VUMC re­searchers test nico­tine patches to treat mem­ory loss

The Commercial Appeal - - News - Holly Fletcher Nashville Ten­nessean USA TO­DAY NET­WORK - TEN­NESSEE

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.”

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