Nootropic Research Articles

Update on Cognitive Enhancers Among the Older Adult Population: A Clinical Review.

The purpose of this review is to identify key classes of medications that are used for the treatment of older adults with neurocognitive disorders. Clinical factors play a critical role in the prescribing of these medication classes for the treatment of dementia. The variation in prescribing trends is determined by the presence of medical and psychiatric comorbidities commonly occurring in older adults and is based on the consideration of potential interactions between pharmacotherapies for the comorbidities and for the dementia. Six medication classes currently exist to address the neurocognitive aspect of dementia, with varying pharmacokinetic and pharmacodynamic profiles. We review these six classes in this report and provide a provision of clinical insights regarding the use of these agents. While literature exists on the safety and efficacy of individual medication options for the treatment of dementia in the older adult population, further research is needed to provide clearer guidance regarding the specific use of these agents in clinical practice.

Modern doctors' view on the problem of diagnostics and treatment of asthenic syndrome in different regions of the Russian Federation

Introduction: The problem of asthenic disorders is determined by their high prevalence, the lack of diagnostic criteria and recommendations for therapy, and the absence of unified principles of coding in ICD-10. The aim of the study was to evaluate the current practice of neurologists and physicians of the Russian Federation (RF) in the diagnosis and pharmacotherapy of asthenic syndrome (AS). Materials and Methods: An anonymous author-developed questionnaire survey of physicians on the issues of diagnostics and treatment of asthenia was conducted on the Google forms platform. Results: Total 238 specialists from 23 regions of the RF, 62.5% of neurologists and 37.5% of physicians, took part in the survey. Women suffer from AS more often than men. AS is most frequently verified at the age of 40-60 (65.5%) and under 40 (39.6%). Doctors use the codes G90.8 – other disorders of the autonomic nervous system – and I67.8 – other specified cerebral vascular lesions. The main causes of AS are affective disorders in 67.2% of patients and infectious diseases in 70% of patients. Almost 67% of doctors use anxiety and depression assessment scale, and only 13% of respondents use MFI-20 scale. The choice of therapy depended on the psychopathologic syndrome in 73.9% of cases. Most doctors favored nootropic drugs, metabolic action drugs, and B vitamins. Conclusion: The current medical practice of diagnosing and treating AS was studied and informative data were obtained with regard to understanding the clinical-typological structure and nosological affiliation of AS. The results demonstrate the expediency of developing a unified algorithm for the management of patients with various manifestations of AS.

TECH preserves global cognition of older adults with MCI compared with a control group: a randomized controlled trial

BackgroundCognitive training using touchscreen tablet casual game applications (apps) has potential to be an effective treatment method for people with mild cognitive impairment (MCI).AimsThis study aimed to establish the effectiveness of ‘Tablet Enhancement of Cognition and Health’ (TECH), a novel cognitive intervention for improving/preserving cognition in older adults with MCI.MethodsA single-blind randomized controlled trial with assessments pre-, post-, and at 6-month follow-up was conducted. TECH entailed 5 weeks of daily self-training utilizing tablet apps, facilitated by weekly group sessions. Global cognition was assessed by the Montreal Cognitive Assessment (MoCA), and specific cognitive components were assessed using WebNeuro computerized battery. Short Form Health Survey (SF-12) assessed health-related quality of life (HRQoL). Intention-to-treat analysis was conducted and the %change was calculated between pre–post and between pre–follow-up. Cohen’s d effect size was also calculated.ResultsSixty-one participants aged 65–89 years were randomly allocated to TECH (N = 31, 14 women) or to standard care (N = 30, 14 women). Pre–post and pre–follow-up MoCA %change scores were significantly higher in TECH than control (U = 329.5, p < .05; U = 294.5, p < .05) with intermediate effect size values (Cohen’s d = .52, Cohen’s d = .66). Forty percent of TECH participants versus 6.5% of control participants achieved a minimal clinical important difference in MoCA. Pre–post between-group differences for specific cognitive components were not found and HRQoL did not change.Discussion and conclusionsTECH encouraged daily self-training and showed to preserve global cognition of older adults with MCI. The implementation of TECH is recommended for older adults with MCI, who are at risk for further cognitive decline.

Potentiation of prefrontal cortex dopamine function by the novel cognitive enhancer d-govadine

Cognitive impairment is a debilitating feature of psychiatric disorders including schizophrenia, mood disorders and substance use disorders for which there is a substantial lack of effective therapies. d-Govadine (d-GOV) is a tetrahydroprotoberberine recently shown to significantly enhance working memory and behavioural flexibility in several prefrontal cortex (PFC)-dependent rodent tasks. d-GOV potentiates dopamine (DA) efflux in the mPFC and not the nucleus accumbens, a unique pharmacology that sets it apart from many dopaminergic drugs and likely contributes to its effects on cognitive function. However, specific mechanisms involved in the preferential effects of d-GOV on mPFC DA function remain to be determined. The present study employs brain dialysis in male rats to deliver d-GOV into the mPFC or ventral tegmental area (VTA), while simultaneously sampling DA and norepinephrine (NE) efflux in the mPFC. Intra-PFC delivery or systemic administration of d-GOV preferentially potentiated medial prefrontal DA vs NE efflux. This differential effect of d-GOV on the primary catecholamines known to affect mPFC function further underscores its specificity for the mPFC DA system. Importantly, the potentiating effect of d-GOV on mPFC DA was disrupted when glutamatergic transmission was blocked in either the mPFC or the VTA. We hypothesize that d-GOV acts in the mPFC to engage the mesocortical feedback loop through which prefrontal glutamatergic projections activate a population of VTA DA neurons that specifically project back to the PFC. The activation of a PFC-VTA feedback loop to elevate PFC DA efflux without affecting mesolimbic DA release represents a novel approach to developing pro-cognitive drugs.

Insulin-like growth factor 2 (IGF-2) rescues social deficits in NLG3-/y mouse model of ASDs.

Autism spectrum disorders (ASDs) comprise developmental disabilities characterized by impairments of social interaction and repetitive behavior, often associated with cognitive deficits. There is no current treatment that can ameliorate most of the ASDs symptomatology; thus, identifying novel therapies is urgently needed. Here, we used the Neuroligin 3 knockout mouse (NLG3-/y), a model that recapitulates the social deficits reported in ASDs patients, to test the effects of systemic administration of IGF-2, a polypeptide that crosses the blood-brain barrier and acts as a cognitive enhancer. We show that systemic IGF-2 treatment reverses the typical defects in social interaction and social novelty discrimination reflective of ASDs-like phenotypes. This effect was not accompanied by any change in spontaneous glutamatergic synaptic transmission in CA2 hippocampal region, a mechanism found to be crucial for social novelty discrimination. However, in both NLG3+/y and NLG3-/y mice IGF-2 increased cell excitability. Although further investigation is needed to clarify the cellular and molecular mechanisms underpinning IGF-2 effect on social behavior, our findings highlight IGF-2 as a potential pharmacological tool for the treatment of social dysfunctions associated with ASDs.

Pharmacological effects of fonturacetam (Actitropil) and prospects for its clinical use

Phenylpiracetam (PP) is a nootropic drug with additional pharmacological effects, including anxiolytic, antiasthenic, antidepressant, anti-inflammatory and anticonvulsant effects. The paper presents the results of an analysis of experimental and clinical studies, which indicate the prospects for the use of PP in cerebral ischemia, neurodegenerative pathologies, epilepsy, asthenia, and mental disorders. The adaptogenic properties and mitochondrial protective effect of PP are considered, assessments of the possible effect of PP on neurotransmitter systems, regulation of carbohydrate and fat metabolism with the prospects for the use of PP in patients with metabolic syndrome.

α7 nicotinic acetylcholine receptors induce long-term synaptic enhancement in the dorsal but not ventral hippocampus.

Agents that positively modulate the activity of α7nAChRs are used as cognitive enhancers and for the treatment of hippocampus-dependent functionaldecline. However, it is not known whether the expression and the effects of α7nAChRs apply to the entire longitudinal axis of the hippocampus equally. Given that cholinergic system-involving hippocampal functions are not equally distributed along the hippocampus, we comparatively examined the expression and the effects of α7nAChRs on excitatory synaptic transmission between the dorsal and the ventral hippocampal slices from adult rats. We found that α7nAChRs are equally expressed in the CA1 field of the two segments of the hippocampus. However, activation of α7nAChRs by their highly selective agonist PNU 282987 induced a gradually developing increase in field excitatory postsynaptic potential only in the dorsal hippocampus. This long-term potentiation was not reversed upon application of nonselective nicotinic receptor antagonist mecamylamine, but the induction of potentiation was prevented by prior blockade of α7nAChRs by their antagonist MG 624. In contrast to the long-term synaptic plasticity, we found that α7nAChRs did not modulate short-term synaptic plasticity in either the dorsal or the ventral hippocampus. These results may have implications for the role that α7nAChRs play in specifically modulating functions that depend on the normal function of the dorsal hippocampus. We propose that hippocampal functions that rely on a direct α7 nAChR-mediated persistent enhancement of glutamatergic synaptic transmission are preferably supported by dorsal but not ventral hippocampal synapses.

Behavioral economics enhancers

Abstract Recent meta-analyses suggest that certain drugs act as cognitive enhancers and can increase attentional investment and performance even for healthy adults. The current review examines the potential of behavioral economics enhancers (BEEs) for similarly improving cognitive performance and judgments. Traditionally, behavioral economics theory has adopted a skeptical approach regarding the notion of whether individuals can overcome judgment biases through variables that increase cognitive effort. We focus mostly on the effects of two BEEs: incentivization and losses. Summarizing results from different meta-analyses, we find a small but robust positive effect size for BEEs, with comparable effect sizes to those found in studies of pharmacological cognitive enhancers.

Integrated yoga changes attention, motor, and mental function in expecting mothers: A randomized controlled trial

ABSTRACT Background: Pregnancy is a natural phenomenon associated with several changes including attention, learning motor function, and other psychological domains. Substantial evidence shows that decreased cognitive function and increased anxiety levels during pregnancy affect the day-to-day activities of pregnant women. Scientific investigations on yoga reported enhancement of cognition and improvement of mental health. Objective: The present study was planned to explore the effect of integrated yoga (IY) on attention, motor speed, and mental speed among expecting mothers. Materials and Methods: Total 96 expected mothers aged between 20 and 35 years and having 18­20 weeks of gestation were recruited for the study and randomized into the yoga group and control group. The yoga group practiced IY and the control group practiced standard exercise. Pre- and posttests were done at the baseline and at 36th week. Results: The result showed a significant improvement in divided attention (p &lt; 0.001), focused attention (p &lt; 0.001), sustained attention (p &lt; 0.001), mental speed (p &lt; 0.001), and motor speed (p &lt; 0.001) in the yoga group. There was also improvement in the control group, but Mann­Whitney U-test revealed that the magnitude of change in the yoga group was higher than the control group. Conclusion: This study showed that integrated antenatal yoga starting from the second trimester helps in improving cognitive functions among expecting mothers.

A Framework for Developing Haptics Based Virtual Environment for Spatial Cognition Enhancement in Autistic People

A Framework for Developing Haptics Based Virtual Environment for Spatial Cognition Enhancement in Autistic People

Cognitive Enhancing Activities of Coenzyme Q10, Ramipril, and Vinpocetine Through Modulating Neuroinflammatory Response and Oxidative Damage Inflicted by Acute REM Sleep Deprivation in Rats

Sleep plays a vital role to help in normal biological functions that are required for normal cognitive functioning. This study was done to determine the cognition-modulating effects of coenzyme Q10 (CoQ10), ramipril, and vinpocetine on REM sleep-deprived acute insomniac rat models. A total of Forty-eight albino rats were divided into eight groups (Gr) (n=6).). Gr. 1 was REM control and Gr. 2 was REM sleep-deprived rats treated with water. Gr. 3 to Gr.8 - REM sleep-deprived rats were administered corn oil, donepezil, vinpocetine, coenzyme Q10+corn oil, ramipril, and (coenzyme Q10 + corn oil + ramipril) respectively. Except for the control Gr 1, REM sleep deprivation was induced in Gr. 2 and 8 daily for 7 days. All the rats were subjected to a Morris water maze (MWM) to test the navigation memory dysfunction after 7 days of acute insomnia. The rats were deprived of REM sleep by using a modified multiple platform method. The body weight of the animals was measured on day 1 and day 7. On day 1 and Day 2 acquisition trials, all groups of rats showed comparable latency time required to reach the hidden platform. However, on day 3 and Day 4, rats treated with coenzyme Q10, ramipril, and the combination (CoQ10+ Ramipril) showed a significant decrease in latency time (p&lt;0.01). In the probe trial, sleep-deprived rats showed a significant decrease (p&lt;0.001) in the percentage of time spent in the target quadrant as compared to the REM control. However, there was a significant increase in the percentage time spent in CoQ10, ramipril, the combination (CoQ10+ ramipril), donepezil, and vinpocetine as compared to sleep-deprived rats (p&lt;0.05). At the end of day 7 of insomnia, when the body weight of rats was compared with day 1, there was a significant decrease in weight gain was seen with the sleep-deprived rats treated with corn oil, ramipril, vinpocetine, CoQ10, and (CoQ10+ramipril) (p&lt;0.05). The present study shows that coenzyme Q10, ramipril, and their combination improve sleep deprivation induced cognition impairment.

Smart drugs among students – multidimensional view on present ways of cognitive enhancement

Background: Nootropic drugs, at the beginning of their career, were used in the treatment of diseases such as attention deficit hyperactivity disorder (ADHD), Alzheimer's disease and narcolepsy. Nowadays, they are becoming more and more popular among students, where they are often called smart drugs or cognitive enhancers. Their properties that improve intellectual abilities and cognitive functions are used to, among other things, improve academic performance.&#x0D; Aim of the study: The purpose of this article was to summarize the current state of knowledge relating to the use of smart drugs among students. This study discusses the multidimensional issues of using this group of drugs.&#x0D; Material and methods: A cross-sectional search of relevant literature was performed in databases using accepted wording. Publications from 2003-2023 were included. The entire process has been supplemented with additional procedures to increase the reliability of this publication.&#x0D; Results: In most sources, the most common representative of smart drugs turned out to be methylphenidate. Nootropics were most often obtained by obtaining a prescription from a doctor, online trading or from friends. The factors motivating the use of substances from this group are primarily the desire to improve academic results, competitiveness and the number of obligations at the university. There are many risks associated with their use, but students are more aware of the positive effects.&#x0D; Conclusion: This paper presents various dimensions of the progressive spread of nootropic drugs. In addition to their undeniably positive effects, there are many risks, which are discussed in this article. Students' awareness should be formed through appropriate educational methods.

The Neuroprotective Effects of Piracetam on Cisplatin-Induced Cognitive Decline

ABSTRACT Aim This work explores the effect of Cisplatin—a chemotherapeutic agent known to cause deterioration in cognitive function in cancer patients, and spatial memory in mice. It also investigates the potential neuroprotective effects of Piracetam, which is a nootropic drug recognized for improving cognitive ability. Materials and Methods The study incorporates four groups of mice receiving varied medication regimens, with memory tested using the Novel Location Recognition (NLR) method. Results The findings from our study revealed that memory decline and a suppression of cellular proliferation were observed in adult male mice subjected to Cisplatin treatment; furthermore, a decline in antioxidant efficacy within the hippocampal dentate gyrus was evident. Moreover, analysis of treatment effects on the animals’ weight revealed that the Cisplatin and Piracetam group exhibited the most significant weight loss during drug administration. Despite the significant weight loss, the simultaneous use of Cisplatin and Piracetam demonstrated a notable improvement in memory and an augmentation of hippocampal proliferation and antioxidant effect. Limitations It is important to note that our study was hampered by budget limits, a lack of additional animals, and mice’s low tolerance for protracted treatment. Conclusions Should the outcomes of Piracetam observed in this investigation be applicable to patients, it might offer a relatively straightforward approach to mitigate the cognitive impacts endured by cancer survivors following exposure to chemotherapy. Future research will be needed to study Piracetam’s effect on mice with brain cancer after Cisplatin treatment in order to extrapolate the results onto cancer patients.

Therapeutic Effects of Glycyrrhiza Glabra Linn.

Glycyrrhiza glabra Linn. (Licorice, Yashtimadhu in Sanskrit; Family: Fabaceae) is a popular Indian medicinal plant mentioned as a Medhya Rasayana in Ayurvedic literatures and Nighantus. The important chemical constituent of Yashtimadhu is glycyrrhizin (about 2-9%), Glycyrrhetinic acid (glycyrrhetic) (0.5-0.9%). Isoflavonoids, chalcones, triterpenoids, coumarins, sterols, amino acids, amines, lignans, gums and volatile oils are other active constituents. These are found to be responsible for its various activities like antiulcer activity, wound healing activity, eye problems, cognitive function enhancing activity, anti-inflammatory, antioxidant activity, anti-tussive activity etc. Recent researches have also shown its positive effect as a memory enhancer, neuroprotectant, and attenuating neuroinflammation. In Ayurveda, Medhya rasayana comprises a major category of nootropic herbs that are indicated for all mental disorders. Yashtimadhu is one of Medhya drugs mentioned to enhance mental abilities, concentration, cognitive function and intelligence. The objective of this paper is to review the literature regarding its traditional uses, its impact on the Doshas, and the scientific evidence supporting its therapeutic properties.

Exploring thienothiadiazine dioxides as isosteric analogues of benzo- and pyridothiadiazine dioxides in the search of new AMPA and kainate receptor positive allosteric modulators

The synthesis and biological evaluation on AMPA and kainate receptors of new examples of 3,4-dihydro-2H-1,2,4-thieno[3,2-e]-1,2,4-thiadiazine 1,1-dioxides is described.The introduction of a cyclopropyl chain instead of an ethyl chain at the 4-position of the thiadiazine ring was found to dramatically improve the potentiator activity on AMPA receptors, with compound 32 (BPAM395) expressing in vitro activity on AMPARs (EC2x = 0.24 μM) close to that of the reference 4-cyclopropyl-substituted benzothiadiazine dioxide 10 (BPAM344).Interestingly, the 4-allyl-substituted thienothiadiazine dioxide 27 (BPAM307) emerged as the most promising compound on kainate receptors being a more effective potentiator than the 4-cyclopropyl-substituted thienothiadiazine dioxide 32 and supporting the view that the 4-allyl substitution of the thiadiazine ring could be more favorable than the 4-cyclopropyl substitution to induce marked activity on kainate receptors versus AMPA receptors.The thieno-analogue 36 (BPAM279) of the clinically tested S18986 (11) was selected for in vivo evaluation in mice as a cognitive enhancer due to a safer profile than 32 after massive per os drug administration. Compound 36 was found to increase the cognition performance in mice at low doses (1 mg/kg) per os suggesting that the compound was well absorbed after oral administration and able to reach the central nervous system.Finally, compound 32 was selected for co-crystallization with the GluA2-LBD (L504Y,N775S) and glutamate to examine the binding mode of thienothiadiazine dioxides within the allosteric binding site of the AMPA receptor. At the allosteric site, this compound established similar interactions as the previously reported BTD-type AMPA receptor modulators.

Exploring the potential for cognition enhancement with derivatives of P-benzoquinone

Exploring the potential for cognition enhancement with derivatives of P-benzoquinone

Potential cognitive enhancers: Discovery and development of multi‐targeting aminoalkyl chalcones

AbstractBackgroundInhibition of acetylcholinesterase (AChE) enzyme is considered as the most promising approach to improve the cognitive deficit complex disorders such as Alzheimer’s disease, dementia etc. The AChE also promote the aggregation of amyloid‐β complexes, mitochondrial dysfunction, a buildup of oxidative stress and neuronal cell death. Consequently, the development of compounds having polyfunctional potential could manage the complex neurodegenerative disorders like Alzheimer’s disease.MethodThe chalcone analogues were developed using bioisosteric replacement and SBDD strategies having improved therapeutic potential. The kinetics and interaction pattern with target protein of designed analogues were further evaluated using in silico methods. The leading compounds were synthesized and evaluated against AChE, AGEs formation with additional radical scavenging potential.ResultThe docking results revealed that synthesized chalcones properly fit into the active gorge of the target enzyme and displayed crucial interactions with the peripheral and catalytic sites of and having drug like properties. The in vitro assays of designed compounds against different targets showed IC50 values in nano to micro molar range.ConclusionThe dynamic simulations of the designed compounds will be carried out to evaluate the stability of the target‐ligand complex. Thus, the designed chalcones could be taken further to improve cognition deficit mainly in Alzheimer’s disease.

Evaluation of the cognitive enhancing properties of diosmin in lipopolysaccharide‐induced memory impairment in mice

AbstractBackgroundCognitive impairment is a major feature of many neurodegenerative disorders such as Alzheimer’s disease, dementia etc. The progressive cognitive decline in Alzheimer’s disease (AD) can be attributed to the fact that current anti‐Alzheimer’s drug only treat AD symptoms without completely reversing cognitive impairment in AD patients. Therefore, it is imperative to develop new therapeutic remedies that can improve memory and ameliorate cognitive impairment in AD patients. Disomin is a flavone with antioxidant, anti‐inflammatory and anti‐apoptotic properties. This study evaluated the neuroprotective effects of diosmin on LPS‐induced cognitive impairment in mice.MethodThirty‐six Swiss mice were randomly divided into six groups (n = 6). Group 1 received vehicle, group 2 received vehicle, groups 3 to 5 received diosmin (50, 100 and 200 mg/kg, p.o.) respectively group 6 received donepezil (50 mg/kg, p.o.). Sixty minutes after the treatment with the vehicle/Diosmin/Donepezil, lipopolysaccharide (LPS) (250ug/kg, i.p.) was administered daily to groups 2 to 6 for seven days. Twenty‐four hours after treatment on day 7, mice were subjected to Y‐maze test and the Novelty object recognition test (NORT) to assess their spatial and non‐spatial working memory. Subsequently, the mice were sacrificed and their brain samples were harvested for biochemical analysis (TNF‐alpha, Interferon gamma and interleukin‐12), immunohistochemical examinations (Amyloid beta, BDNF, IBA‐1, NLRP3 expression) and Golgi staining procedure for morphological alterations.ResultOur data shows that diosmin increased percentage alternation in Y‐maze test and discrimination ratio in NORT compared with the control group. Diosmin significantly (p&lt;0.05) decreased TNF‐alpha, Interferon gamma and interleukin‐12 and reduced neurodegeneration in the CA1 region of the hippocampus &amp; dendate gyrus when compared with the control group.ConclusionDiosmin reversed LPS‐induced cognitive impairment, which can be attributed to its neuroprotective and anti‐inflammatory properties.

Symptomatic Alzheimer’s Disease Therapy Utilization in 3 National Cohorts

AbstractBackgroundAlthough the positive results of the first disease modifying therapies is anticipated to moderately slow disease progression, significant need remains for cognitive enhancers to address AD symptoms and improve quality of life. Despite potential benefits of current treatments, the literature suggests that a large percentage (40‐60%) of AD patients do not use symptomatic treatments for AD and treatment patterns may have considerable geographic variation.MethodPatients with AD (ICD‐10 code G30 or READ code for AD) in 2018‐2019, with ≥1‐year baseline period before index date (first AD diagnosis date during 2018‐2019) and ≥1‐year follow‐up after the index date were selected from the US Humana Research Database (Humana) and the UK Clinical Practice Research Datalink GOLD (CPRD). Patients with an AD diagnosis during the baseline period were excluded. Within the Japan Medical Data Vision (MDV) database, an ICD‐10 code for AD (G30) was required prior to/on the same date as the first provider visit with an associated prescription for a specified AD medication during the 2018‐2020 study period (defined as the index date). Patients with AD medication visits ≤6 months before the index date were excluded. Percentages of patients initiating donepezil, rivastigmine, galantamine, and memantine, median time on first therapy, and use of a second therapy were calculated.ResultAD therapy was initiated by 35,459, 8,901, and 51,115, patients in the US, UK, and Japan, respectively. Sixty‐three percent were female, in the US and UK, and 59% in Japan; mean age ranged from 81‐82 years. Donepezil was used most frequently (69%, 61%, and 50%), followed by memantine monotherapy (19%, 28%, and 22%) in the US, UK, and Japan, respectively. Median time on first therapy was 213, 334, and 111 days, and a second treatment was used by 30%, 12%, and 10%, respectively.ConclusionIn contemporary cohorts of US, UK, and Japanese individuals newly initiating symptomatic AD therapy, donepezil was the most frequently used therapy followed by memantine monotherapy. Time on first therapy was relatively short (&lt;1 year) and the majority of patients did not utilize a second therapy. These results underscore the unmet need for additional therapies to alleviate the significant burden of AD.

Analysis of persistence rate of cognitive enhancers in Alzheimer’s disease using the common data model

AbstractBackgroundAchEIs are used by first‐diagnosed Alzheimer’s dementia patients. The effect of drug has been proven in safety and efficacy but it is known that the drug cannot be taken continuously due to side effects of about 10% in existing studies. However, studies report higher drug discontinuation rates. Cognitive function improvers or ‘nootropics’ such as choline alfocerate are used together with AchEI. Therefore, purpose of this study was to analyze the usage patterns of cognitive enhancers in Alzheimer’s patients and to confirm retention rate using a common data model.MethodFrom 2010 to 2019, using the data of Alzheimer’s patients registered in the common data model server of Kangwon National University Hospital, we will investigate the prescription rate of cognitive function improving drugs (choline alfocerate) and drug analysis patterns such as ChEI and combination therapy. The analysis is conducted using the FeederNet‐based ATLAS WEB tool, and additional analysis is compared with the results obtained through the DBMS approach using SQL.ResultAs a result of the analysis of treatment trends and persistence for 10 years, among 2,658 newly diagnosed patients with Alzheimer’s disease, donepezil was prescribed the most with 1,518 patients (57.11%), choline alfocerate with 654 patients (24.6%), and memantine with 214 patients. (8.05%), rivastigmine in 74 (2.78%), and galantamine in 147 (5.53%) each. During observation, trend of increasing prescriptions was Donepezil (31.5% in 2010 to 68.7% in 2019), Nootropics (24.6% in 2010 to 34.2% in 2019), Memantine (3.7% in 2010 to 7.9% in 2019), and Rivastigmine(0.53% in 2010 to 3.32% in 2019), while galantamine decreased (12.2% in 2010 to 0.3% in 2019). Persistence was approximately 50% for donepezil and memantine and approximately 40% for rivastigmine, galantamine and choline alfocerate over 12 monthsConclusionComparing treatment trends of cognitive function improvers, donepezil, memantine, ribistigmine, and choline alfocerate showed a tendency to increase, whereas galantamine showed a tendency to decrease. Also, donepezil and memantine were associated with longer persistence than rivastigmine and galantamine and choline alfocerate. In particular, in case of Nootropics, a high rate of initial prescription is given to patients with dementia, but rate of continuous prescription is not high.