Transdermal nicotine may improve cognitive performance in
patients with age-associated memory impairment (AAMI), according to the
results of a preliminary, double-blind, placebo-controlled study in
Psychopharmacology and published online
“In folks with relatively minor changes in their memory and thinking, there
was some improvement with nicotine skin patches in the areas of attention
and their general perception of their own memory,” lead author Heidi White,
MD, from Duke University Medical Center in Durham, North Carolina, says in a
news release. “We hope that will translate into treatments that allow people
to actually function better in their daily lives.”
Previous studies suggest that chronic transdermal nicotine may improve
attentional performance in Alzheimer’s disease. In this crossover-design
study, 11 subjects older than 60 years diagnosed with AAMI each wore a
nicotine patch for four weeks and a placebo patch for four weeks separated
by a two-week washout period. The nicotine patch was worn for 16 hours daily
and delivered 5 mg/day during week 1, 10 mg/day during week 2 and week 3,
and 5 mg/day during week 4. Mild adverse effects reported during nicotine
patching were skin irritation and nausea.
On eight occasions during the 10-week study, subjects rated their own
perception of memory improvement or decline on the Clinical Global
Impression (CGI) scale, and clinicians evaluated their medical condition and
performance on the Automated Neuropsychological Assessment Metrics battery
and the Conners’ Continuous Performance Test (CPT).
Compared with the placebo patch, more subjects using the nicotine patch
reported a minimal improvement on the CGI. The average CGI score was
unchanged during use of the placebo patch. Decision times decreased from
approximately 200 milliseconds to less than 100 milliseconds during nicotine
treatment, and the consistency of performance on tests of reaction time also
improved significantly, suggesting that nicotine heightened attention in
individuals with AAMI.
Nicotine did not significantly affect delayed matching to sample and
Sternberg memory tests, errors on the CPT, Stroop task performance, and
mental rotation processing speed, nor was any dose-effect relationship
noted.
The authors warned that these findings should not in any way justify
smoking, and that nicotine patches had not been approved for long-term use
because of associated health risks, including nausea, dizziness, and
increases in blood pressure and heart rate.
“While the results are encouraging, seniors should not try nicotine skin
patches until larger studies testing the efficacy and safety of their use
have been conducted,” says coauthor Edward Levin, PhD, also from Duke. “The
results of this study suggest that when used appropriately and under the
right conditions, nicotine may alleviate the symptoms of mild forms of
memory loss. In addition, such treatment may even attenuate the decline in
memory function as people age.”
Pharmacia, Inc., donated the nicotine and placebo patches used in this
study. The National Institute on Aging is funding additional research on the
efficacy and safety of nicotine patches for the treatment of mild cognitive
impairment.
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