Level of Evidence = C


Nicergoline may show some positive effects on cognition and behaviour in older patients with mild to moderate cognitive impairment of various origins.

A Cochrane review [1] included 14 studies. The follow-up time ranged from 2 to 12 months. There was a difference in favour of the active treatment in reducing the behaviour symptoms described by the Sandoz Clinical Assessment Geriatric Scale (-5.18 points out of 133 points, 95% CI -8.03 to -2.33, n=814). In general other behavioural outcome measures with include the GSR, the IADL, and the MACC failed to show statistically significant results. There was a difference between treatment and control groups in MMSE favouring nicergoline treatment (effect size 2.86, 95% CI 0.98 to 4.74 at 12 months, assessed in 261 patients). The effect size for the ADAS-Cog, used exclusively with Alzheimer´s disease patients, did not reveal a significant benefit. Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals) and by inconsistency (heterogeneity in interventions and outcomes).The drug has not been evaluated using current diagnostic categories such as MCI or in association with therapeutic agents of different nature such as cholinesteralse or antioxidant drugs.