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Grand Rounds

Does Lithium Exposure Decrease Risk for Dementia?

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BACKGROUND AND PURPOSE:

  • Animal studies show lithium improves learning and memory
  • Human observational studies suggest lithium treatment may reduce the risk of dementia in individuals with bipolar disorder
  • Kessing et al. (JAMA Psychiatry, 2017) sought to assess whether incidence of dementia is associated with long-term exposure to microlevels of lithium in drinking water

METHODS:

  • Population-based, nested case-control study
  • Longitudinal data on municipality of residence, lithium levels drinking water measurements and incidence of dementia (inpatient and outpatient)
  • Primary outcome
    • Dementia diagnosis
  • Secondary outcomes
    • Alzheimer disease
    • Vascular dementia diagnoses

RESULTS:

  • A total of 73,731 patients with dementia and 733,653 controls were included in the study, age 50-90 years
  • Lithium exposure differed between patients with a diagnosis of dementia (median, 11.5 µg/L) and controls (median, 12.2 µg/L; (P < .001)
  • Compared with individuals exposed to 2.0 – 5.0 µg/L, the incidence rate ratio (IRR) of dementia was
    • Decreased in those exposed to more than 15.0 µg/L (IRR, 0.83; 95% CI 0.81-0.85; P < .001) and 10.1 to 15.0 µg/L (IRR, 0.98; 95% C 0.96-1.01; P = .17)
    • Increased with 5.1 to 10.0 µg/L (IRR, 1.22; 95% CI 1.19-1.25; P < .001)
  • Secondary outcomes: Similar patterns to the above were identified when Alzheimer disease and vascular dementia were studied

CONCLUSION:

  • Long-term increased lithium exposure in drinking water is correlated with lower incidence of dementia, with lower levels associated with higher risk
  • Confounding factors could not be excluded, such as differing availability of healthcare which could impact whether a patient would receive a formal diagnosis

Learn More – Primary Sources

Association of Lithium in Drinking Water With the Incidence of Dementia

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Related ObG Topics:

Omega-3 PUFAs: Do They Really Work for the Treatment of Dementia?
Does Hormone Therapy Protect Against Alzheimer’s?
AUGS Statement on Anticholinergic Medications for Overactive Bladder and Dementia Risk

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