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Washington. Older adults who are starting to have problems with memory may benefit from small amounts of nicotine therapy, according to a US study published early this week.The research in Neurology, the medical journal of the American Academy of Neurology, included 74 non-smokers with an average age of 76. Half were given a daily nicotine patch for six months, the other half wore a placebo patch.Those on nicotine therapy showed better results on cognitive tests for attention, memory, as well as how fast and consistently they could process information.
After six months on the patch, the nicotine group “regained 46 per cent of normal performance for age on long-term memory, whereas the placebo group worsened by 26 per cent over the same time period,” said the study.
However, the study authors cautioned that older adults should not begin to smoke cigarettes to help their brain function, and said more research is needed to see if the positive effects endure over a long period of time.
Also, nicotine is not likely to help people whose memory already works well, said study author Paul Newhouse, director of the Center for Cognitive Medicine at Vanderbilt University Medical Center.
“If you’re already functioning fine, but slip down the hill, nicotine will push you back up toward the top. A little bit of the drug makes poor performers better,” he said.
“Too much, and it makes them worse again, so there’s a range. The key issue is to find the sweet spot where it helps.”The study was funded by the National Institute on Aging, and received no money from pharmaceutical companies, Mr Newhouse said. Nicotrol 15 mg patches were donated for the study by Pfizer.
The link between nicotine and memory was first shown in the 1980s. Nicotine stimulates receptors in the brain that are important for thinking and memory. People with Alzheimer’s disease tend to lose some of those receptors.
Dr Jeremy Koppel, a geriatric psychiatrist at Zucker Hillside Hospital in Glen Oaks, New York, who was not involved in the study, said more research is needed to gauge the true nature of nicotine’s potential benefit.
“While this small study did find that patients treated with transdermal nicotine performed better on tests of attention, and some tests of memory, there was no evidence of global improvement in the group treated with nicotine,” Dr Koppel said.
“Further, this study does not provide evidence that nicotine can reverse or slow the progression from MCI (mild cognitive impairment) to Alzheimer’s disease.”
Mr Newhouse said he hopes to next examine how nicotine therapy might change the curve of cognitive decline over time.
“I don’t think it’s going to become a treatment for Alzheimer’s disease by itself. That would be like trying to rebuild a house after a fire when the fire’s still going,” he said.
“You need to prevent the fire. The holy grail would be changing the deterioration curve.”
People who wore the patch reported some nausea, dizziness, and mild weight loss, but did not report any withdrawal symptoms once they stopped wearing it.
Meanwhile, another study has a said that gums, patches and nasal sprays that supply smokers with nicotine do not help people quit cigarettes over the long term any better than going it alone. The research by the Harvard University School of Public Health followed 787 adults in the state of Massachusetts who had recently quit smoking, and found that over time just as many relapsed after nicotine replacement therapy (NRT) as without -- about a third.
“This study shows that using NRT is no more effective in helping people stop smoking cigarettes in the long term than trying to quit on one’s own,” said lead author Hillel Alpert, a research scientist at Harvard. Study participants were surveyed over three time periods: 2001-2002, 2003-2004, and 2005-2006.
Not only were relapse rates about the same among those who used NRT and those who did not, the study found that heavily dependent smokers who took NRT without professional therapy were twice as likely to relapse as those who did not use NRT.
“This may indicate that some heavily dependent smokers perceive NRT as a sort of ‘magic’ pill and upon realizing it is not, they find themselves without support in their quitting efforts, doomed to failure,” said the study in the journal Tobacco Control.
Although previous randomized controlled studies have shown NRT to be effective in helping smokers quit, the latest research shows the weakness of those trials among the general population in a real-life setting, the authors argued.
The study also showed that very few people follow the recommendations of using NRT for eight weeks, with many opting for shorter periods of use.
The NRT industry has boomed since nicotine gum was first introduced in 1984, according to background information in the article. Back then, NRT products were a $45 million industry in the United States. Since over-the-counter sales of NRT were approved in 1996, the industry has soared to $800 million per year. On top of that, sales of prescription drugs to stop smoking reached $841 million dollars in 2007.
More public funds are also helping to subsidize stop-smoking therapies to low-income Americans, with 39 state Medicaid programs covering one or more kinds of NRT in 2011, compared to 17 states in 1996.
Rates of smoking in the United States have levelled off at about 20 per cent of the population in the past five years after a steady period of decline.
“What this study shows is the need for the Food and Drug Administration... to approve only medications that have been proven to be effective in helping smokers quit in the long-term and to lower nicotine in order to reduce the addictiveness of cigarettes,” said co-author Gregory Connolly, director of Harvard’s Center for Global Tobacco Control.
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