title: The CITIRIVAD Study: CITIcoline plus RIVAstigmine in Elderly Patients Affected with Dementia Study.
abstract: BACKGROUND
  Acetylcholinesterase inhibitors (AchEIs), such as rivastigmine, coadministered with cholinergic precursors, such as citicoline, could be effective in Alzheimer's disease (AD) and in mixed dementia (MD), because they are able to increase the intrasynaptic levels of acetylcholine more than the single drugs given alone.
  
  
  OBJECTIVE
  The aim of the present study was to show the effectiveness of oral citicoline plus rivastigmine in patients with AD and MD.
  
  
  METHODS
  The CITIRIVAD study was a retrospective case-control study on 174 consecutive outpatients aged ≥65 years, affected with AD or MD, mean age 81.3 ± 4.5 years. Of the 174 patients, 92 had been treated with rivastigmine + citicoline 1000 mg/day given orally (group A); 82 patients had been treated with rivastigmine (group B). In both groups rivastigmine patch had been used for at least six months at the highest tolerated dosage. Group A comprised 62 patients affected with AD and 30 patients with MD. Group B comprised 53 patients affected with AD and 29 with MD. Cognitive functions had been assessed by Mini Mental State Examination (MMSE), daily life functions by activities of daily living (ADL) and instrumental activities (IADL), behavioral symptoms by neuropsychiatric inventory (NPI), comorbidities by the Cumulative Illness Rating Scale and mood by geriatric depression scale (GDS)-short form tests, which had been administered at baseline, 3 and 9 months.
  
  
  CONCLUSIONS
  Data show the effectiveness of combined administration versus the AchEI alone, mainly in slowing disease progression and consequently in disease management, both in AD and in MD. No differences regarding the combined treatment were found between the two groups. Treatment with citicoline plus rivastigmine was safe and well tolerated.
authors: Center for Cognitive Disorders and Dementia, Catanzaro Lido and Soverato-Chiaravalle-ASP Catanzaro, 88100, Catanzaro, Italy.
authors: Alberto
authors: A
authors: Castagna
authors: Hospital and Territorial Geriatrics, ASL Turin2, Turin, Italy.
authors: Antonino Maria
authors: AM
authors: Cotroneo
authors: Geriatric Unit, Azienda Ospedaliera "Pugliese-Ciaccio", Catanzaro, Italy.
authors: Giovanni
authors: G
authors: Ruotolo
authors: Center for Cognitive Disorders and Dementia, Catanzaro Lido and Soverato-Chiaravalle-ASP Catanzaro, 88100, Catanzaro, Italy. pietro.gareri@alice.it.
authors: Pietro
authors: http://orcid.org/0000-0003-4277-3426
authors: P
authors: Gareri
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D016022:Case-Control Studies; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D003566:Cytidine Diphosphate Choline / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D000068836:Rivastigmine / Q000627:therapeutic use*; D057968:Transdermal Patch
chemical_list: D002800:Cholinesterase Inhibitors; D003566:Cytidine Diphosphate Choline; D000068836:Rivastigmine