The ‘Behind the Headlines’ service from NHS Choices has featured a quality assessment of press reports on a small pilot study that has suggested that nicotine may improve cognitive performance and clinical status in people with mild cognitive impairment (BBC news, Daily Mail, Daily Express).

This small randomised controlled trial showed that six-month nicotine replacement for non-smoking older people with mild cognitive impairment was safe and improved scores on some memory tests compared to people who had a placebo treatment. The treatment did not improve scores on all the memory tests and an overall clinical assessment stated that there was no difference between the two groups.

The assessment notes the following limitations of the study:

• The main limitation of this study was the small sample size.

• The study did not follow the participants over a long enough time to see whether there was a difference in the number of people who progressed to having more severe cognitive impairment (i.e. whether nicotine reduced progression of mild cognitive impairment).

• As this study was in people with mild cognitive impairment (and not dementia), it is not possible to say whether nicotine patches would have any effect in dementias such as Alzheimer’s, which is characterised by progressive memory loss.

The assessment concludes that this study has shown that nicotine patches were well tolerated and will be followed up with larger and longer trials to see whether they have any protective effect for dementias.