{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:40:49Z","timestamp":1791308449808,"version":"4.3.1"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Over 44 million people worldwide live with dementia, affecting their quality of life and well-being. Choline alphoscerate and citicoline supplements are commonly used to improve cognitive function in dementia patients. However, their efficacy remains inconsistent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review aimed to investigate and compare the effects of choline alphoscerate and citicoline on cognitive impairments, behavioural symptoms, and other clinical conditions in patients with dementia disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed and Scopus were searched to identify relevant studies. We calculated weighted mean differences (WMD) or standardized mean differences (SMD) and 95% confidence intervals (CI) for continuous outcomes and odds ratios (OR) and 95% CI for binary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This review included data from 358 participants across three randomized controlled trials (RCTs). As measured by the Sandoz Clinical Assessment for Geriatric Patients (SCAG), choline alphoscerate significantly improved clinical conditions in patients with dementia disorders compared with citicoline at the end of treatment [WMD: \u22123.92 (95% CI: \u22127.41 to \u22120.42)]. Specifically, our pooled analysis revealed that choline alphoscerate showed significant improvements in cognitive function, interpersonal relationships, affective disorders, apathy, and somatic functioning compared to citicoline at the end of treatment, as measured by the SCAG. However, there was no significant difference between the choline alphoscerate and citicoline treatment groups on memory or word fluency tests (WFT). Dropout rates for choline alphoscerate and citicoline were 9.4 and 6.7%, respectively [OR: 1.44 (95% CI: 0.66 to 3.13)], indicating no significant differences in acceptability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings indicate that choline alphoscerate is more effective than citicoline in improving the clinical conditions of dementia patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024626782<\/jats:uri>\n                      , Identifier: CRD42024626782.\n                    <\/jats:p>\n                  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