From Our 2012 Archives
Nicotine Patch May Improve Memory in Pre-Dementia Patients
Small Study Shows Significant Benefits in Memory
By Matt McMillen
Reviewed by Laura J. Martin, MD
A new study published in the journal Neurology shows that wearing a nicotine patch improved the brain performance of such adults.
The study, which the authors acknowledge was a small one, involved 45 men and 29 women. The average age of the group was 76, and just over half were former smokers. Each of them showed signs of early memory loss, but their symptoms were not severe enough to qualify for a diagnosis of dementia.
Dementia is an umbrella term for certain brain disorders involving problems with memory and thinking, including Alzheimer's disease.
The participants were divided into two groups. For six months, one group wore 15-milligram nicotine patches, while the other was given a placebo. Each patient took memory and brain function tests at three separate times: one at the beginning of the study, another halfway through, and a final test at the study's conclusion.
By the end of the study, the patients who had worn the nicotine patches were better able to pay attention, and they also demonstrated better long-term memory than patients who didn't use the nicotine patches.
"The patients improved enough that they noticed the difference," says researcher Paul Newhouse, MD, a professor of psychiatry at Vanderbilt University School of Medicine in Nashville, Tenn. "Their doctors noticed the improvements, too, but not as much as their patients."
Nicotine, the addictive ingredient in cigarettes, appears to provide increasing benefits the longer it is taken. Newhouse says he and his team noticed a small effect a week into the study. By the three- and six-month marks, that effect had grown substantially.
"It seems that the effect grows over time," says Newhouse. "I was quite pleased with that finding."
Neuroscientist Joshua Grill, PhD, says the study shows good results, but larger and longer studies will be needed to determine whether nicotine will improve more than just memory. Grill, who reviewed the study for WebMD, points out that the study showed no improvement in more extensive functioning -- the ability to perform everyday activities. He is also concerned about safety.
Nicotine therapy was associated with a small reduction in blood pressure and weight loss of about 5 pounds at the end of the study period. In elderly adults, this is not always a healthy thing.
"It's much safer than treating people with cigarettes, that's obvious," says Grill, director of the Katherine and Benjamin Kagan Alzheimer's Disease Treatment Development Program at UCLA. "But there is potential for addiction, and reductions in blood pressure are worth discussing, especially in older patients."
Newhouse says there is a lot of interest in the development of nicotine-based drugs. Pfizer, the pharmaceutical company, donated the patches used for the study, which was funded in part by the National Institute on Aging and the National Institute of General Medical Sciences.
How the Patch Works
The patch used in this study is different from patches commonly available in the U.S., says Newhouse.
"They don't dump nicotine [into the bloodstream] as quickly as American patches. Instead, they release it more slowly. For our study, they worked particularly well," he says.
Newhouse says that nicotine appears to help the brain consolidate memory. By that he means the process of taking in information and permanently storing it in the brain for future recall.
"Memories need to be encoded, stored, and retrieved, and all of these steps can have problems," says Newhouse. "It looks like nicotine helps that process. Patients in the study did not remember more right away, but they forgot less over time."
More Research Needed
While the results of the study are promising, Newhouse says it will take a much larger study, one that includes hundreds of patients, to draw real conclusions about nicotine's potential to restore memory loss and to protect against disease. He is optimistic.
"There's strong interest now, and we understand the biology much better," Newhouse says.
Both Newhouse and Grill say researchers in the field are pushing hard to identify the onset of dementia at earlier and earlier stages, in hopes of finding ways to halt its progress and prevent the devastation of the disease. Doing so, however, will require new methods of studying how patients react to treatments.
"As our field moves earlier in the disease process, our current tools may not have the sensitivity to measure the results," says Grill, who is encouraged by the current study.
"I'd have to put myself in the camp of optimism," he says. "We need treatments for the millions of people with mild [memory loss], and we don't have any FDA-approved treatments."
SOURCES: Paul Newhouse, MD, professor of psychiatry, Vanderbilt University School of Medicine, Nashville, Tenn.Joshua Grill, PhD, director, Katherine and Benjamin Kagan Alzheimer's Disease Treatment Development Program, UCLA.Newhouse, P. Neurology, Jan. 10, 2012.News release, American Academy of Neurology.