I have had several questions asked of me this week that are based on recent news about Alzheimer’s disease and cognitive decline. First, in response to my article on nicotine “Is Nicotine a New Treatment for Alzheimer’s Disease” (January 31), I was asked “Should I start smoking again?” The question arose in response to the recent finding that the nicotine patch may be helpful to those with mild cognitive decline or Alzheimer’s disease. The answer is clearly no. A study published in the Archives of General Psychiatry (February 6, 2012) links smoking to cognitive decline – especially in men. Smoking delivers a multitude of chemicals in addition to nicotine as well as carcinogens. The nicotine patch delivers only nicotine.

Another client asked “Should I be giving coconut oil to my husband [he has significant dementia]?” She gave me an article that she read on the internet which claimed that taking coconut oil reversed dementia. The article is based on an anecdotal case study and the claim was that a caregiver gave her demented husband coconut oil and he was able to read again, talk on the phone again, run again, and do yard work again. As impressive as the case is, it is founded on one person not several. We also don’t know details of diagnosis and course. I have had several of my clients try coconut oil (also anecdotal) to no avail. No one is hiding potential treatments from the public. There just aren’t any substances, medical or supplements, that have been shown to be effective in well designed studies. Aricept, Exelon, Razadyne, and Namenda are the best options we have at the preset time.

Finally, “What do you think about the new report that deep brain stimulation strengthens memory?” The research (New England Journal of Medicine, February 9, 2012) reports on the effects of deep brain stimulation used to treat serious epilepsy. Stimulation of a region (the entorhinal cortex) of the brain near the hippocampus (the area of the brain that allows new information to be stored into long-term memory) improved memory. The study was small as there were only 7 patients. The memory system studied was spatial memory (patients played the role of taxi drivers). The researchers speculated that they hoped that this would be helpful in improving memory is Alzheimer’s patients. But they also point out that these findings may not generalize to other diseases. Furthermore, the treatment requires brain surgery. It’s way too early to be counting on “neuroprosthetic” devices.