title: The Citicholinage Study: Citicoline Plus Cholinesterase Inhibitors in Aged Patients Affected with Alzheimer's Disease Study.
abstract: Citicoline can have beneficial effects both in degenerative and in vascular cognitive decline in a variety of ways (apoptosis inhibition, neuroplasticity potentiation, phospholipid, and acetylcholine (ACh) synthesis). Acetylcholinesterase inhibitors (AChEIs) have been used for treatment of Alzheimer's disease (AD). When co-administered with cholinergic precursors, they are able to increase the intrasynaptic levels of ACh more than when the single drugs given alone.
  
  
  
  The aim of the present study was to show the effectiveness of oral citicoline plus AChEIs in patients affected with AD.
  
  
  
  This was a retrospective multi-centric case-control study, involving seven Centers for Cognitive Impairment and Dementia in Italy, on 448 consecutive patients aged 65 years old or older affected with AD. 197 patients were treated with an AChEI while 251 were treated with an AchEI + citicoline 1000 mg/day given orally. Cognitive functions were assessed by MMSE, daily life functions by ADL and IADL, behavioral symptoms by NPI, comorbidities by CIRS, and mood by GDS-short form. Tests were administered at baseline (T0), after 3 (T1), and 9 months (T2). The primary outcomes were effects of combined administration versus AChEIs given alone on cognitive functions assessed by MMSE. The secondary outcomes were possible side effects or adverse events of combination therapy versus AChEIs alone.
  
  
  
  Patients treated with citicoline plus an AChEI showed a statistically significant increase in MMSE between T0 and T1 (16.88±3.38 versus 17.62±3.64; p = 0.000) and between T1 and T2 (17.62±3.64 versus 17.89±3.54; p = 0.000).
  
  
  
  The present study encourages the role of combined administration in disease management by slowing disease progression.
authors.affiliation: Center for Cognitive Disorders and Dementia - Distretto Socio-Sanitario Catanzaro Lido - ASP Catanzaro, Catanzaro, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Gareri
authors.affiliation: Center for Cognitive Disorders and Dementia - Distretto Socio-Sanitario Catanzaro Lido - ASP Catanzaro, Catanzaro, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Castagna
authors.affiliation: Director Department of Elderly Health Care - Birago di Vische Hospital and Botticelli Territorial Geriatrics - ASL TO 2, Turin, Italy.
authors.forename: Antonino Maria
authors.initials: AM
authors.lastname: Cotroneo
authors.affiliation: Associazione Geriatri Extraospedalieri (AGE), Naples, Italy.
authors.forename: Daria
authors.initials: D
authors.lastname: Putignano
authors.affiliation: Scientific Responsible Nursing Home San Giuseppe - Monte Compatri, Rome, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Conforti
authors.affiliation: Associazione Geriatri Extraospedalieri (AGE), Treasurer, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Santamaria
authors.affiliation: Operative Unit Elderly Care, District 53 Castellammare di Stabia ASL NA3 Sud, Italy.
authors.forename: Saverio
authors.initials: S
authors.lastname: Marino
authors.affiliation: Operative Unit Elderly Care, District 30, ASL Napoli Centro - Associazione Geriatri Extraospedalieri (AGE) President, Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Putignano
mesh_terms: D000284:Administration, Oral; D000339:Affect / Q000187:drug effects; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D016022:Case-Control Studies; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D015897:Comorbidity; D003566:Cytidine Diphosphate Choline / Q000009:adverse effects / Q000627:therapeutic use*; D018450:Disease Progression; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D000073216:Mental Status and Dementia Tests; D018697:Nootropic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D018697:Nootropic Agents; D003566:Cytidine Diphosphate Choline
keywords: Acetylcholinesterase inhibitors; Alzheimer’s disease; citicoline; donepezil; elderly; galantamine; rivastigmine