Cipolli C, Chiari G
Clin Ter. 1990 Mar 31;132(6 Suppl):479-510.
In this paper the preliminary findings of a multicentre study on the effects of Acetyl-L-Carnitine on mildly impaired elderly are reported. Statistical analysis was carried out on 236 out of 469 subjects sampled in 42 different Italian geriatric or hospital units. Each subject was treated over 150 days, and a battery of tests (investigating cognitive functioning, emotional-affective state and relational behavior) was administered at the beginning on the treatment and the conclusion of each of its four phases. In the first and the last phases there was a 30 days placebo treatment (aimed respectively to wash-out the effects of previous drug and to assess the residual effects of the treatment), while in the second and the third ones (both 45 days long) the subjects took 1500 mg/day of Acetyl-L-carnitine. Repeated multivariate analysis of variance and of covariance (taking as independent variables phases of treatment, age, gender, etiology and severity of mental impairment, as dependent variables the scores either of each test administered or of groups of items and as covariants the level of depression and the sensitivity to placebo effect) showed that drug treatment significantly increased the effectiveness of performance on all the measures of cognitive functioning and of emotional-affective state and on some scores of the relational behavior. Age resulted significantly influential on cognitive functioning and relational behavior, but not on emotional-affective state. Severity of mental impairment significantly influenced also several measures of cognitive functioning and relational behavior, while less consistent results were shown for gender and etiology of mental impairment. The placebo effect, although significant for some cognitive processes, was lower than that of treatment. There findings suggest that Acetyl-L-carnitine treatment is effective against the outcomes of mental impairment in the cognitive (in particular, for memory functioning and constructional thinking) and emotional-affective domains, while its effects on relational behaviour are less consistent, probably because they are partly biased in the subjective evaluation of caregivers and relatives by factors such as age and levels of mental impairment and depression.
本文报告了一项关于乙酰左旋肉碱对轻度认知功能受损老年人影响的多中心研究的初步结果。对在意大利42个不同老年病科或医院科室抽取的469名受试者中的236名进行了统计分析。每位受试者接受了150天的治疗，并在治疗开始时、四个阶段中的每个阶段结束时进行了一系列测试（包括认知功能、情绪情感状态和社交行为的调查）。在第一阶段和最后阶段进行了为期30天的安慰剂治疗（分别旨在消除先前药物的影响和评估治疗的残留效果），而在第二阶段和第三阶段（均为45天），受试者每天服用1500毫克乙酰左旋肉碱。重复的多变量方差分析和协方差分析（将治疗阶段、年龄、性别、精神障碍的病因和严重程度作为自变量，将每项测试的得分或项目组的得分作为因变量，将抑郁水平和对安慰剂效应的敏感性作为协变量）表明，药物治疗显著提高了认知功能、情绪情感状态的所有测量指标以及社交行为某些得分的表现效果。年龄对认知功能和社交行为有显著影响，但对情绪情感状态没有影响。精神障碍的严重程度也显著影响了认知功能和社交行为的多项测量指标，而精神障碍的性别和病因方面的结果则不太一致。安慰剂效应虽然对某些认知过程有显著影响，但低于治疗效果。这些发现表明，乙酰左旋肉碱治疗对认知（特别是记忆功能和建构性思维）和情绪情感领域的精神障碍结果有效，而其对社交行为的影响不太一致，可能是因为在照顾者和亲属的主观评价中，这些影响部分受到年龄、精神障碍程度和抑郁水平等因素的影响。
