Purpose Dementia is a progressive disease that involves tremendous burdens for patients, their families and society as a whole. One treatment option with proven efficacy (Birks & Evans, 2004; Cochrane Review summarizing 33 RCTs) is the Ginkgo biloba extract EGb 761®*. The purpose of this study was to investigate the effectiveness (caregivers' and patients' quality of life [QL]) and efficiency (total health care costs) of EGb 761® in the routine care of non-hospitalized dementia patients.

Methods The trial design specified a non-randomised, open label, two-armed cohort study that followed-up each patient for a period of 12 months. One cohort of patients received EGb 761® from the beginning of the study, the other cohort received any form of antidementia treatment except Ginkgo biloba. Patients were eligible for this trial when they suffered form mild to moderate dementia (MMST-score 12 to 24 points) and received home care by one primary family member. Patients were recruited in 133 family doctor practices all over Germany. It was the doctors' choice either or not to treat the patient with EGb 761®. Primary endpoint was the caring person's QL (PLC; Siegrist et al., 1996) 12 months after start of treatment. Patients' cognitive (MMST) and functional (Barthel-index) status were assessed. Total health care costs per patient per year were calculated including all direct costs.

Results A total of N = 683 patients were included in the study, n = 281 received EGb 761® (1-2 x 120 mg/d) and n = 402 did not. At the 12-months assessment point, the caring persons' QL was significantly higher in the Ginkgo biloba cohort than in the control cohort (all six PLC scores, p < 0.001). In the same manner, patients' cognitive (MMST) and functional (Barthel-Index) functioning were higher (p < 0.001). Average total cost per patient amounted to 3.031,78 € in the Ginkgo biloba cohort, and 3.614,75 € in the control cohort (p < 0.10).

Conclusions This study demonstrated that in the reality of family doctor patient care, Ginkgo biloba extract EGb 761® positively affects the “system” of dementia patients. Better cognitive and functional status of the patients and a better QL of their caring partners were achieved without increasing the total costs for health care.