EFFECTIVENESS OF GOTU KOLA (CENTELLA ASIATICA), AEROBIC EXERCISE, AND ITS COMBINATION IN WOMEN WITH MILD COGNITIVE IMPAIRMENT AND DEMENTIA

• Main Author: Anisa Fitriana, Lisna
• Format: Dissertations
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/53779
• Institution: Institut Teknologi Bandung

Gotu kola (Centella asiatica) and aerobic exercise are known to improve cognitive function, but the effects of their combination on biochemical parameters in women with mild cognitive impairment and dementia are still limited. The purpose of this study was to analyze the efficacy of Gotu kola (Centella asiatica), aerobic exercise, and their combination on amyloid beta-42, p-tau, acetylcholinesterase (AChE), superoxide dismutase (SOD), brain-derived neurotrophic factor (BDNF), estradiol, apolipoprotein E, and tumor necrosis factor-?(TNF-?) plasma, cognitive function, physical fitness, and quality of life in women with MCI (Mild Cognitive Impairment) and dementia. The study design was a 12-week single-blind randomized controlled trial in MCI women and a 24-week double-blind randomized controlled trial in dementia women. The research subjects consisted of 64MCI women aged 53.25 ± 4.82 years, and 62 dementia women aged 75.03 ± 9.69 years. Subjects were divided into four groups, namely: the CA group (Centella asiatica, 1x500 mg/day), the AE group (aerobic exercise, 2x75 minutes/week for MCI women and 3x45 minutes/week for dementia women), the CA-AE combination group, and placebo/control group. The variables measured were plasma amyloid beta-42, p-tau, AChE, SOD, BDNF, estradiol, APOE, and TNF-?determined by ELISA. Physical fitness assessment included hand muscle strength with the handgrip test and lower extremity strength with the 30 seconds chair stand test, while the balance was assessed with the oneleg standing test. Quality of life was measured by WHO-QoL questionnaire, and cognitive function is measured by MMSE, MoCA-Ina, Verbal Fluency, Digit Span, Visual Memory, and Trail Making Test. The results showed that Centella asiatica, aerobic exercise, and their combination were effective in increasing plasma BDNF, estradiol, cognitive function, physical fitness, and quality of life as well as decreasing APOE and TNF-?plasma in Mild Cognitive Impairment (MCI) women. CA was shown to induce the highest increase in semantic fluency (?=4,44; p=0,002), forward digit span (?=0,63; p=0,001), and backward digit span (?=2,75; p<0,001). AE was shown to induce the highest increase in BDNF plasma (?=331,13; p=0,001) and one leg balance with openeyes (?=34,06; p=0,007). Meanwhile, the CA-AE combination led to the highest increase in TNF-?plasma (?= -10,48; p=0,007), MoCA-Ina (?=4,63; p<0,001), phonemic fluency (?=1,75; p=0,003), visual recall (?=6,88; p<0,001), TMT-B (?=-21,38; p=0,007), righthand strength (?=4,09; p<0,001), lefthand strength (?=3,44; p=0,002), and lower extremity strength (?=6,88; p<0,001). Assessment on quality of life showed the CA had significant increases in physical (p=0.028) and environmental (p=0.016) domains, while the AE and the CA-AE combination had significantly increased values in all domains of physical, psychological, social relations, and the environment. The results of studies in dementia women showed that Centella asiatica (CA), aerobic exercise (AE), and their combination were effective in increasing plasma beta amyloid-42, acetylcholinesterase (AChE), BDNF, SOD, cognitive function, and lowering phosphorylated-tau plasma. Further examination showed that the CA led to the highest increase in amyloid ?-42 (?=298,17; p=0,001), BDNF (?=- 10,50; p=0,006), and plasma SOD (?=4,03; p=0,022). AE was shown to induce the highest increase in semantic fluency (?=6,56; p<0,001), backward digit span (?=1,31; p=0,008), and QoL-environmental domain (?=6,88; p=0,010). Meanwhile, the CA-AE combination led to the highest increase in AChE plasma (?=38,46; p<0,001), MMSE (?=3,00; p<0,001), and visual recall (?=9,40; p=0,002) in dementia women. Taken together, the results of the present investigation indicates that Gotu kola (Centella asiatica), aerobic exercise, and their combination are effective in ameliorating plasma levels of APOE, acetylcholinesterase, BDNF, amyloid beta42, estradiol, SOD, TNF-?, cognitive function, physical fitness, and quality of life in women with mild cognitive impairment and dementia. For further research, clinical trials can be conducted with a larger number of respondents.