Attentia

As part of the natural process of aging, we may experience a progressive decline in cognitive function. Attentia contains four well-researched ingredients that work synergistically to help enhance cognitive wellness.

Attentia comprises four synergistic ingredients:

Eleuthero (Eleutherococcus senticosus) Root Extract (containing .8% eleutherosides).  This herb is also known as Siberian ginseng. The applicable parts of Siberian ginseng are the root and leaf. The root, which is most commonly used, contains active compounds referred to as eleutherosides A through M. (1) Eleutheroside B (syringin) and eleutheroside E (syringaresinol) are the most plentiful and are used as marker compounds for Siberian ginseng products. (2) The eleutherosides include a variety of diverse compounds including saponins (daucosterol, beta-sitosterol, hederasaponin B), coumarins (isofraxidin), lignans (sesamin, syringaresinol), phenylpropanoids (syringin, caffeic acid, sinapyl alcohol, coniferyl aldehyde, protocatechuic acid), betulinic acid, vitamin E, and provitamins like beta-carotene. (1) Siberian ginseng root, the lignan constituent sesamin, and the phenylpropanoid syringin seem to have immunostimulatory effects. (1)

• Siberian ginseng constituents have a variety of other pharmacological effects. Protocatechuic acid seems to inhibit platelet aggregation. (3) Other constituents are also thought to be anti-inflammatory, sedative, diuretic, gonadotropic, estrogenic, protein-anabolic, and stimulate the pituitary-adrenocortical system. (4)

Ginkgo (Ginkgo biloba) Leaf Extract (containing 24% ginkgoflavoneglycosides).  Ginkgo leaf and its extracts contain several active constituents including flavonoids, terpenoids, and organic acids. Many ginkgo leaf extracts are standardized to contain 24% to 25% flavonoid glycosides and 6% terpenoids. The major flavonoids are primarily derived from the flavanol rutin and include isorhamnetin, quercetin, kaempferol, and proanthocyanidins. The primary terpenoids are ginkgolides A, B, C, M, and J, and bilobalide. (5) Although many of ginkgo's constituents have intrinsic pharmacological effects individually, there is evidence that the constituents work synergistically to produce more potent pharmacological effects than any individual constituent. (6,7)

Although the mechanism of action of ginkgo leaf is only partially understood, there are several theories about how it might work for various disease states. One theory is that ginkgo leaf might work by protecting tissues from oxidative damage. Ginkgo leaf flavonoids have antioxidant and free radical scavenging properties. (8,9,10,11) The flavonoids seem to prevent or reduce cell membrane lipid peroxidation (5), and decrease oxidative damage to erythrocytes. (10)

Central nervous system (CNS) disorders, such as dementia, and other conditions including peripheral arterial disease, hypersensitivity disorders, allergies, asthma, and bronchitis might benefit from ginkgo's anti-inflammatory effects. It is not clear exactly how ginkgo causes vascular contraction and improves venous tone, but these effects might be due to phosphodiesterase inhibition, resulting in increased cAMP levels and release of catecholamines. (12) 

Ginkgo leaf extract might be helpful for Alzheimer's disease due to effects on beta-amyloid proteins. There is preliminary evidence that ginkgo leaf extract can inhibit toxicity and cell death induced by beta-amyloid peptides. (7) Ginkgo might also influence certain neurotransmitter systems, such as the cholinergic system, (13) and seems to produce EEG changes similar to the acetylcholinesterase inhibitor tacrine (Cognex). (14)

It is suggested that ginkgo leaf inhibits catechol-O-methyl transferase (COMT), an enzyme which breaks down adrenergic transmitters, and increases the number of alpha-adrenoreceptors in the brain; which would help reverse the decline in brain alpha-adrenoceptor activity that occurs with aging. (8) There is some evidence that ginkgo flavonoids have GABAergic effects and might directly affect benzodiazepine receptors. (15) However, the clinical significance of this effect is not known. The ginkgolides A and B seem to decrease glucocorticoid biosynthesis, which might also play a role in ginkgo's proposed anti-stress and neuroprotective effects. (16,17,18)

Ashwagandha (Withania somnifera) Root (containing 2.5% withanolides).  The applicable parts of ashwagandha are the root and berry. Ashwagandha contains several active constituents including alkaloids (isopelletierine, anaferine), steroidal lactones (withanolides, withaferins), and saponins (19, 20). Ashwagandha does not contain nicotine as some researchers have reported (21).

Preliminary animal evidence suggests ashwagandha may have a variety of pharmacological effects including analgesic, antipyretic, anxiolytic, immunomodulatory, sedative, hypotensive, anti-inflammatory, and antioxidant effects. (21,22,23,24,20) It might also stimulate respiratory function, cause smooth muscle relaxation, and stimulate thyroid synthesis and/or secretion. (21) 

Some researchers think ashwagandha has a so-called "anti-stressor" effect. Preliminary evidence suggests ashwagandha might suppress stress-induced increases of dopamine receptors in the corpus striatum of the brain. (21) It also appears to reduce stress-induced increases of plasma corticosterone, blood urea nitrogen, and blood lactic acid. (20)

Ashwagandha might also have anxiolytic effects, possibly by acting as a gamma-aminobutyric acid (GABA) mimetic agent. It might also have anticonvulsant activity, by binding to the GABA receptor. (21) Ashwagandha and its constituents also seem to have immunomodulatory effects.

Grapeseed (Vitis vinifera) Extract (standardized to 95% (Proanthocyanidins).  Grape seeds are typically obtained as a by-product of the manufacturing of wine. Constituents called oligomeric proanthocyanidins (OPCs) or procyanidins may have pharmacological effects.

Preliminary evidence also suggests grape seed proanthocyanidins may provide greater protection against reactive oxygen species, free radical-induced lipid peroxidation, and DNA damage than the combination of vitamin E, vitamin C, and beta-carotene or a combination of vitamin E and vitamin C. (25)

Grape seed proanthocyanidins seem to inhibit the cytochrome P450 2E1 (CYP2E1) enzyme, which might protect normal cells against drug and chemical-induced toxicity. (25)

OPCs are also thought to inhibit the proteolytic enzymes collagenase, elastase, hyaluronidase, and beta glucuronidase, which are involved in the breakdown of structural components of the vasculature and skin. (26)

Grape seeds also contain catechin, which preclinical research suggests might inhibit allergen-induced histamine release from mast cells. (27)

Dr. D’Adamo has formulated Attentia, designated to help maintain healthy brain function and provide an overall feeling of well-being.

Cognitive performance. There is preliminary evidence that suggests Siberian ginseng might improve memory and feelings of well-being in middle-aged people. (28)

Age-related memory impairment. Taking ginkgo leaf extract orally seems to improve cognitive function in some elderly people with mild to moderate age-related memory impairment. Ginkgo leaf extract might modestly improve some measures of cognitive function, particularly short-term visual memory and possibly speed of cognitive processing, in non-demented patients with age-related memory impairment. (10,29)

Cognitive function.  Taking ginkgo leaf extract orally seems to improve some measures of cognitive function in healthy young to middle-aged people. Ginkgo might modestly improve memory and speed of cognitive processing, including increasing speed of performance on factors assessing attention in people with no complaints of memory impairment. (30,31,18,32,33,34) Lower doses of 120-240 mg per day seem to be as effective or more effective than higher doses up to 600 mg per day. (30,18,33)

Dementia.  Taking ginkgo leaf orally seems to modestly improve symptoms of Alzheimer's, vascular, or mixed dementias. Studies lasting from 3-12 months show that ginkgo leaf extract can stabilize or improve some measures of cognitive function and social functioning in patients with multiple types of dementia. (6,5,35,36,37,38,39) Although there is one report with conflicting findings, (40) the majority of evidence indicates that ginkgo leaf extract can be modestly helpful. Some researchers suggest that the improvement with ginkgo leaf extract is roughly equivalent to a six-month delay in disease progression. (6) However, outcome studies have not yet verified ginkgo's effects on disease progression. Doses ranging from 120 mg to 240 mg daily have been beneficial after 6-8 weeks of treatment. German practitioners consider ginkgo leaf extract the treatment of choice for dementia. (41) However, ginkgo leaf extract has not been directly compared to conventional medicines for dementia. Improvement appears to be less than that found with the prescription drugs donepezil (Aricept), tacrine (Cognex), and other cholinesterase inhibitors. Consider ginkgo for patients who cannot take cholinesterase inhibitors.

Stress.  Some evidence supports ashwagandha having a so-called "anti-stressor" effect. Preliminary evidence suggests ashwagandha might suppress stress-induced increases of dopamine receptors in the corpus striatum of the brain (21). It also appears to reduce stress-induced increases of plasma corticosterone, blood urea nitrogen, and blood lactic acid (20). Ashwagandha might also have anxiolytic effects, possibly by acting as a gamma-aminobutyric acid (GABA) mimetic agent. It might also have anticonvulsant activity, by binding to the GABA receptor (21).

Neural Protection.  Grapeseed Extract, which is high in Oligomeric Proanthocyanidins (OPC’s or PCO’s), is a powerful antioxidant which can reduce the damage done by free radicals, strengthen and repair connective tissue, and promote enzyme activity. OPC’s can also help moderate allergic and inflammatory responses by reducing histamine production. PCO’s are one of the few antioxidants that cross the blood-brain barrier to protect neural tissue.

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12. Campos-Toimil M, Lugnier C, Droy-Lefaix M, et al. Inhibition of type 4 phosphodiesterase by rolipram and Ginkgo biloba extract (EGb 761) decreases agonist-induced rises in internal calcium in human endothelial cells. Arterioscler Thromb Vasc Biol 2000;20:e34-e40.
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32. Polich J, Gloria R. Cognitive effects of a Ginkgo biloba/vinpocetine compound in normal adults: systematic assessment of perception, attention and memory. Hum Psychopharmacol 2001;16:409-16.

33. Mix JA, Crews WD. A double-blind, placebo-controlled, randomized trial of Ginkgo biloba extract EGb 761 in a sample of cognitively intact older adults: neuropsychological findings. Hum Psychopharmacol 2002;17:267-277. 

34. Wesnes KA, Ward T, McGinty A, Petrini O. The memory enhancing effects of a Ginkgo biloba/Panax ginseng combination in healthy middle-aged volunteers. Psychopharmacology (Berl) 2000;152:353-61.

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39. Kanowski S, Herrmann WM, Stephan K, et al. Proof of efficacy of the ginkgo biloba special extract (EGb 761) in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Pharmacopsych 1996;29:47-56.

40. van Dongen MC, van Rossum E, Kessels AG, et al. The efficacy of ginkgo for elderly people with dementia and age-associated memory impairment: new results of a randomized clinical trial. J Am Geriatr Soc 2000;48:1183-94.

41. Forstl H. Clinical issues in current drug therapy for dementia. Alzheimer's Dis Assoc Disord 2000;14:S103-S108