A boswellia-and-omega-3 nutraceutical improved cognition in older adults
STUDY: Trabace L et al, European Journal of Clinical Nutrition 2026
STUDY TYPE: Randomized, double-blind, placebo-controlled pilot trial
FUNDING: Pharmaceutica San Marco
Background
Boswellia—also widely known as Indian frankincense or olibanum—is an herbal extract derived from the fragrant gum resin of Boswellia trees. It is used in Ayurvedic medicine to reduce inflammation and, like omega-3, has neuroprotective properties. In animal models, the boswellia and DHA omega-3 combine synergistically to reduce amyloid toxicity, a cause of dementia.
This study tested a branded combination of the two from Italy, GeNeurofil. The sublingual supplement also contains other ingredients I’ll list below, like myrrh and clove-derived beta-caryophyllene.
The Study
- 54 institutionalized patients, ages 65 to 85, with cognitive impairment ranging from mild cognitive impairment to mild/moderate dementia (Dementia scale, CDR 0.5 to 2), kept on their usual medications.
- Randomized to GeNeurofil or an identical-tasting placebo, three times daily for six months.
- Tracked cognition (Cognitive scale, MMSE), dementia severity (CDR), mood (Depression scale, Zung), and two Alzheimer’s biomarkers in blood: neurofilament light and phosphorylated tau.
By six months, the Cognitive scale (MMSE) rose from 21 to 27 with GeNeurofil versus a one-point bump with placebo, a moderate difference (effect size = 0.46). Dementia severity (CDR) and Alzheimer’s biomarkers also improved more with GeNeurofil
The Depression scale (Zung) improved in both groups equally, in line with other trials that suggest DHA omega-3 is more potent for cognition and EPA omega-3 for mood.
Side Effects
Mild and rare: an unpleasant taste in two patients, no serious events, and fewer adverse events overall with GeNeurofil than placebo (7% vs 22%).
Limitations
Small, industry sponsored; uneven randomization in that placebo group had more patients on multiple medications, possibly reflecting greater severity there.
GeNeurofil’s Ingredients
- Clove (Syzygium aromaticum) liquid extract: 42 mg/day, of which betacaryophyllene 37.8 mg, terpenes 4.2 mg;
- Myrrh liquid extract: 24 mg/day, of which furanodienes 19.2 mg, terpenes 4.8 mg;
- Boswellia serrata powder: 42 mg/day, of which boswellic acids 27.3 mg, amyrins 8.4 mg;
- Microalgae oil extract: 1853 mL/day, titrated 550 mg in DHA (1000 mg/ day) and 3.1 mg in EPA (5.7 mg/day).
- Flavoring: lemon and sweet orange essential oils.
Practice Implications
- The improvements in biomarkers and dementia measures are encouraging. But whether the benefits are due to DHA omega-3 alone or the other ingredients is not clear.
- We already have 2 large and 6 small randomized trials showing cognitive benefits in older adults with omega-3, dosed at 1,000–1,500 mg QD of a high-DHA product (trials used 50–100% DHA and 0–50% EPA).
—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
