Nicotine patches may help with mild memory loss

By Sophie Ramsey

BMJ Group News

What do we know already?

Nicotine is best-known as the addictive chemical in tobacco that gives smokers a ‘high’. It does this by rapidly travelling to the brain, where it binds with receptors on nerve cells and triggers the release of dopamine, a chemical that helps us feel pleasure.

However, nicotine is also being studied as a possible treatment for Alzheimer’s disease and other conditions affecting memory and thinking (cognitive function). Short-term research shows that nicotine can boost smokers’ performance on demanding mental tasks, and may improve attention and memory in people with Alzheimer’s.

Studies have also found that some types of nicotine receptors are important for memory and thinking. These receptors decline in Alzheimer’s disease, but are plentiful in people with mild cognitive impairment (MCI) - a diagnosis given when a person’s memory loss is more than would be expected with normal ageing, but doesn’t yet meet the criteria for dementia. Having many receptors might mean that people with MCI are particularly likely to be helped by nicotine treatment.

In the new study, researchers recruited 74 non-smokers with MCI and randomly assigned them to wear nicotine patches for six months or dummy (placebo) patches that contained no nicotine. Neither the participants or the researchers knew who had been given the nicotine patches until the end of the study. The participants’ average age was 76.

What does the new study say?

People who wore nicotine patches had better scores on tests measuring their level of attention, long-term memory and mental processing, compared with those using the placebo patches. They also rated their cognitive abilities higher overall, as did the people closest to them (their spouse, for example).

But the study didn’t find much difference between the groups in how doctors scored people’s cognitive abilities over the study. So it’s not clear whether the improvements were large enough to make a meaningful difference.

Participants using the nicotine patches reported few side effects, although stomach problems were more common in this group. At the end of the study, participants had no withdrawal symptoms when they stopped using the patches.

How reliable is the research?

This was a randomised controlled trial, which is the most reliable type of study for finding out the effects of a treatment. However, the study included only 74 people, so we need larger trials to confirm these findings and also to look at other groups of people, such as current smokers with MCI.

What does this mean for me?

This was a pilot study, which means the research is at a very early stage. So it’s too soon to recommend nicotine patches as a treatment for mild memory loss. Also, bear in mind that these findings don’t apply to nicotine delivered through smoking, which has many harmful effects.

If you or someone close to you is having memory problems, it’s important to see a doctor so you can explore possible causes and treatments.