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Choline alfoscerate (alpha-glycerylphosphorylcholine) is a parasympathomimetic acetylcholine precursor used primarily for cognitive enhancement in dementia and Alzheimer's disease. It works by increasing the synthesis and release of acetylcholine in the brain and providing glycerophosphate for neuronal membrane repair. Clinically, it is approved in several countries, including South Korea and Italy, for Alzheimer's disease, vascular dementia, and cognitive impairment following stroke. Recent research has expanded its potential applications to include the treatment of dry eye disease (keratoconjunctivitis sicca), where it may act as a surfactant and anti-inflammatory agent, and the management of depressive symptoms and insulin resistance in elderly diabetic patients. It is also being investigated for its neuroprotective effects in glioblastoma and ischemic stroke recovery.
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