This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. MCI is defined as a subjective and objective decline in cognition and function that does not meet criteria for a diagnosis of dementia and that represents a transitional state between the cognition of normal aging and mild dementia. The plant alkaloid nicotine may represent a promising agent to test for its ability to improve the cognitive symptoms of MCI and delay progression to dementia. The primary goal of this trial will be to establish the safety of long-term nicotine in non-smoking older patients with a secondary goal of examining whether nicotine will alleviate cognitive symptoms of MCI and whether this effect will be detectable by patients and clinicians. This study is a three-site 12-month pilot clinical trial of the safety and efficacy of transdermal nicotine in alleviating symptoms of MCI. The trial will consist of 6 months of randomized double-blind placebo-controlled treatment with nicotine or placebo followed by 6 months of open label nicotine treatment.