Alzheimer's Drug Keeps Healthy Minds Aloft

Helps pilots without disease perform better on simulators

TUESDAY, July 9, 2002 (HealthDayNews) -- A common Alzheimer's drug can give healthy brains a boost by sharpening their ability to pay attention to difficult tasks.

California researchers have found the drug donepezil, which slows the progression of Alzheimer's disease, can improve a pilot's performance on flight simulation tests.

Donepezil prevents the breakdown of a brain molecule called acetylcholine, a messenger chemical critical to memory, attention and learning. Since the pilots were in good mental health, the latest work indicates donepezil counteracts the effects of normal aging, as well as declines linked to disease.

The results might draw raised eyebrows from pilots in this country, who are required by the Federal Aviation Administration to retire when they hit age 60. However, the study, reported in today's issue of Neurology, has implications well beyond the cockpit.

Many people lose brain power as they age without developing Alzheimer's, and they may increasingly see drugs such as like donepezil as a way to break the fall. These treatments hold obvious allure for the young, too, from test-taking teen-agers to competitive chess players. In recent years, chemicals said to enhance brain performance have earned the label "smart drugs," and are sold in bars and elsewhere to an IQ-conscious audience.

The study was led by Dr. Jerome Yesavage of the Palo Alto VA Health Care System and Stanford University. The researchers followed 18 pilots, with an average age of 52, and compared the effects of donepezil or a placebo on their ability to operate a flight simulator. Donepezil inhibits the ability of the enzyme cholinesterase to chew up acetylcholine, making more available at the synapses of neurons.

The pilots first took seven spins in the machine to record their baseline performance. For the next 30 days, half were given daily doses of the Alzheimer's drug and half took the sugar pills. They then re-entered the simulator for two more 75-minute tests to measure how well they retained their skills.

The researchers chose flight simulators because they require a great deal of attention. They also demand the execution of many competing tasks, skills that tend to wane with age.

Pilots who'd taken the Alzheimer's medication retained their flight skills more than those not on the drug, Yesavage's group found. Their performance also seemed better on the most difficult elements of the tests, including an emergency drill and the landing sequence.

Yesavage, who holds a pilot's license, calls the effects of the drug "subtle," and "not the kind of thing pilots are going to be fully aware of." However, he adds, it could mean the difference between a centered landing and one that's off the midline of the runway.

Yesavage admits the study isn't likely to affect the airline industry. After all, pilots are supposed to be "pure as the driven snow," he says, and federal law forbids them from taking any performance-enhancing substances.

On the other hand, he says, the public isn't under such restrictions. "If there is an advantage, even if it's subtle, are people going to start using drugs like this? If people can gain a millimeter, they're going to want to take it."

If the practice became common, it could widen the socioeconomic gulfs between those with the money to buy intellect-preserving potions and the "have-nots" who can't afford them.

James McGaugh, director of the Center for the Neurobiology of Learning and Memory at the University of California at Irvine, says the results weren't surprising. Scientists have known for decades that blocking the breakdown of acetylcholine can improve memory, he explains.

McGaugh dismisses the term "smart drugs" as a "tabloid" phrase that trivializes important scientific research. However, he says it's clear that certain compounds do shore up cognitive functioning.

While donezepil may be one of them, "it is not a drug that you would want to take on a regular basis because of undesirable side effects," he says. Those include dizziness, nausea and upset stomachs.

What To Do

For more on Alzheimer's disease, try the Alzheimer's Association or the National Institute on Aging. Learn more about donepezil from MedlinePlus.

SOURCES: Jerome Yesavage, M.D., director, Aging Clinical Research Center, Stanford University School of Medicine, Palo Alto, Calif.; James McGaugh, Ph.D., director, Center for the Neurobiology of Learning and Memory, University of California, Irvine; July 9, 2002, Neurology
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