Health Conditions News

Nicotine Patch May Aid Memory Problems

by Robert H. Shmerling, M.D.
Harvard Medical School

Wearing a nicotine patch may provide a small boost for older adults with mild losses in attention and memory, a study suggests. The study included 67 older adults with mild cognitive impairment. This is a decline in mental function that is not severe enough to be called dementia. People with this condition are more likely to develop dementia, however. People in the study were randomly assigned to wear either a nicotine patch or a placebo (fake) patch for 6 months. Test scores for reaction times, attention and long-term memory improved among those wearing the nicotine patch. Their short-term memory did not improve as much. Test scores went down for people wearing the placebo patch. The journal Neurology published the study. The New York Times and HealthDay News wrote about it January 9.

What Is the Doctor's Reaction?

We know smoking is bad for your health. But could nicotine be good for your brain?

The answer is "maybe," according to a new study. The medical journal Neurology published it.

Previous research has shown improved measures of brain function among people using nicotine treatments. For example, when they chewed nicotine gum, they were better able to pay attention to a complex task. A study of people with Alzheimer's disease also found that nicotine infused into a vein seemed to improve memory and attention.

This latest research looked at people whose brain function was not entirely normal, but not as abnormal as in people with dementia. This is known as "mild cognitive impairment." People with this condition have difficulty with memory or thinking. However, they are not disabled by it. They do have a high risk of developing Alzheimer's disease or another form of dementia.

In this study, 74 elderly men and women with mild cognitive impairment were randomly divided into two groups. One group wore patches containing nicotine. The other wore placebo patches. The dose was similar to what someone who smokes 10 cigarettes or fewer per day might use while trying to quit.

After six months of treatment, long-term memory improved significantly among those wearing the nicotine patch. Meanwhile, memory test scores got worse for those wearing placebo patches. No major side effects were reported.

These results were surprising. But there is a potential scientific explanation. One of the ways the brain responds to nicotine is by releasing a chemical messenger called glutamate. This chemical is involved in memory and learning.

Interesting? Yes! But does this study mean that smoking might not be so bad for you? Does it mean that you should use nicotine to improve your memory? Not yet! It's too early to embrace nicotine as a way to ward off Alzheimer's disease or reverse cognitive impairment. Here's why:

• The study was quite small. A larger study would provide a more reliable measure of whether nicotine helps people with mild cognitive impairment.
• Doctors evaluating people in the study did not detect overall improvement among those receiving nicotine treatment. The changes were shown only in test scores.
• This study provides no information about the ideal dose or how long treatment should last. Cognitive impairment and dementia usually can't be reversed. So long-term treatment would likely be needed.
• The safety of long-term use of nicotine among the elderly is not known. A small study lasting only 6 months cannot assure us that this approach is safe.
• Smoking is linked with many serious health problems. Even if other studies confirm a benefit for nicotine, the risks of smoking would still far outweigh the benefits. Nicotine treatment might be recommended in the future for its effects on the brain. But this would take the form of nicotine gum or patches. Smoking would never be recommended.

What Changes Can I Make Now?

You can make changes now that may reduce your risk of cognitive impairment or dementia. But it's too soon to say that the use of nicotine should be one of them.

Here's what you can do now.

• Exercise regularly.
• Improve your diet. Make sure it includes more fruits, vegetables, fiber and omega-3 fatty acids (such as those found in fish).
• Keep your blood pressure in a normal range.
• Keep your blood lipids (such as cholesterol) in a healthy range.
• Maintain a healthy weight.
• Don't smoke (despite the findings of this study).
• "Exercise" your mind. It's not clearly proven, but a busy social life, hobbies and activities that challenge your brain (such as crossword puzzles) may be linked with a lower risk of dementia.

For those already diagnosed with Alzheimer's disease, medicines intended to slow the decline in mental function are available. If you're worried that your memory or thinking abilities are declining, see your doctor. He or she can evaluate you or refer you to a doctor who focuses on brain function (such as a neurologist or a neuropsychologist). The good news is that many people who are concerned about their memory as they age discover that their memory is actually normal.

What Can I Expect Looking to the Future?

It's not yet clear that nicotine will ever be used to prevent or treat dementia. But this new study should promote more research. We'll need more studies to find out whether a substance with such a bad reputation could actually provide hope for those at risk of developing dementia.

Categories: Addiction, Men's Health, Women's Health

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