Short-term treatment with citicoline has shown benefits in individuals with lower cognition at the beginning of studies, but due to discrepancies across studies, there is insufficient evidence that it is beneficial in healthy people with otherwise good cognition.
Citicoline supplementation improved speed in cognitive tasks in teenage boys [1], and reaction time in young adults in their 20s [2; 3]. However, another small study in young men found that while performance on measures of processing speed, memory, and executive function improved following supplementation in low performers, it declined slightly in those with high performance at baseline [4]. Similarly, improvements in memory in healthy elderly adults have primarily been observed in those with memory problems [5]. One study in healthy middle-aged women reported that citicoline improved attention [6], while another study in healthy middle age to older adults found a small effect on memory but no effects on attention [7]. Reduction in markers of oxidative stress have also been observed with citicoline supplementation [3].
No studies have examined whether citicoline can prevent dementia, but studies to date have shown little to no benefit regarding protection against stroke or brain injury-related cognitive impairment. Citicoline has not shown benefits in ischemic stroke relative to the current standard of care [8; 9; 10]. In traumatic brain injury, modest neuroprotection has been observed with intravenous citicoline, while no clear benefits have been observed with other forms of administration [11].
APOE4 CARRIERS:
The impact of APOE4 on the effects of citicoline is unclear. One small pilot study in people with the APOE4 variant reported that citicoline treatment for three months improved cognition compared to patients on a placebo [12], another study reported that APOE4 carriers showed less benefit [13], while a third study indicated that cognitive benefits were independent of APOE4 status [14]. For more information on what the APOE4 gene allele means for your health, read our APOE4 information page.
For Dementia Patients
Pilot studies suggest that citicoline may provide cognitive benefits in patients with Alzheimer's disease, but no large randomized controlled trials have been conducted [12; 15; 16; 17]. Five case-control observational studies reported cognitive benefits when citicoline is added to standard-of-care symptomatic treatments for Alzheimer’s disease relative to those receiving the standard-of-care alone. The modest effects on cognition generally required citicoline treatment for at least nine to 12 months [18; 19; 20; 21; 22]. Some studies also suggest citicoline may be beneficial for patients with vascular cognitive impairment [14; 23; 24], and may allow for lower levodopa doses in patients with Parkinson’s disease [25].
