Nearly six million people in the United States are living with Alzheimer’s disease, and levels are projected to increase (AA 2023). It’s estimated that one in nine people aged 65 and older have the condition (AA 2023). Other “neurodegenerative” illnesses, such as Parkinson’s disease, are also on the rise. Scientists believe these diseases are caused by a combination of environmental, genetic, and lifestyle factors.
In response, over the past two decades, pharmaceutical companies have invested a huge amount of money and resources to develop new drugs for dementia treatment. Unfortunately, failure rates of new drugs for dementia are extremely high, with only 2% of drugs actually getting approved for patients since 2003 (Kim 2022).
As for prevention, little progress has been made in the search for new approaches. Yet data on an old “drug” has been garnering interest. Most people are familiar with lithium as a treatment for bipolar disorder or as a component of batteries to power your cell phone or electric car. However, data continues to build in support of the mineral’s ability to prevent dementia.
Lithium
Lithium is a mineral often found in tap water and soil. Depending on your location and diet, you may consume between one-half and three milligrams of lithium daily through food and water. As a drug, it was approved in the United States in 1970 to stabilize mood in bipolar disorder, although at much higher levels. A prescription of lithium carbonate (the standard form) provides anywhere from 114 to 342 mg of lithium; these are levels 100 times higher than the nutritional intake of the mineral.
Prescription Lithium, Bipolar and Dementia
Decades after its introduction as a bipolar treatment, an extraordinary finding was made. Bipolar disorder has been associated with a three times higher risk of developing dementia (Velosa 2020). Yet initial data from over 16,000 bipolar patients showed that those who were using lithium as a mood stabilizer reduced the incidence of dementia back to that of the general population (Kessing 2008). In other words, lithium appeared to be a powerful factor in preventing dementia in at-risk bipolar patients.
Lithium for the Prevention and Treatment of Dementia
And some of the research suggests that it doesn’t take much lithium to have a significant benefit. One study in 2013 showed stable memory tests for patients with cognitive decline by taking just 0.3 mg of lithium a day over 15 months. Those who did not take lithium saw a progressive decline (Nunes 2013).
In Denmark, a population wide study exploring lithium levels in groundwater and dementia incidence found an inverse correlation (Kessing 2017). Individuals exposed to higher levels of the small amount of lithium found in tap water had a lower incidence of developing dementia.
Another study published in 2019 followed 61 elderly adults with mild cognitive decline for two years with low-dose lithium treatment or placebo (Forlenza 2019). Lithium was prescribed at levels just under standard prescription strength. For those taking lithium, cognitive function remained stable over the two year period. Yet for patients on placebo, cognitive and functional decline continued. In 2023, a follow-up study was published on the same patients after more than ten years finding that those who had received lithium treatment had large benefits for retaining cognitive function as compared to subjects who received placebo (Damiano 2023).
How does lithium work to improve dementia? We are only just starting to understand the different mechanisms. Lithium helps to stop the formation of both plaques and tangles in the brain through inhibition of a specific enzyme: glycogen synthase kinase 3 (GSK-3). It also has antioxidant and anti-inflammatory effects.
Psychiatry Redefined Continuing Education
At Psychiatry Redefined, our integrative training program for mental health practitioners examines the uses of low-dose nutritional lithium in-depth. The mineral has significant utility for preventive therapy in dementia and degenerative brain illnesses, along with other benefits for mood, suicide prevention, addiction, and irritability. We review the latest research on lithium and its biological mechanisms that underpin its positive impact on brain function.
To learn about lithium and other breakthrough integrative mental health treatments, join our Fellowship starting this January. Our curriculum includes scientific training on lithium, lecture recordings from our international symposium, seminar presentations on nutritional lithium, and dozens of expert webinars – all diving deep into this extraordinary mineral.
For the general public and anyone interested in the science of nutritional lithium, you can explore more information here.
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References
Alzheimer’s Association. 2023 Alzheimer’s Disease Facts and Figures. Alzheimers Dement 2023;19(4). DOI 10.1002/alz.13016.
Damiano RF, Loureiro JC, Pais MV, et al. Revisiting global cognitive and functional state 13 years after a clinical trial of lithium for mild cognitive impairment. Braz J Psychiatry. 2023;45(1):46-49. Published 2023 Mar 11. doi:10.47626/1516-4446-2022-2767
Eyre-Watt B, Mahendran E, Suetani S, Firth J, Kisely S, Siskind D. The association between lithium in drinking water and neuropsychiatric outcomes: A systematic review and meta-analysis from across 2678 regions containing 113 million people. Aust N Z J Psychiatry. 2021;55(2):139-152. doi:10.1177/0004867420963740
Forlenza OV, Radanovic M, Talib LL, Gattaz WF. Clinical and biological effects of long-term lithium treatment in older adults with amnestic mild cognitive impairment: randomised clinical trial. Br J Psychiatry. 2019;215(5):668-674. doi:10.1192/bjp.2019.76
Kessing LV, Søndergård L, Forman JL, Andersen PK. Lithium treatment and risk of dementia. Arch Gen Psychiatry. 2008;65(11):1331-1335. doi:10.1001/archpsyc.65.11.1331
Kessing LV, Gerds TA, Knudsen NN, et al. Association of Lithium in Drinking Water With the Incidence of Dementia. JAMA Psychiatry. 2017;74(10):1005-1010. doi:10.1001/jamapsychiatry.2017.2362
Kim CK, Lee YR, Ong L, Gold M, Kalali A, Sarkar J. Alzheimer’s Disease: Key Insights from Two Decades of Clinical Trial Failures. J Alzheimers Dis. 2022;87(1):83-100. doi:10.3233/JAD-215699
Matsunaga S, Kishi T, Annas P, Basun H, Hampel H, Iwata N. Lithium as a Treatment for Alzheimer’s Disease: A Systematic Review and Meta-Analysis. J Alzheimers Dis. 2015;48(2):403-410. doi:10.3233/JAD-150437
Mury FB, da Silva WC, Barbosa NR, et al. Lithium activates brain phospholipase A2 and improves memory in rats: implications for Alzheimer’s disease. Eur Arch Psychiatry Clin Neurosci. 2016;266(7):607-618. doi:10.1007/s00406-015-0665-2
Nunes MA, Viel TA, Buck HS. Microdose lithium treatment stabilized cognitive impairment in patients with Alzheimer’s disease. Curr Alzheimer Res. 2013;10(1):104-107. doi:10.2174/1567205011310010014
Velosa J, Delgado A, Finger E, Berk M, Kapczinski F, de Azevedo Cardoso T. Risk of dementia in bipolar disorder and the interplay of lithium: a systematic review and meta-analyses. Acta Psychiatr Scand. 2020;141(6):510-521. doi:10.1111/acps.13153
