VUMC researchers test nicotine patches to treat memory loss

Researchers are trying to treat early stage memory loss with nicotine patches to prevent those diagnosed from moving into full-blown Alzheimer’s.

Vanderbilt University Medical Center is collaborating with the University of Southern California on a two-year trial to see if mild cognitive impairment, or MCI, can be treated, possibly preventing those people from moving into more progressive forms of memory loss.

There are more than 8 million Americans with an MCI diagnosis.

“We believe that many if not most of the patients, if untreated, will go on to full-blown Alzheimers disease or something similar,” said Dr. Paul Newhouse, director of the Center for Cognitive Medicine at VUMC and national directory of the study. “What we’d like to do with this treatment is see if we can both improve memory loss and prolong the period in which they are functioning well.”

The trial is in the early stages of enrolling 300 people to see if is using nicotine patches — similar to those for purchase a drug stores to help people quit smoking — helps stave off further impairment. Newhouse is hoping to get 25 of the trial participants

The study, funded by the National Institute on Aging, is following up on decades of research. An earlier study showed the treatment worked for up to six months. Now researchers are taking following people for two years to see if results are sustained.

A wife concerned about forgetfulness found a brochure

Reece Dean, a retired truck driver in Bellevue, is participating in the trial because his wife of 49 years, Mary Ann, saw a brochure about it at Vanderbilt’s One Hundred Oaks campus and took it home for him to think about.

Reece was diagnosed with MCI after she began noticing he was forgetting names and how to get to places — “things that are routine.” MCI became diagnosable as a standalone disease in 2015 when new diagnosing codes went into effect, Newhouse said.

Mary Ann said his forgetfulness was very hard for both of them to handle. Having the diagnosis was “a little bit of a relief” for Mary Ann because at least she knew then why he was forgetting.

“I didn’t know how to deal with some of the things he didn’t remember,” said Mary Ann.

He’s been wearing a patch since June. Since it’s a blind study there’s no way to know if he’s using a nicotine patch or a placebo. And so far there’s been no indication about whether doctors are seeing an improvement.

The Deans, grandparents of seven, are in a wait-and-see period.

‘We’ve had some successes and a lot of failures’

About 120,000 people in Tennessee and 5 million in the U.S. are impacted by Alzheimer’s, said Tiffany Cloud-Mann, vice president of programs at the Mid South Chapter of the Alzheimer’s Association. The disease hits friends and family who watch the heart-wrenching decline.

Research is looking at earlier stages of memory loss because studies are showing that there are pathology changes in the brain up to 20 years before outward symptoms begin to appear, said Cloud-Mann.

There is a lot of research going into treating memory loss and Alzheimers but there weren’t any breakthroughs presented a recent conference in Boston, Newhouse said.

There’d been hopes for some big results on molecular strategies to get at the underlying proteins, he said.

“We’ve had some successes and a lot of failures,” Newhouse said. “Those failures teach us things so we learn even when drugs fail.”

The pendulum is swinging back to studying how to keep people from getting to Alzheimer’s in the first place, he said.

Why nicotine?

Nicotine is a plant derivative that has been used for medicinal purposes throughout history.

It’s safe enough that it can be sold over-the-counter and “by itself it’s a pretty safe compound,” said Newhouse. Using the patch is not the same as smoking tobacco, which contains thousands of other chemicals if inhaled.

“The joke is you can say nicotine is a good drug with a bad delivery system,” said Newhouse.

In the future, treating memory loss will require a combination approach. But first the individual pieces have to be proven to work, said Newhouse.

Right now, he and his colleagues are testing how people perform on attention and memory tasks. They are looking for both actual improvement and for how they perform in their every day life.

“Will nicotine do the whole job? I don’t necessarily think that,” Newhouse said. “If we can show that nicotine enhances memory and functioning with patients with mild memory loss or even stave off the decline in memory in patients with MCI, then I think we could make a real contribution to the prevention.”