Abstract
Nicotinamide (vitamin B3) has photoprotective effects and reduces skin cancer incidence in high risk patients. Nicotinamide also improves cognition in animal models. As part of the ONTRAC (Oral Nicotinamide To Reduce Actinic Cancer) phase III placebo-controlled, randomized trial to assess nicotinamide’s efficacy in skin cancer prevention, we included clinical neurocognitive function and patient-reported quality of life assessments at baseline and after 12 months of intervention in individuals with previous skin cancer in order to assess any effect of oral nicotinamide (500 mg po twice daily) on cognitive function and quality of life. In our sample of 310 participants who completed neurocognitive function testing at baseline and at 12 months, we were not able to detect any significant effect of oral nicotinamide on cognitive function nor on quality of life. Further studies of nicotinamide’s effects on cognition in humans might include individuals with pre-existing mild cognitive impairment, and it may be that higher doses of nicotinamide are required to significantly influence cognitive function compared to doses required to reduce skin cancer.
Highlights
As a precursor of nicotinamide adenine dinucleotide (NAD+ ), nicotinamide plays a central role in cellular energy metabolism
In our cohort of largely elderly, community dwelling skin cancer patients assessed over a 12-month intervention period, there was no compelling statistical evidence of an effect of nicotinamide on neurocognitive performance nor on quality of life (QoL)
Participants were stratified by gender, study site and by number of nonmelanoma skin cancers in the previous five years (≤5 or ≥6)
Summary
As a precursor of nicotinamide adenine dinucleotide (NAD+ ), nicotinamide (vitamin B3) plays a central role in cellular energy metabolism. Geriatrics 2019, 4, 31 double-blind, randomised placebo-controlled trial Cancer) found that oral nicotinamide (vitamin B3) significantly reduced the incidence of nonmelanoma skin cancer (basal cell and squamous cell carcinoma) by 23% relative to a placebo in a high risk population [5] (Australian New Zealand Clinical Trials Registry number ACTRN12612000625875). Secondary pre-specified objectives of ONTRAC included an evaluation of the effect of oral nicotinamide on neurocognitive function (NCF) and quality of life (QoL). The NCF objective was pursued given the evidence for the role of nicotinamide in cognitive and neurological function available at the time ONTRAC was designed. Exposure to nicotinamide has been associated with improved short term memory [6], reduced cognitive decline in an Alzheimer’s model [6], and improved recovery from cortical contusion injury [7]. Lower dietary nicotinamide has been associated with increased dementia risk [9], and dementia is a known symptom of nicotinamide deficiency (pellagra) [10]
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