Background: the issues of early diagnosis and therapy of cognitive disorders that do not reach the degree of dementia remain relevant.The purpose of the research was to study the immediate and long-term effects of course cholinergic therapy (choline alfoscerate, CA) in patients with an amnestic mild cognitive impairment (aMCI).Patients and methods: in the course of an open comparative prospective study, the dynamics of cognitive functioning indicators were analyzed in 150 patients with aMCI who received infusion or oral course therapy in comparison with the control group (without treatment). All patients were divided into 3 groups. The first group of patients received an infusion course of CA (Gliatilin), the second group received an oral course of the drug (Gliatilin), the third group (control) did not receive treatment. MRI, clinical-psychological, psychometric, statistical methods were used in the study.Results: it has been shown that course therapy with CA has a positive effect on cognitive functioning in patients with aMCI in both therapeutic groups. The greatest effectiveness was observed in group 1 patients who underwent an infusion course of therapy for a month. In group 2 patients who took CA orally for 2 months, there was also an improvement in cognitive functions, however, in the control group there was a statistically significant decrease in cognitive functioning after 90 days of follow-up, in two cases (4%). This trend continued after a year of follow up. The indicators of improvement of cognitive status compared to the baseline level remained in 41% of cases in patients of group 1 and only in 28% and 2% in patients of group 2 and 3 respectively. Only in group 3 Alzheimer’s disease was diagnosed in 2 patients (4%) after a year of follow-up.Conclusion: the long-term positive effect of CA on cognitive functioning allows us to consider the drug as a possible model of therapy aimed at preventing the progression of cognitive deficits and the development of dementia in people with aMCI.