Dayna Dye
Sage Advice

Sage History
“Salvia officinalis L., also known as the ‘salvation plant,’ has been long used and well-documented in traditional medicine around the globe,” wrote Martina Jakovljević and colleagues in a recent review. “Its bioactive compounds, and especially its polyphenol profile, have been extensively researched and reviewed. However, sage’s beneficial effects reach much further, and nowadays, with a range of new extraction techniques, we are discovering new components with new therapeutic effects, especially in the context of neurodegenerative diseases. ”1
What is Acetylcholine?
Acetylcholine is a neurotransmitter involved in learning, short term memory and attention.4
Neurotransmitters, simply put, are chemical substances that facilitate the transmission of impulses from one neuron to another or to muscle or glandular cells. The space in which this transmission takes place is known as a synapse.
The nutrient choline, formerly categorized as a member of the vitamin B complex, is necessary for the formation of acetylcholine. Choline is found in foods such as egg yolk, fish, poultry, whole grains, and some beans, nuts, fruit and vegetables, as well as in nutritional supplements. Choline is also produced in modest amounts by the liver.
Acetylcholine Deficiency
One of many explanations of the development of Alzheimer’s disease is the cholinergic hypothesis, which posits dysfunction or loss of the brain’s cholinergic neurons (which contain acetylcholine and secrete it into the synapse) as a major contributor to the disease.5
Acetylcholinesterase is an enzyme that breaks down acetylcholine. Of the five drugs currently approved for the treatment of Alzheimer’s disease, three are acetylcholinesterase inhibitors and one is a combination of an acetylcholinesterase inhibitor with another drug.
A review of investigations of the genus Salvia’s cognitive enhancing and protective effects noted that extracts of Salvia officinalis decreased acetylcholinesterase activity in vitro and in mice, in addition to demonstrating an antioxidant effect and an ability to support a healthy level of inflammation.6
Clinical Benefits of Sage
In other research, the proprietary extract revealed an association with increased lifespan in roundworms.8 The effect may be related to this extract’s ability to increase the expression of lipid metabolism and insulin signaling genes.9
In a trial that involved women with mild to moderate Alzheimer disease, an extract of Salvia officinalis given for 16 weeks resulted in better cognition and less agitation compared to a placebo.10
A double-blind crossover study that included 30 young, healthy participants resulted in improved mood in the absence of a stressor and better task performance in association with the intake of 600 milligrams per day of dried sage leaf.11
A systematic review of clinical trials that evaluated Salvia species’ effects on memory, cognitive impairment and Alzheimer’s disease concluded that sage enhanced cognitive performance in healthy subjects, as well as those with cognitive impairment or dementia and is safe to use.12
Sage Polyphenols
Sage contains polyphenols that include flavone glycosides, rosmarinic acids and rosmarinic acid derivatives, among other compounds.13 Increased polyphenol consumption has been associated with short-term benefits to brain function and long-term brain health.14 Rosmarinic acid in sage and other herbs has been found to inhibit the aggregation of amyloid beta, a protein that forms damaging clumps in the brains of Alzheimer’s disease patients.15 It has also been demonstrated to reverse tau phosphorylation (which plays a role in Alzheimer’s disease) induced by stress and aging in mice.16
The Bottom Line
The wisdom of the past has found validation in these and other studies that reveal a memory benefit for sage. Sage’s long history of use in food and as medicine and the data revealed by recent studies make sage supplementation a safe and effective means of enhancing cognitive function among healthy people and potentially improving cognitive impairment in older adults.
About the author: Dayna Dye has been a member of the staff of Life Extension® since shortly after its inception. She has served as the department head of Life Extension® Wellness Specialists, is the author of thousands of articles published during the past two decades in Life Extension® Update, Life Extension Magazine® and on www.LifeExtension.com, and has been interviewed on radio and TV and in newsprint. She is currently a member of Life Extension’s Education Department.
References:
1. Jakovljević M et al. Plants (Basel). 2019 Mar 6;8(3):55.
2. Perry EK et al. J Altern Complement Med. Winter 1998;4(4):419-28.
3. Tildesley NTJ et al. Physiol Behav. 2005 Jan 17;83(5):699-709.
4. Klinkenberg I et al. Behav Brain Res. 2011 Aug 10;221(2):430-42.
5. Hampel H et al. Brain. 2018 Jul 1;141(7):1917-1933.
6. Lopresti AL. Drugs R D. 2017 Mar;17(1):53-64.
7. Scholey AB et al. Psychopharmacology (Berl). 2008 May;198(1):127-39.
9. Confidential S. Sage Gene Expression Analysis. 2018.
10. Akhondzadeh S et al. J Clin Pharm Ther. 2003 Feb;28(1):53-9.
11. Kennedy DO et al. Neuropsychopharmacology. 2006 Apr;31(4):845-52.
12. Miroddi M et al. CNS Neurosci Ther. 2014 Jun;20(6):485-95.
13. Lu Y et al. Food Chem. 2001 Nov;75(2):197-202.
14. Kennedy DO. Sports Med. 2019 Feb;49(Suppl 1):39-58.
15. Habtemariam S. Int J Mol Sci. 2018 Feb 3;19(2):458.
16. Shan Y et al. J Alzheimers Dis. 2016;49(3):829-44.