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Nicotine Patch May
Alleviate "Senior Moments"
Dec. 3, 2003 - The nicotine patches that help smokers
quit might also boost the recall of senior citizens with the mildest
form of memory loss, according to results of a preliminary clinical
trial on 11 people conducted at Duke University Medical Center. While
nicotine itself has not been approved for long-term use, the research
could point the way toward other nicotine-like drugs that might improve
memory without the side effects of nicotine, according to the Duke
researchers.
Previous research conducted by the Duke team
and others has found evidence that nicotine might benefit people with a
variety of disorders -- including schizophrenia, attention deficit
hyperactivity disorder and Alzheimer's disease. However, the latest
study is the first to examine the drug's effects on people with
age-associated memory impairment (AAMI), a common condition among older
people characterized by so-called "senior moments."
In a small sample of seniors, the
researchers found that four weeks of nicotine treatment halved decision
times on a standardized test of memory and increased participants'
ability to focus their attention – a skill critical for learning and
memory. While receiving nicotine, seniors' assessments of their own
memories also showed small but significant improvement.
"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," said Duke geriatrician Heidi White, M.D. "We hope
that will translate into treatments that allow people to actually
function better in their daily lives."
White and nicotine researcher Edward
Levin, Ph.D., also at Duke, report their findings in a forthcoming issue
of the journal Psychopharmacology (currently available online).
Pharmacia, Inc. donated the nicotine and placebo patches.
The researchers emphasize that, despite
the possible benefits of nicotine, the results should not encourage
smoking. They also caution that nicotine patches have associated health
risks – including nausea, dizziness, and increases in blood pressure and
heart rate – and have not been approved for long-term use.
"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," Levin
said.
Eleven participants over the age of 60
with AAMI completed the 10-week, double-blind clinical trial. Each
senior wore a nicotine patch for four weeks and a placebo patch for an
additional four weeks separated by a two-week resting period.
Clinicians monitored participants eight
times over the course of the study to measure their medical condition
and performance on three standard tests of memory
-- the Clinical Global Impression (CGI)
scale in which participants rated their own perception of improvement or
decline in memory ability
-- the Automated Neuropsychological
Assessment Metrics battery including six tests measuring quickness of
thinking, attention to a task, and memory and
--the Conners' Continuous Performance
Test, a longer computerized test of attentiveness.
The researchers reported that
participants' perceptions of their own memories were significantly
improved after four weeks on the nicotine patch compared to the placebo
patch, with more seniors receiving the drug reporting a small
improvement in memory. While on the placebo patch, seniors on average
reported no memory change.
The four-week nicotine patch treatment
also cut seniors' decision times from approximately 200 milliseconds to
less than 100 milliseconds and significantly improved the consistency of
participants' performance on tests of reaction time, an indication that
nicotine heightened attention in individuals with AAMI.
Participants reported only mild side
effects of the patch treatments including skin irritation and nausea.
Nicotine's activity in the brain stems
from its ability to mimic the natural chemical acetylcholine, a nerve
signal that plays a role in learning and memory among other functions,
said Levin.
"Although nicotine isn't naturally
present in the body, the receptors that respond to it are," he said.
"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."
The Duke team and their colleagues at
the University of Vermont and Georgetown University have received
funding from the National Institute on Aging to pursue the benefits and
safety of nicotine patches for the treatment of mild cognitive
impairment (MCI), a slightly more severe form of memory loss than AAMI.
Patients with MCI are at increased risk for developing the dementia
characteristic of Alzheimer's disease. |
