This systematic review of three RCTs with 358 participants found choline alphoscerate (alpha-GPC) significantly improved clinical conditions in dementia patients compared to citicoline (CDP-choline), including cognitive function, interpersonal relationships, affective disorders, apathy, and somatic functioning. No significant differences were seen in memory or word fluency tests. Dropout rates were similar between groups.

A meta-analysis of 25 studies involving 370 people with anxiety disorders and 342 controls found choline levels 8% lower in the brains of those with generalized anxiety, panic, and social anxiety disorders, particularly in the prefrontal cortex. Researchers suggest nutritional approaches like choline supplementation may help restore brain chemistry, though more research is needed. Most Americans do not get enough choline.

This review highlights clinical evidence that maternal choline supplementation (550 mg/day with DHA) increases maternal and fetal DHA status during pregnancy. Preclinical models show adequate choline preserves metabolic health, slows cognitive decline, and reduces amyloid-β plaques in Alzheimer's disease. Calls for standardized protocols to define optimal supplementation.