rospective and observational study to assess the efficacy of citicoline in elderly patients suffering from stupor related to complex geriatric syndrome Original Research (3195) Total Article Views Authors: Putignano S, Gareri P, Castagna A, Cerqua G, Cervera P, Cotroneo AM, Fiorillo F, Grella R, Lacava R, Maddonni A, Marino S, Pluderi A, Putignano D, Rocca F Published Date May 2012 Volume 2012:7 Pages 113 - 118 DOI: http://dx.doi.org/10.2147/CIA.S29366 Received: 21 December 2011 Accepted: 06 February 2012 Published: 23 May 2012 Salvatore Putignano, Pietro Gareri, Alberto Castagna, Giuliano Cerqua, Pasquale Cervera, Antonino Maria Cotroneo, Francesco Fiorillo, Roberto Grella, Roberto Lacava, Antonio Maddonni, Saverio Marino, Alice Pluderi, Daria Putignano, Filomena Rocca Associazione Geriatri Extraospedalieri – Geriatria Italiana Territoriale, Tenore 17, Naples, Italy Abstract: A significant percentage of elderly subjects (50%–80%) suffering from sub-acute ischemic cerebrovascular disease, with or without moderate or severe cognitive memory decline and with or without associated behavioral and psychological symptoms, shows a complex syndrome. This syndrome is related to the progressive impairment of health conditions and/or stressing events (ie, hospitalization), characterized by confusion and/or stupor, which are consequently difficult to manage and require a great deal of care. Geriatric patients often suffer from multiple chronic illnesses, may take numerous medications daily, exhibit clinical instability, and may experience worsening of medical conditions following cerebral ischemic events and thus have an increased risk of disability and mortality. There are several studies in literature which demonstrate the efficacy of citicoline, thanks to its neuroprotective function, for the recovery and in postischemic cerebral rehabilitation. It has been shown that, even soon after an ischemic stroke, administration of oral citicoline (500–4000 mg/day) improves the general conditions evaluated with the Rankin scale and the National Institute of Health Stroke Scale 12. In particular, it has been shown that the CDP-choline improves the cognitive and mental performance in Alzheimer's dementia and vascular dementia. We have evaluated the administration of citicoline in geriatric patients following a protocol of intravenous study on improvement of individual performances.