Key Takeaways
Despite widespread belief in its effectiveness, scientific evidence reveals important truths about ginkgo biloba and memory health for adults over 55.
• Large-scale studies prove ginkgo biloba doesn't prevent dementia or improve memory in healthy adults over 55, despite 67% of users believing it works
• Regular exercise reduces dementia risk by 31%, while Mediterranean diet adherence can lower Alzheimer's risk by 71% - far more effective than supplements
• Ginkgo biloba poses bleeding risks and interacts with 290+ medications, making it potentially dangerous for older adults on blood thinners
• Many memory problems stem from treatable causes like vitamin B12 deficiency, depression, or thyroid issues rather than normal aging
• Quality sleep (6+ hours nightly), social engagement, and managing blood pressure provide proven cognitive protection that supplements cannot match
The evidence is clear: evidence-based lifestyle interventions offer genuine brain protection, while ginkgo biloba provides false hope with potential risks. If memory concerns persist, consulting a healthcare provider proves far more valuable than relying on unproven supplements. Two-thirds of supplement users believe ginkgo biloba memory benefits can prevent dementia, and the prevalence of its use stands at 15.3% . Long-term studies show that ginkgo biloba for memory loss is not a proven treatment and does not reduce the risk of developing Alzheimer's disease or other forms of dementia . This creates a gap between popular belief and scientific evidence. This piece gets into what research reveals about ginkgo biloba and memory in adults over 55. It explores genuine ginkgo biloba benefits and presents evidence-based alternatives that support brain health.
What Is Ginkgo Biloba and Why Do Over 55s Use It?
A Traditional Remedy for Modern Memory Concerns
Ginkgo biloba stands as one of Earth's oldest living tree species, with origins dating back over 200 million years [1]. Scientists refer to it as a "living fossil" because it represents the last remaining species from a primitive family of plants that survived the ice age [1]. The tree, native to China and also called the maidenhair tree, has been an integral part of Asian culture and traditional medicine for thousands of years [1].
Chinese medical practitioners used ginkgo leaves and seeds to treat various ailments during ancient times. The oldest Chinese Materia Medica from 2800 B.C. recommended ginkgo biloba for conditions ranging from asthma and coughs to vascular disorders and brain function [1]. Practitioners believed the plant improved memory and reduced symptoms related to blood circulation abnormalities [2].
Modern ginkgo supplements differ from traditional preparations. Extract manufacturers collect material from the dried green leaves rather than seeds and standardize the product to contain specific amounts of active compounds [1]. These standardized extracts, particularly EGb 761, dominate the European and American supplement markets, where the focus has shifted mainly to cognitive enhancement and dementia prevention [1].
How Ginkgo Biloba Is Supposed to Work
Ginkgo extract contains two main groups of active compounds. Flavonol glycosides make up about 24% of standardized extracts, while terpene compounds such as ginkgolides and bilobalide account for about 6% [3]. These substances possess potent free radical scavenging and antioxidant properties that may play a role in neuroprotection [3].
The proposed mechanisms involve multiple biological pathways. Terpenoids help dilate blood vessels and reduce blood viscosity, which theoretically increases blood supply to the brain [4]. Brain cells receive more oxygen and nutrients needed for optimal function through this boosted circulation [1]. The flavonoids curb free radicals, unstable molecules that accumulate with age and damage brain cells, which can lead to memory loss [5].
Ginkgo also appears to influence neurotransmitter systems critical for cognition. Animal studies show that the extract increases acetylcholine release in hippocampal synaptosomes [3]. Modulation of this cholinergic system affects cognitive processes, especially working memory, since increases in cholinergic transmission boost memory performance while reductions compromise it [3]. The extract shows modest anticholinesterase inhibitory activity, which increases cholinergic transmission in the brain [1].
Other mechanisms include limiting stress-induced hormone secretion by reducing adrenal peripheral benzodiazepine receptors and inhibiting monoamine oxidase, which affects serotonin and dopamine uptake [1]. These multiple pathways suggest why proponents believe ginkgo biloba for memory might offer benefits.
Why It's Popular Among Older Adults
The prevalence of ginkgo biloba use among educated elderly people reaches 15.3%, with women taking the supplement slightly more than men [1]. Awareness extends far beyond actual usage. Much of the participants in one study, about 90.4%, reported knowing about ginkgo biloba, with women having heard about it substantially more than men [1].
Physician involvement drives much of this usage. Doctors recommended the supplement to over half of all users, specifically 53.8% [1]. Most people heard about the supplement from physicians and pharmacists, who accounted for 73.3% of information sources [1]. This medical endorsement carries weight despite the lack of supporting evidence.
Belief in ginkgo biloba benefits remains strong. About 66.7% of people assume ginkgo works for cognitive enhancement, while 61.5% believe it boosts memory [1]. Even more striking, 64.1% assume the supplement treats cognitive decline, and nearly one-third believe it prevents dementia [1]. The majority of participants remain convinced that ginkgo's effects have been proven, which creates a disconnect between perception and research findings [1].
The supplement holds a leading position in the herbal product market and ranks among the best-selling options despite missing clinical evidence [1]. German and Chinese practitioners prescribe it as the most common herbal medication, with German doctors calling it the treatment of choice for dementia and age-related memory dysfunction [1]. Sales in the United States reached substantial figures, with the 45 to 65 age group showing the highest usage rates [1].
Does Ginkgo Biloba Really Improve Memory in People Over 55?
What Large-Scale Studies Show
The Ginkgo Evaluation of Memory (GEM) study remains the largest clinical investigation to date. It enrolled over 3,000 people ages 75 or older with normal and mildly impaired cognitive function [3]. Participants took 120 mg of ginkgo biloba twice daily or a placebo for around six years. The conclusion was definitive: ginkgo biloba did not work at reducing the incidence of dementia or Alzheimer's disease [3].
The GuidAge trial in France followed a path much like this. This randomized, double-blind study tracked French participants with subjective memory deficits for more than five years [1]. EGb 761 treatment could not prevent dementia incidence [1]. A post-hoc analysis of a subgroup taking EGb 761 for at least four years showed a 50% reduction in dementia development compared to placebo [1], but this finding came from selective data analysis rather than the main study results.
Multiple meta-analyzes confirm these findings. One systematic review of 36 trials in 2009 and another of 38 trials in 2018 showed that ginkgo biloba was relatively safe but did not support clinical benefit for patients with cognitive impairment and dementia [6]. A recent analysis of 18 studies representing 7,558 participants found small and clinically meaningless effects on cognition, behavior, and functional ability [6].
Results in Healthy Older Adults
Healthy elderly people show no measurable benefits from ginkgo biloba for memory. Studies consistently confirm this. A randomized, double-blind trial of 230 participants aged 60 to 82 years evaluated ginkgo over six weeks using standardized tests of learning, memory, attention, and expressive language [6]. Analysis indicated there were no substantial differences between treatment groups on any outcome measure [6].
A 12-week study assessed effects in healthy older adults with a mean age of 61.7 years using cognitive abilities tests, chronometric tests, and subjective well-being measures [6][3]. There were no statistically substantial differences on any tests [6][3]. A study of 214 participants allocated to 160 mg/day or 240 mg/day of ginkgo biloba for 24 weeks found scores for cognitive tests were not statistically substantial [6][3]. The results were much the same.
The large majority of studies suggest that ginkgo biloba does not have cognitive effects in older subjects without cognitive impairment [3]. Several studies show lack of positive effects on particular cognitive domains such as alertness, attentiveness, reaction time, memory, and mood, whatever extracts are used once or over several months [3].
Results in Mild Cognitive Impairment
Evidence in mild cognitive impairment shows more nuanced results. A study of 300 patients with very mild cognitive impairment, aged 45 to 65 years, received EGb 761 at 240 mg daily or placebo for 12 weeks [1]. These patients showed improvement in memory performances measured through face recognition tests and substantial attention improvement [1].
A recent investigation in amyloid PET-positive MCI patients found the ginkgo group showed substantially higher responder rates at 12 months (100% vs. 59.1%) [3]. No conversion to Alzheimer's dementia occurred in the ginkgo group compared to 13.6% in the non-ginkgo group [3]. The ginkgo group managed to keep and slightly improved in both cognitive and functional outcome measures [3].
Broader assessments show that the efficacy of ginkgo biloba extracts as monotherapy in biomarker-confirmed mild cognitive impairment remains uncertain [3]. The picture is still unclear.
Results in Dementia and Alzheimer's Disease
Research in dementia populations presents conflicting evidence. A randomized control trial of 513 outpatients with mild to moderate dementia of the Alzheimer type did not support the efficacy of ginkgo extract [6]. But multiple trials using EGb 761 at 240 mg daily for 22 to 24 weeks showed substantial differences in cognitive test batteries, neuropsychiatric symptoms, and activities of daily living [6][3].
Studies using 240 mg per day with treatment lasting over 24 weeks show the most consistent benefits [6][3][3]. 70% of included clinical studies conclude that ginkgo biloba extract can improve cognitive ability in Alzheimer's patients [3]. The age groups showing outcomes that work were mainly distributed in the 60-70 and 70-80 year old groups [3].
Most patients showing no substantial improvement were over 75 years old [3]. The lower dose of 120 mg per day did not clearly influence symptoms of Alzheimer's disease [3].
Understanding Age-Related Memory Changes After 55
Normal Aging vs. Concerning Memory Loss
Age-related memory changes affect nearly 40% of people after turning 65 years old [1]. Most people retain strong memories throughout their lives, and knowing how to remember does not decline faster or substantially with normal aging [1]. Older adults maintain skills and knowledge learned throughout their lives well into old age [1].
Changes occur in all parts of the body with aging, and the brain is no exception. Some people notice they don't remember information as well as they once did and can't recall it as quickly [3]. They may misplace things from time to time or forget to pay a bill [3]. These signs point to mild forgetfulness, not a serious memory problem [3].
The biggest difference between age-related memory loss and dementia centers on daily functioning. Normal forgetfulness has little effect on daily performance and what someone wants to do [3]. Dementia involves a persistent, disabling decline in two or more intellectual abilities such as memory, language, and judgment [3].
Forgetting what someone ate for dinner last night but remembering after a hint represents normal aging. Forgetting what was eaten for dinner with no recall even with reminders signals a concerning pattern [1]. Misplacing house keys from time to time is substantially different from always losing keys and finding them in strange places like the refrigerator [1].
People experiencing normal age-related changes can function on their own and pursue normal activities despite occasional memory lapses [3]. They can recall and describe incidents of forgetfulness [3]. Those with dementia can't perform simple tasks like paying bills or dressing appropriately and cannot recall or describe specific instances where memory loss caused problems [3].
Common Causes of Memory Problems in Older Adults
Memory problems stem from factors unrelated to dementia or normal aging. These problems disappear once the root condition receives successful treatment [3]. Depression can mimic signs of memory loss and makes concentration difficult while affecting the capacity to stay organized, remember things, and complete tasks [3]. Depression occurs commonly in older adults, especially when you have less social contact and activity or recently experienced important losses [3].
Vitamin B12 deficiency protects neurons and proves vital to healthy brain functioning [3]. Older people have slower nutritional absorption rates, which makes it difficult to get adequate B12 [3]. Addressing a B12 deficiency early can reverse associated memory problems. Treatment is available through monthly injections [3].
Thyroid problems affect metabolism and can cause memory issues such as forgetfulness and difficulty concentrating [3]. Medication can reverse these symptoms [3]. Head injuries, blood clots, tumors, or brain infections can cause memory problems [3]. Kidney or liver problems also contribute to cognitive difficulties [3].
Medication side effects represent an especially common cause in older adults because they break down and absorb medication more slowly [3]. Mental health conditions such as anxiety, along with alcohol or drug misuse and sleep problems, can impair memory [3]. Low levels of important nutrients and inadequate healthy food intake also affect cognitive function [3].
Major, traumatic, or stressful life events can cause temporary memory problems [3]. Someone who retired or is coping with a spouse's death may feel sad, lonely, worried, or bored recently [3]. These memory problems from negative emotions are temporary and improve as stress and emotions fade [3].
When Memory Issues Need Medical Attention
Specific warning signs indicate when to talk with a doctor. Asking the same questions over and over, getting lost in familiar places, having trouble following recipes or directions, becoming confused about time and people, or not taking proper self-care requires medical evaluation [3].
Memory lapses become concerning when they occur frequently enough to worry the person experiencing them or a family member [3]. If memory problems persist after a few weeks, talking with a doctor becomes important to determine the best course of action [3]. Finding the cause proves essential to determine appropriate treatment [3].
People with mild cognitive impairment and their families will likely notice the decline in memory or mental function [3]. But unlike those with dementia, they can still function in daily life without relying on others [3]. Friends and relatives worried about someone's memory, even when that person shows no awareness of problems, signals a concerning pattern requiring assessment [1].
Risks and Side Effects of Ginkgo Biloba for Older Adults
Bleeding Risks and Blood Thinners
Ginkgo biloba may interact with over 290 drugs. Most interactions are classified as moderately clinically significant [7]. A hospital analysis revealed that 12.94% of prescriptions containing ginkgo showed drug interactions [8]. Among 747 patients analyzed for bleeding disorders, 4.15% expressed bleeding symptoms [8].
Bleeding complications are the biggest problem. Ginkgo inhibits platelet aggregation by increasing concentrations of endothelium-derived thrombolytics such as nitric oxide and prostacyclin [3]. Ginkgolide B, a component of the extract, directly inhibits platelet-activating factor from binding to receptors on platelet membranes [3]. Case reports document severe intracranial bleeding events between 1996 and 2003, with eight episodes requiring surgical evacuation in two cases and causing permanent neurologic defects in two others [3]. One patient died [3].
Warfarin combinations pose particular dangers. Patients taking both medications face increased chances of bruising and serious bleeding. This requires dose adjustments or more frequent monitoring [9]. Aspirin and clopidogrel interactions appeared in 69 prescriptions at 2.61% prevalence each [8]. One documented case involved spontaneous bleeding from the eye after just one week of ginkgo use combined with low-dose aspirin [9].
Patients should stop ginkgo at least two weeks before elective surgery due to bleeding risk [10]. Some sources recommend discontinuation 36 hours beforehand at minimum [9].
Drug Interactions to Watch For
Seizure medications require careful attention. Ginkgo may decrease the effectiveness of anticonvulsant medicines while lowering seizure threshold at the same time [11]. Large amounts can cause seizures directly [11]. The increased risk stems largely from ginkgotoxin, a compound mainly found in ginkgo seeds but often present as a contaminant in supplements [9].
HIV medications such as efavirenz may lose antiviral effectiveness when combined with ginkgo [7]. Alprazolam levels decrease in the body when taken with ginkgo and may reduce anxiety control [11]. Nifedipine levels can double, causing severe headaches and dizziness [9].
Statin interactions vary by medication. Ginkgo appears to lower atorvastatin effects while raising simvastatin levels [11]. Diabetes medications may produce unpredictable blood sugar responses [11].
Other Side Effects
Common side effects include headache, stomach upset and dizziness. Heart palpitations, constipation and allergic skin reactions also occur [11]. Some analyzes identified cough, somnolence and increased blood pressure as adverse events [12].
Never consume raw or roasted ginkgo seeds. Seeds are poisonous. Eating more than 10 roasted seeds daily can cause seizures [13]. Fresh seeds may lead to death [11].
What Actually Works for Memory Health After 55
Physical Exercise and Brain Health
Regular physical activity reduces dementia risk by 31% in older adults [14]. Just 12 weeks of consistent exercise produces noticeable improvements in cognition, memory and executive function [15]. Exercise increases blood flow to the brain and stimulates brain-derived neurotrophic factor release while reducing inflammation [15]. Physical activity preserves brain volume in regions critical for memory, especially the hippocampus [16]. Aerobic exercises like walking improve blood flow and support memory. Strength training regulates insulin levels and improves cognitive resilience [15].
Managing Blood Pressure and Heart Health
Midlife hypertension substantially increases dementia risk later in life. People with blood pressure at or above 140/90 mm Hg during ages 40 to 60 face elevated cognitive impairment risk [17]. High blood pressure treatment slows cognitive decline. Treatment groups show cognitive decline rates as with those without hypertension [18]. High blood pressure causes microbleeds in the brain and reduces brain volume, especially in the hippocampus [19].
Quality Sleep and Memory
People who get less than six hours of sleep during their 50s and 60s are 30% more likely to be diagnosed with dementia decades later [20]. The brain flushes away toxins during sleep, including beta amyloid and tau proteins [20]. Poor sleep disrupts memory consolidation, the process of transferring information from short-term to long-term memory [21].
Mental Stimulation and Learning
High levels of cognitive activity delay Alzheimer's onset by up to five years [11]. People in the top 10% of cognitive activity developed Alzheimer's at an average age of 93.6 years compared to 88.6 years for those in the bottom 10% [11]. Brain training improves specific tasks but requires at least three sessions of 30 minutes weekly [3]. New skill learning builds cognitive reserve and provides a buffer against neurodegenerative problems [20].
Social Engagement
Frequent social activity reduces dementia risk by 38% and mild cognitive impairment risk by 21% [22]. The least socially active older adults developed dementia around age 87, about five years earlier than the most socially engaged who developed it around age 92 [22]. Social activity strengthens neural circuits and makes them more resistant to brain damage [22]. Living with others, being in a relationship and never feeling lonely showed the strongest associations with slower cognitive decline [23].
Mediterranean Diet for Brain Function
High adherence to the Mediterranean diet reduces mild cognitive impairment risk by 75% and Alzheimer's disease risk by 71% [24]. The diet improves episodic memory and working memory while lowering attention somewhat [24]. Fish consumption twice weekly provides brain-healthy omega-3 fatty acids [8]. People gained one extra year less of brain aging for each point of higher compliance with the diet [8]. The diet emphasizes fruits, vegetables, whole grains and olive oil while limiting red meat and processed foods [24].
What to Do If You're Concerned About Memory Loss
Talking with a doctor becomes necessary when memory problems affect everyday life or persist after a few weeks [9]. Healthcare providers perform tests and assessments to determine the source of memory difficulties and may refer patients to neurologists who specialize in brain and nervous system conditions [9].
Medical Tests Your Doctor May Recommend
Original assessments involve cognitive screening tools that review memory, thinking, language, reasoning and problem-solving skills [25]. The General Practitioner Assessment of Cognition represents a common pen-and-paper test administered during office visits [26]. Patients can take the Self-Administered Gerocognitive Exam at home before appointments [25].
Doctors arrange blood tests to exclude reversible causes of cognitive decline. These tests check liver function, kidney function, thyroid function, HbA1c for diabetes, vitamin B12 and folate levels [27]. Physical examinations look for neurological signs, coordination abnormalities, cardiovascular issues and other conditions that explain symptoms [27]. Brain scans such as MRI provide detailed structural information, while CT scans check for strokes or tumors [28]. SPECT and PET scans get into brain function and blood flow patterns but remain uncommon [7].
Treatable Causes of Memory Problems
Blood vessel disorders, sleep disorders, hypothyroidism, vitamin deficiencies, depression, anxiety, stress, concussions, strokes and urinary tract infections can all cause reversible cognitive impairment [10]. Treatment of the underlying condition resolves memory difficulties in these cases [9].
When to Seek Help Immediately
Contact a primary care provider when memory concerns first arise [29]. Early detection provides access to treatments at their most effective point and allows time for future planning [30].
Conclusion
Ginkgo biloba remains a popular choice among older adults, but the scientific evidence tells a different story. Large-scale studies show it doesn't prevent dementia or improve memory in healthy people over 55. In fact, the gap between belief and reality remains substantial.
The proven strategies involve regular physical exercise and managing blood pressure. Quality sleep matters too. A Mediterranean diet and staying socially connected reduce dementia risk by substantial percentages and support genuine cognitive health.
Anyone experiencing persistent memory concerns should consult a doctor rather than relying on supplements. Many reversible conditions cause memory problems. Early detection provides access to treatments when they work best.
FAQs
Q1. Is ginkgo biloba safe and effective for older adults? Ginkgo biloba is generally considered safe for most seniors, but large-scale research shows it doesn't effectively prevent dementia or significantly improve memory in healthy older adults. While many people use it hoping to slow age-related cognitive decline, the scientific evidence supporting these benefits remains limited. It's important to consult with a healthcare provider before starting any supplement regimen.
Q2. How long should you take ginkgo biloba before expecting memory improvements? If you decide to try ginkgo biloba, it typically takes 4 to 6 weeks of daily use before any potential effects might be noticed. For best results, it should be taken consistently on a long-term basis. However, it's essential to be aware of possible drug interactions and health conditions that ginkgo may worsen before beginning supplementation.
Q3. What are the main risks of taking ginkgo biloba for seniors? The most serious concern is increased bleeding risk, especially for those taking blood thinners like warfarin, aspirin, or clopidogrel. Ginkgo can interact with over 290 medications and may cause side effects including headaches, stomach upset, dizziness, and allergic skin reactions. Seniors should stop taking ginkgo at least two weeks before any scheduled surgery and never consume raw or roasted ginkgo seeds, which are poisonous.
Q4. What actually works to improve memory and brain health after age 55? Evidence-based strategies that genuinely support cognitive health include regular physical exercise (which reduces dementia risk by 31%), managing blood pressure, getting quality sleep of at least six hours nightly, following a Mediterranean diet, staying socially engaged, and participating in mentally stimulating activities. These approaches have been proven through research to reduce dementia risk and support brain function more effectively than supplements.
Q5. When should memory problems prompt a visit to the doctor? You should consult a healthcare provider when memory issues affect daily functioning, occur frequently enough to cause concern, or persist for more than a few weeks. Warning signs include repeatedly asking the same questions, getting lost in familiar places, trouble following directions, confusion about time or people, and difficulty with self-care. Early medical evaluation is important because many treatable conditions can cause reversible memory problems.
References
[1] - https://www.health.harvard.edu/mind-and-mood/how-memory-and-thinking-ability-change-with-age
[2] - https://pmc.ncbi.nlm.nih.gov/articles/PMC3599149/
[3] - https://www.alzheimers.org.uk/about-dementia/managing-the-risk-of-dementia/additional-treatments-for-dementia-risk/brain-training
[4] - https://www.poison.org/articles/ginkgo-biloba-risks-benefits-181
[5] - https://www.webmd.com/vitamins-and-supplements/benefits-ginkgo-biloba
[6] - https://pmc.ncbi.nlm.nih.gov/articles/PMC7047126/
[7] - https://www.nhs.uk/conditions/dementia/symptoms-and-diagnosis/tests/
[8] - https://www.cnn.com/2021/05/05/health/mediterranean-diet-memory-loss-dementia-wellness
[9] - https://www.nia.nih.gov/health/memory-loss-and-forgetfulness/memory-problems-forgetfulness-and-aging
[10] - https://medlineplus.gov/lab-tests/cognitive-testing/
[11] - https://www.health.harvard.edu/blog/can-physical-or-cognitive-activity-prevent-dementia-202109162595
[12] - https://www.sciencedirect.com/science/article/abs/pii/S0378874124013096
[13] - https://www.webmd.com/vitamins/ai/ingredientmono-333/ginkgo
[14] - https://health.clevelandclinic.org/exercise-and-brain-health
[15] - https://healthcare.msu.edu/news/2025-12-28-Scientists-Say-This-Simple-Habit-Boosts-Brain-Health-in-as-Little-as-12-Weeks.html
[16] - https://pmc.ncbi.nlm.nih.gov/articles/PMC5934999/
[17] - https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(21)00283-X/fulltext
[18] - https://scitechdaily.com/treatment-for-high-blood-pressure-may-slow-cognitive-decline/
[19] - https://nutritionfacts.org/video/higher-blood-pressure-may-lead-to-brain-shrinkage/
[20] - https://mcpress.mayoclinic.org/healthy-brain/preventing-congnitive-decline-with-brain-exercises/
[21] - https://www.walshmedicalmedia.com/open-access/the-relationship-between-sleep-quality-and-memory-consolidation-in-alzheimers-disease.pdf
[22] - https://www.alzinfo.org/articles/prevention/social-activities-can-help-keep-the-brain-young/
[23] - https://www.unsw.edu.au/newsroom/news/2022/10/how-social-connection-keeps-your-brain-young--study
[24] - https://pmc.ncbi.nlm.nih.gov/articles/PMC9372716/
[25] - https://my.clevelandclinic.org/health/articles/22306-cognitive-test
[26] - https://www.dementiauk.org/information-and-support/specialist-diagnosis-and-support/tests-for-dementia/
[27] - https://cks.nice.org.uk/topics/dementia/diagnosis/assessment/
[28] - https://www.alz.org/alzheimers-dementia/diagnosis/medical_tests
[29] - https://www.uclahealth.org/news/article/alzheimers-disease-awareness-when-to-seek-treatment-for-memory-loss-or-dementia
[30] - https://www.alz.org/professionals/health-systems-medical-professionals/cognitive-assessment
