Alzheimer’s disease and other forms of dementia are serious neurocognitive disorders that can progressively affect memory, attention, language, decision-making, behaviour, and the ability to perform everyday activities. For this reason, any research suggesting that a plant-derived substance may influence memory or cognitive function deserves careful attention—but also careful interpretation.
A substantial part of the research on Rosa damascena and cognitive function comes from experimental animal models. However, a small but noteworthy randomized, double-blind, placebo-controlled human clinical trial, published in 2018, investigated whether Rosa damascena extract, when used alongside standard treatment in patients with dementia, could influence cognitive function and related outcomes.
An important distinction must be made from the outset:
The participants in this clinical study did not inhale rose essential oil, use rose water, or receive rose aromatherapy. The intervention consisted of orally administered capsules containing Rosa damascena extract.
The findings therefore cannot be directly extrapolated to rose essential-oil inhalation, rose water, or aromatherapy.
Why Was the Study Conducted?
Earlier experimental studies had produced interesting findings concerning Rosa damascena, learning, memory, and neurological processes. Researchers therefore wanted to investigate whether similar areas might warrant investigation in humans.
The central question was:
Could adding Rosa damascena extract to standard dementia treatment produce measurable differences in cognitive function, mood, behaviour, or activities of daily living?
The study was conducted among older patients and was published in the International Journal of Preventive Medicine in 2018.
Who Participated in the Study?
The trial included patients who were:
over 55 years of age,
experiencing mild to moderate cognitive impairment,
and diagnosed with a neurocognitive disorder/dementia.
The final analyses included 40 patients.
Of these:
20 were men and 20 were women.
The average age was approximately 76 years in the intervention group and 77 years in the control group.
This is an important limitation when interpreting the results.
The study did not involve hundreds or thousands of participants. It was a small clinical trial involving 40 patients, meaning that its findings require confirmation in larger and independent studies.
How Was the Study Designed?
The study used several methodological features intended to reduce bias.
Randomized
Participants were allocated to an intervention group or a control group.
Double-blind
The study was designed so that neither participants nor the relevant investigators knew which patients were receiving Rosa damascena and which were receiving placebo.
Placebo-controlled
The control group received placebo capsules designed to serve as a comparison with the Rosa damascena intervention.
These features strengthen the study design, although they do not eliminate the limitations associated with its small sample size and relatively short duration.
Both Groups Continued to Receive Donepezil
This is one of the most important details of the study.
Rosa damascena was not used as a replacement for conventional dementia treatment.
Both groups continued to receive donepezil, a medication used in the management of dementia symptoms.
The intervention group therefore received:
Donepezil + Rosa damascena extract
while the control group received:
Donepezil + placebo.
The research question was therefore not:
“Can Rosa damascena treat dementia?”
Instead, it was closer to:
“Does adding Rosa damascena extract to standard donepezil treatment produce additional measurable differences in the outcomes being studied?”
How Long Did the Study Last?
Participants were followed for:
Three months
Assessments were conducted at:
baseline,
one month,
and three months.
Importantly, the researchers did not examine memory alone. They assessed several dimensions of cognitive and functional health.
Which Tests Were Used?
1. MMSE — Mini-Mental State Examination
The MMSE is a widely used screening instrument for assessing general cognitive status.
It examines areas such as:
orientation,
registration,
attention,
calculation,
recall,
and language.
It does not provide a complete neurological diagnosis on its own, but it is commonly used to follow cognitive performance.
2. ACE-R — Addenbrooke’s Cognitive Examination-Revised
One of the particularly relevant assessments used in the study was the ACE-R.
It evaluates several cognitive domains, including:
attention and orientation,
memory,
verbal fluency,
language,
visuospatial abilities.
This allowed the researchers to look beyond the broad question of whether “memory improved” and examine different components of cognition.
3. Geriatric Depression Scale
Dementia does not affect memory alone.
Depressive symptoms can accompany cognitive impairment in older adults and may influence motivation, attention, social engagement, sleep, and overall functioning.
The researchers therefore also evaluated depressive symptoms.
4. Behaviour and Activities of Daily Living
Behavioural symptoms and the participants’ ability to perform activities of daily living were also assessed.
This is clinically relevant because the impact of dementia extends far beyond scores on memory tests.
A person's ability to function independently in everyday life is an important part of the overall clinical picture.
One of the Most Notable Findings: Overall Cognitive Performance
At the end of the study, differences between the Rosa damascena + donepezil group and the placebo + donepezil group were reported in measures of overall cognitive performance.
For MMSE:
p = 0.002
For total ACE-R score:
p = 0.001
These findings indicate statistically significant differences in the measured changes between the groups.
However, statistical significance should not be interpreted as proof that:
“Rosa damascena treated dementia.”
The small number of participants, three-month study period, and concurrent use of donepezil all require a more cautious interpretation.
The Attention Finding Is Particularly Interesting
One of the most noteworthy findings concerned the attention domain of the ACE-R assessment.
The change over time in the intervention group was statistically significant, while the control group did not show the same pattern.
When the changes between the two groups were compared, the reported result was:
p = 0.030
This is particularly interesting because attention is an important component of cognitive functioning and interacts closely with learning, memory retrieval, and everyday task performance.
The finding does not establish Rosa damascena as a treatment for attention impairment. It does, however, provide a signal that may justify further investigation in larger clinical trials.
What Happened to Memory?
The memory results require more careful interpretation.
Memory scores improved over time within the intervention group.
However, when the change in the intervention group was directly compared with the change in the control group, the reported value was:
p = 0.06
Using the conventional threshold of p<0.05, this result does not meet the usual criterion for statistical significance.
It would therefore be inappropriate to state:
“Rosa damascena significantly improved memory in patients with dementia.”
A more accurate interpretation is:
Memory scores improved within the intervention group, but the difference in change between the intervention and control groups did not reach the conventional threshold for statistical significance.
This distinction is essential for responsible scientific communication.
What Did the Study Find About Depression?
Differences between the groups were also reported for depression scores:
p = 0.012
This finding is relevant because depressive symptoms may influence:
motivation,
sleep,
attention,
social interaction,
cognitive performance,
and quality of life.
Consequently, cognitive changes observed in a dementia study should not automatically be attributed to a single mechanism.
What About Behavioural Problems?
The study also reported significant differences between the groups in behavioural problems:
p < 0.001
Differences were also reported for activities of daily living:
p < 0.001
These findings are noteworthy because the burden of dementia is not determined by memory impairment alone.
Behavioural changes, emotional symptoms, and loss of independence can profoundly affect both patients and caregivers.
Nevertheless, these findings need replication in larger, longer-term studies.
How Should We Interpret the Study Overall?
The trial reported noteworthy findings in several areas:
Overall cognitive assessment: statistically significant difference
Total ACE-R cognitive score: statistically significant difference
Attention: statistically significant between-group difference
Depression: statistically significant difference
Behavioural problems: statistically significant difference
Activities of daily living: statistically significant difference
However:
The between-group result for the memory domain was p=0.06.
It therefore did not reach the conventional threshold for statistical significance.
Taken together, the study does not demonstrate that Rosa damascena is an established treatment for dementia.
A more scientifically appropriate conclusion is:
A small controlled human trial produced preliminary evidence suggesting that adding Rosa damascena extract to standard treatment may be associated with changes in certain cognitive, behavioural, emotional, and functional outcomes. These findings require confirmation in larger clinical trials.
Can These Results Be Applied Specifically to Alzheimer’s Disease?
An important terminology distinction is required here.
The 2018 human trial investigated patients with dementia/neurocognitive disorder.
The results should therefore not automatically be described as evidence that Rosa damascena has been proven effective specifically in patients with Alzheimer’s disease.
Much of the research more directly related to Alzheimer-like pathology comes from experimental animal models.
These studies are useful for investigating possible mechanisms, but they are not equivalent to clinical trials in people with Alzheimer’s disease.
Rosa damascena in an Experimental Alzheimer-Like Model
In a 2015 study, Rosa damascena extract was investigated in rats in which amyloid-β was used to produce Alzheimer-like cognitive impairment.
Researchers used behavioural tests including the Morris water maze and passive avoidance tasks to evaluate learning and memory.
Amyloid-β was administered to the CA1 region of the hippocampus, a brain structure strongly involved in learning and memory.
The researchers reported that Rosa damascena extract reduced some of the impairments in spatial and long-term memory observed in this experimental model.
This finding is scientifically interesting, particularly in the context of mechanistic research.
However:
An amyloid-β animal model is not the same as Alzheimer’s disease in a human patient.
The study therefore cannot establish that Rosa damascena prevents or treats Alzheimer’s disease in humans.
Rosa damascena and Neurogenesis
Other experimental research has investigated Rosa damascena in relation to:
memory,
neurogenesis,
and synaptic plasticity
in animal models associated with Alzheimer-like cognitive impairment.
Neurogenesis broadly refers to biological processes involved in the generation of new neurons, while synaptic plasticity describes the nervous system’s ability to modify the strength and organization of connections between neurons.
These processes are of considerable interest in neuroscience.
However, findings from experimental animals cannot be assumed to occur in the same way in the human brain.
2024: Rosa damascena Essential Oil and the Cholinergic System
More recent research has also examined Rosa damascena essential oil.
A 2024 animal study investigated the essential oil in rats with scopolamine-induced learning and memory impairment.
The researchers evaluated:
behavioural measures of learning and memory,
acetylcholinesterase activity,
M1 muscarinic acetylcholine receptors,
and BDNF.
The study reported improvements in some measures of learning and memory impairment, together with:
reduced acetylcholinesterase activity,
increased M1 muscarinic receptor levels,
and increased BDNF levels.
These findings are interesting because they suggest possible biological pathways worthy of further investigation.
But the distinction remains essential:
This was an animal experiment, not a clinical trial in people with Alzheimer’s disease or dementia.
Why Is Acetylcholine Important in Alzheimer’s Research?
Acetylcholine is a neurotransmitter involved in:
attention,
learning,
memory,
and cognitive processing.
The cholinergic system has long been an important area of Alzheimer’s disease research.
Notably, donepezil, which was used by participants in the 2018 human study, is an acetylcholinesterase inhibitor.
This makes experimental findings concerning Rosa damascena and the cholinergic system scientifically interesting.
However, whether these mechanisms translate into meaningful clinical effects in humans remains unknown.
Why Is the BDNF Finding Interesting?
BDNF stands for Brain-Derived Neurotrophic Factor.
It is involved in processes related to:
neuronal survival,
synaptic plasticity,
learning,
and memory.
The reported increase in BDNF in the 2024 animal study therefore provides a possible avenue for future mechanistic research.
It does not, however, demonstrate that:
“Rosa damascena increases BDNF in humans.”
Controlled human studies would be needed to establish such an effect.
What Are the Main Limitations of the Human Study?
The positive findings of the 2018 clinical trial need to be considered alongside several important limitations.
1. The sample was small
Only 40 participants completed the study.
2. The follow-up period was short
The trial lasted three months.
Dementia and Alzheimer’s disease are long-term progressive disorders, so a three-month trial cannot establish effects on long-term disease progression.
3. Rosa damascena was not used alone
Both groups continued to receive donepezil.
The trial therefore does not establish the effects of Rosa damascena as a stand-alone intervention.
4. The memory result did not reach conventional between-group statistical significance
The reported value was p=0.06.
5. Larger independent studies are needed
Replication across larger and more diverse populations, longer treatment periods, and clearly defined dementia subtypes would substantially strengthen the evidence.
Does This Research Support Inhaling Rose Essential Oil?
No.
The 2018 clinical trial used:
Oral Rosa damascena extract capsules.
It did not investigate:
inhaled rose essential oil,
rose aromatherapy,
rose water,
or a fragrance ritual.
Research on rose aroma and inhalation belongs to a separate evidence base.
The results of the oral-extract clinical trial should therefore not be used as evidence that inhaling rose essential oil produces the same cognitive effects.
Why Is This Research Still Important?
The study remains noteworthy because many claims about medicinal plants are based only on traditional use, laboratory experiments, or animal research.
In this case, there is at least a small:
randomized,
double-blind,
placebo-controlled
human clinical trial
that investigated Rosa damascena in relation to several clinically relevant outcomes.
The study examined not only memory but also:
overall cognition,
attention,
depressive symptoms,
behaviour,
and activities of daily living.
This makes Rosa damascena an interesting subject for further neurocognitive research—not an established dementia treatment.
What Research Is Needed Next?
The next scientific step should involve substantially larger and longer clinical trials.
Future studies could include:
hundreds of participants,
clearly defined dementia subtypes,
separate analysis of Alzheimer’s disease,
standardized Rosa damascena preparations,
placebo controls,
six- to twelve-month or longer follow-up,
comprehensive neuropsychological testing,
functional outcomes,
biomarkers,
and, where appropriate, neuroimaging or neurophysiological measurements.
In Alzheimer’s disease specifically, potential relationships between Rosa damascena and:
amyloid-β,
tau,
neuroinflammation,
oxidative stress,
the cholinergic system,
BDNF,
and synaptic plasticity
could be explored more directly in human research.
Conclusion: A Promising Research Question, Not Evidence of a Treatment
The existing research on Rosa damascena, dementia, and Alzheimer-related mechanisms is scientifically interesting.
In the small randomized, double-blind, placebo-controlled human study published in 2018, patients receiving Rosa damascena extract alongside donepezil showed different outcomes from the placebo + donepezil group in several measures, including overall cognition, attention, depressive symptoms, behavioural problems, and activities of daily living.
However, the between-group result for the memory domain was p=0.06, which did not meet the conventional threshold for statistical significance.
Experimental animal studies have meanwhile raised additional questions about possible relationships between Rosa damascena and:
learning and memory,
the cholinergic system,
neurogenesis,
synaptic plasticity,
and BDNF.
These findings justify further investigation, but they do not establish clinical efficacy in humans.
The evidence available today does not support the statement:
“Rosa damascena treats Alzheimer’s disease or dementia.”
A scientifically more accurate conclusion is:
Rosa damascena is an intriguing subject of neurocognitive research, with preliminary human findings and experimental evidence that justify larger, longer, and more rigorous clinical studies.
Scientific progress does not always begin with a definitive answer. Sometimes its most important contribution is identifying a question that deserves to be investigated more carefully. Rosa damascena and neurocognitive function currently belong in that category.
Academy Note
This article is an educational review of scientific research and does not constitute medical advice. Alzheimer’s disease and other forms of dementia are serious conditions requiring medical assessment and professional care. Rosa damascena, rose essential oil, rose water, extracts, or aromatherapy should not be used as substitutes for prescribed medical treatment.
Key Scientific References
Esfandiary E, Abdolali Z, Omranifard V, et al. Novel Effects of Rosa damascena Extract on Patients with Neurocognitive Disorder and Depression: A Clinical Trial Study. International Journal of Preventive Medicine. 2018;9:57. DOI: 10.4103/ijpvm.IJPVM_199_17. PMID: 30050668.
Esfandiary E, Karimipour M, Mardani M, et al. Neuroprotective effects of Rosa damascena extract on learning and memory in a rat model of amyloid-β-induced Alzheimer’s disease. Advanced Biomedical Research. 2015;4:131. DOI: 10.4103/2277-9175.161512. PMID: 26322279.
2024 Brain and Behavior study. A comprehensive assessment of the cholinergic-supporting and cognitive-enhancing effects of Rosa damascena essential oil in a scopolamine-induced amnesia model. PMID: 38688895.