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Dementia incidence was virtually identical between groups[4]Ginkgo for Prevention of Dementia (GEM) JAMA View source

the Phase 3 confirmatory publications are what would elevate that tier

Springer.

10.1016/S0272-6386(04)00952-7 73

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Although raised homocysteine levels might be partly due to a poor vitamin B 12 status, the latter was not related to risk of dementia or Alzheimer's disease in this study (73)