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The Cognitive Vulnerability of Older APOE4 Carriers to Weight Loss Clinical trial evidence suggests that APOE4 increases cognitive vulnerability to weight loss

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[21] In a 2003 meta-analysis of 21 clinical trials, a total of 1,204 adults with mild cognitive impairment took supplements containing 1.5 g to 3.0 g/day acetyl L-carnitine (ALCAR) or placebo for 3 to 12 months

It has demonstrated beneficial effects in treating energy impairments in several neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease and Huntington's disease (reviewed by Adhihetty and Beal, G93A mice prevented loss of motor neurons, protected neurons from oxidative damage in the spinal cord, and improved motor performance and survival of mice in a dose dependent manner (Klivenyi et al., 1999)