect on the DBD. Both patients had worsening on the clinical Global Impression Scale (CGI) within the study period. There were no demonstrable adverse effects as shown by physical examinations and laboratory tests. No definite conclusion could be drawn on the efficacy and safety of Kippo in dementia in this short study. We recommend a well-controlled larger scale investigation of the effect of Kippo on well-defined different subtypes of dementia.Key Words: Dementia, herbal products, KippoNigerian Journal of Clinical Practice Vol 8(1) 2005: 51-5

Care arrangements for people with dementia in developing countries.

BACKGROUND: Rapid demographic ageing will soon lead to large increases in the numbers of persons with dementia in developing countries. This study is the first comprehensive assessment of care arrangements for people with dementia in those regions. METHODS: A descriptive and comparative study of dementia care; caregiver characteristics, the nature of care provided, and the practical, psychological (Zarit Burden Interview, General Health Questionnaire) and economic impact upon the caregiver in 24 centres in India, China and South East Asia, Latin America and the Caribbean and Africa. RESULTS: We interviewed 706 persons with dementia, and their caregivers. Most caregivers were women, living with the person with dementia in extended family households. One-quarter to one-half of households included a child. Larger households were associated with lower caregiver strain, where the caregiver was co-resident. However, despite the traditional apparatus of family care, levels of caregiver strain were at least as high as in the developed world. Many had cutback on work to care and faced the additional expense of paid carers and health services. Families from the poorest countries were particularly likely to have used expensive private medical services, and to be spending more than 10% of the per capita GNP on health care. CONCLUSIONS: Older people in developing countries are indivisible from their younger family members. The high levels of family strain identified in this study feed into the cycle of disadvantage and should thus be a concern for policymakers in the developing world