These pieces of mostly crap-ware were
possibly useful back in the days of Win 2000 and even to a minor extent with Win XP but not any longer. Just let Windows do its thing. Current versions of Windows handle the registry just fine
While systems do break, from what I've seen, too many issues are caused by this type of software that is supposed to improve performance.
This may sound rather odd but I sort of relate the registry to cookies in a browser. While losing a needed cookie will not hose the system it can still cause issues where you can no longer get auto log in on a site. With the registry it becomes a bit more serious as you may no longer be able to access a program... or, possibly, much worse.
I have ALWAYS looked at registry cleaners/optimizers as a tool that should NEVER be used by anyone that could not do the same thing manually. If you could not do it on your own how can you know how to answer when the cleaner/optimizer presents what it wants to remove?
The registry is a data base of system information. This is partly why I associate it with cookies within a browser. It is sort of like a GPS system. With a GPS enabled device you always know where you are. The Registry and Cookies sort of work the same way in that they let the system know where it is.
Remove the wrong registry entry and the system no longer knows its location resulting in the need for computer help forums...