Acetyl-L-Carnitine in Dementia and Other Cognitive Disorders: A Critical Update
Open accessAbstract
Several studies explored the effects of acetyl-L-carnitine (ALC) in dementia, suggesting a role in slowing down cognitive decline. Nevertheless, in 2003 a systematic review concluded there was insufficient evidence to recommend a clinical use, although a meta-analysis in the same year showed a significant advantage for ALC for clinical scales and psychometric tests. Since then, other studies have been published; however, a critical review is still lacking. We provide an update of the studies on ALC in primary and secondary dementia, highlighting the current limitations and translational implications. Overall, the role of ALC in dementia is still under debate. The underlying mechanisms may include restoring of cell membranes and synaptic functioning, enhancing cholinergic activity, promoting mitochondrial energy metabolism, protecting against toxins, and exerting neurotrophic effects. The effects of ALC on the gut–liver–brain axis seem to identify the category of patients in which the new insights contribute most to the mechanisms of action of ALC, likely being the liver metabolism and the improvement of hepatic detoxifying mechanisms the primary targets. In this framework, our research group has dealt with this topic, focusing on the ALC-related cross-talk mechanisms. Further studies with homogeneous sample and longitudinal assessment are needed before a systematic clinical application.
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Research findings are mixed regarding A-GPC's potential to impact cognition.
“Currently, research findings are mixed regarding A-GPC’s potential to impact cognition [7,8].”
From Acute Alpha-Glycerylphosphorylcholine Supplementation Enhances Cognitive Performance in Healthy Men (2024) · cites this paper as [7]
The Introduction (§1.3) and Discussion (§4.1) describe mixed findings for acetyl-L-carnitine (ALC), not A-GPC. Searches for A-GPC, alpha-GPC, and choline alfoscerate found no passage addressing A-GPC’s effects on cognition in our copy. (LLM, conf=0.78)
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- Authors
- Pennisi, M., Lanza, G., Cantone, M., D’Amico, E., Fisicaro, F., Puglisi, V., Vinciguerra, L., Bella, R., Vicari, E., & Malaguarnera, G.
- Affiliations
- University of Catania (IT)
- Department of Neurology, Sant’Elia Hospital, Azienda Sanitaria Provinciale (ASP) Caltanissetta, Via Luigi Russo 6, 93100 Caltanissetta, Italy
- Azienda Socio Sanitaria Territoriale di Cremona (IT)
- Corresponding author
- Lanza, Giuseppe
- ORCID
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2020-05-12
- Volume
- 12
- Issue
- 5
- Pages
- 1389
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC7284336
- OpenAlex
- W3024670105
- Cited by
- 87
- References
- 119
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 19 · 2023: 15 · 2022: 20 · 2021: 9 · 2020: 6
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Neuroscience › Neurology › Neurological Disorders and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- acetyl-L-carnitine, dementia, cognitive decline, Alzheimer's disease, cholinergic activity, mitochondrial bioenergetics, neurotrophic effects, gut-liver-brain axis, hepatic detoxification, synaptic function, cognitive impairment
- MeSH terms
- Acetylcarnitine, Brain, Cognition, Cognition Disorders, Dementia, Humans, Liver, Nootropic Agents, Translational Research, Biomedical
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