Ginseng and CaHMB nutritional formula shows modest cognitive and strength gains in trial

A six-month randomized controlled trial has found that a nutritional formula enriched with ginseng extract and calcium β-hydroxy-β-methylbutyrate (CaHMB) produced modest between-group differences favoring the intervention in cognitive scores and handgrip strength among older adults living with both cognitive impairment and sarcopenia. The study, published in Aging Clinical and Experimental Research, enrolled 136 adults aged 65 years or older and assigned them to receive either the enriched formula or a nutritionally matched control formula at 100 grams per day for six months.

Cognitive impairment and sarcopenia frequently coexist in older adults, and both conditions are associated with loss of independence. According to the study’s background, evidence for nutritional interventions that target both conditions at once remains limited, which motivated the trial’s design.

The trial was single-center, randomized, and blinded for both participants and outcome assessors. Outcomes were measured at baseline and again at months three and six. The researchers prespecified four primary outcomes: scores on the Mini-Mental State Examination (MMSE), scores on the Montreal Cognitive Assessment (MoCA), handgrip strength, and appendicular skeletal muscle mass index (ASMI), with month six designated as the primary analysis time point.

The prespecified principal efficacy analysis used the per-protocol set, which included 121 participants. A supportive full-analysis-set and intention-to-treat analysis covered all 136 randomized participants, using multiple imputation to handle missing follow-up outcomes. Primary outcomes were analyzed with baseline-adjusted mixed models for repeated measures, and a Holm adjustment was applied to the month-six primary-outcome family to control for multiple comparisons. Additional sensitivity analyses included HC3 ANCOVA, jump-to-reference, delta-adjusted, and tipping-point approaches.

At month six, the adjusted between-group differences favored the intervention across three of the four primary outcomes. MMSE scores differed by 1.40 points (95% confidence interval, 1.14 to 1.67), MoCA scores by 1.71 points (95% CI, 1.49 to 1.93), and handgrip strength by 1.44 kilograms (95% CI, 1.20 to 1.69), all with Holm-adjusted P values below 0.001. These three findings remained statistically significant across the missing-data sensitivity analyses, indicating that they were not driven by particular assumptions about participants lost to follow-up.

The fourth primary outcome, ASMI, showed a less consistent picture. The adjusted between-group difference favored the intervention in the principal analysis at 0.227 kilograms per square meter (95% CI, 0.005 to 0.448; Holm-adjusted P = 0.045) and under multiple imputation, but the estimate was not statistically significant under jump-to-reference or delta-adjusted assumptions. The authors concluded that the ASMI finding was sensitive to assumptions regarding missing outcomes and remains uncertain.

Month-six secondary outcomes also showed Holm-adjusted between-group differences favoring the intervention, though the trial’s prespecified hierarchy placed the greatest weight on the four primary measures. On safety, events judged at least possibly related to the study product were more frequent in the intervention group, largely because of bitterness-related sensory and tolerability complaints. No serious adverse events occurred during the trial.

The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2400087204) on July 22, 2024, and the registration was retrospective, meaning it was recorded after the trial began rather than before enrollment. The study was also a single-center investigation, which limits the generalizability of the findings to other settings and populations. The article was published as an open-access, peer-reviewed accepted manuscript shared ahead of the final version of record.

In their conclusions, the researchers stated that over six months the combined ginseng- and CaHMB-enriched nutritional intervention was associated with modest between-group differences favoring the intervention in cognitive scores and handgrip strength, while the ASMI estimate was less robust. They emphasized that larger, prospectively registered multicenter trials are needed to confirm these findings and to determine their clinical relevance. Until such trials are completed, the results should be understood as an early signal from a single-center study rather than a basis for clinical recommendations.

Subject of Research: A randomized controlled trial of ginseng extract and CaHMB nutritional supplementation in older adults with cognitive impairment and sarcopenia

Article Title: Nutritional supplementation with ginseng extract and CaHMB in older adults with cognitive impairment and sarcopenia: A randomized controlled trial

Article References: Ao, C., Chen, L., Zhang, S., Zhang, X., Li, H., Huang, Q., Lu, Y., & Li, Z. (2026). Nutritional supplementation with ginseng extract and CaHMB in older adults with cognitive impairment and sarcopenia: A randomized controlled trial. Aging Clinical and Experimental Research. https://doi.org/10.1007/s40520-026-03539-5

Image Credits: AI Generated

DOI: 10.1007/s40520-026-03539-5

Keywords: ginseng extract, CaHMB, sarcopenia, cognitive impairment, older adults, randomized controlled trial, handgrip strength, MMSE, MoCA, ASMI, nutritional supplementation, clinical trial