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Generating genius: how an Alzheimer s drug became considered a cognitive
enhancer for healthy individuals
#MMPMID24885270
Wade L
; Forlini C
; Racine E
BMC Med Ethics
2014[May]; 15
(?): 37
PMID24885270
show ga
BACKGROUND: Donepezil, an acetylcholinesterase inhibitor used in the treatment of
Alzheimer's disease, has been widely cited in media and bioethics literature on
cognitive enhancement (CE) as having the potential to improve the cognitive
ability of healthy individuals. In both literatures, this claim has been
repeatedly supported by the results of a small study published by Yesavage et al.
in 2002 on non-demented pilots (30-70 years old). The factors contributing to
this specific interpretation of this study's results are unclear. METHODS: We
examined print media and interdisciplinary bioethics coverage of this small
study, aiming to provide insight into how evidence from research may be shaped
within different discourses, potentially influencing important policy, ethics,
and clinical decisions. Systematic qualitative content analysis was used to
examine how this study was reported in 27 media and 22 bioethics articles.
Articles were analyzed for content related to: (1) headlines and titles; (2)
colloquialisms; and, (3) accuracy of reporting of the characteristics and results
of the study. RESULTS: In media and bioethics articles referencing this small
study, strong claims were made about donepezil as a CE drug. The majority of
headlines, titles, and colloquialisms used enhancement language and the majority
of these suggest that donepezil could be used to enhance intellectual ability.
Further, both literatures moved between reporting the results of the primary
study and magnifying the perceived connection between these results and the CE
debate that was alluded to in the primary study. Specific descriptions of the
results overwhelmingly reported an improvement in performance on a flight
simulator, while more general statements claimed donepezil enhanced cognitive
performance. Further, a high level of reporting accuracy was found regarding
study characteristics of the original study, but variable levels of accuracy
surrounded the presentation of complex characteristics (i.e., methods) or
contentious properties of the CE debate (i.e., initial health status of the study
subjects). CONCLUSIONS: Hyped claims of CE effects cannot be completely accounted
for by sheer inaccuracy in reporting. A complex interaction between the primary
and secondary literature, and expectations and social pressures related to CE
appears to drive enthusiastic reports.
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