Use of Citicoline in Aging Process and Cognitive Impairment: A Systematic Review of Current Clinical Evidence

Öz

Citicoline (CDP-choline) has long been studied as a potential agent for the treatment of cognitive disorders due to its role in cell membrane phospholipid synthesis, its neurotransmitter-modulating effects, and its neuroprotective properties. Conducted in accordance with the PRISMA 2020 guidelines, this systematic review aims to evaluate the current clinical evidence regarding the use of citicoline in older adults and those with cognitive impairment. The literature search was limited to studies published between 2010 and 2025 in the PubMed, Scopus, Web of Science, and Cochrane databases. Randomized controlled trials involving human participants, as well as prospective and retrospective observational studies, were included in the review. Of the 58 articles whose full texts were evaluated for eligibility, 16 studies that met the final inclusion criteria were included in the systematic review. In several studies, citicoline was associated with measurable changes in cognitive domains such as memory, attention, and executive function. These effects were particularly evident in mild cognitive impairment and vascular cognitive impairment. The results lack consistency across studies, and there is significant heterogeneity in terms of sample size, follow-up duration, and methodological quality. While current evidence suggests that citicoline may be considered a potential supportive agent for age-related cognitive decline and early-stage cognitive impairment, larger-scale, double-blind, and methodologically robust randomized controlled trials are needed to draw definitive conclusions regarding its efficacy.

Anahtar Kelimeler

• Citicoline
• cognitive function
• dementia
• mild cognitive impairment
• aging

Yaşlanma Süreci ve Bilişsel Bozukluklarda Sitikolin Kullanımı: Güncel Klinik Kanıtların Sistematik Derlemesi

Öz

Sitikolin (CDP-kolin), hücre membranı fosfolipid sentezindeki rolü, nörotransmitter düzenleyici etkileri ve nöroprotektif özellikleri nedeniyle bilişsel bozuklukların tedavisinde potansiyel bir ajan olarak uzun süredir araştırılmaktadır. Bu sistematik derlemenin amacı, yaşlı bireylerde ve bilişsel işlev bozukluklarında sitikolin kullanımına ilişkin güncel klinik kanıtları PRISMA 2020 rehberine uygun biçimde değerlendirmektir. Literatür taraması PubMed, Scopus, Web of Science ve Cochrane veri tabanlarında 2010–2025 yılları arasında yayımlanan çalışmalarla sınırlandırılmıştır. İnsan katılımcılarla yürütülen randomize kontrollü çalışmalar ile prospektif ve retrospektif gözlemsel çalışmalar derlemeye dahil edilmiştir. Uygunluk açısından tam metni değerlendirilen 58 makaleden nihai olarak dahil edilme kriterlerini karşılayan 16 çalışma sistematik derlemeye alınmıştır. İncelenen çalışmaların bir bölümünde sitikolin kullanımının bellek, dikkat ve yürütücü işlevler gibi bilişsel alanlarda ölçülebilir değişikliklerle ilişkili olduğu bildirilmiş; bu bulgular özellikle hafif bilişsel bozukluk ve vasküler bilişsel bozukluk olgularında daha belirgin görülmüştür. Sonuçlar çalışmalar arasında tutarlılık göstermemekte olup, örneklem büyüklüğü, izlem süresi ve metodolojik kalite açısından belirgin heterojenlik mevcuttur. Mevcut kanıtlar, sitikolinin yaşa bağlı bilişsel gerileme ve erken evre bilişsel bozukluklarda potansiyel bir destekleyici ajan olarak değerlendirilebileceğine işaret etmekle birlikte, etkinliğine ilişkin kesin çıkarımlar yapılabilmesi için daha geniş örneklemli, körleme içeren ve metodolojik açıdan güçlü randomize kontrollü çalışmalara ihtiyaç bulunmaktadır.

Anahtar Kelimeler

• Sitikolin
• bilişsel işlevler
• demans
• hafif bilişsel bozukluk
• yaşlanma

Kaynakça

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