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From the Desk of Dr. James Greenblatt

Dear friends,

Alzheimer’s disease, the most common form of dementia, is a devastating illness. And the latest research suggests things are only getting worse.

Currently, 50 million people struggle with some form of dementia. By 2050, it’s projected to reach 152 million. And of the leading causes of death, dementia is the only one without a pharmaceutical treatment that can slow or stop the disease process.

The situation is dire, but there are glimmers of hope. From a systems neurobiology perspective, two simple approaches from the research stand out: treating elevated homocysteine and low-dose lithium.

Homocysteine is a toxic amino acid with a clear association to dementia. In fact, in 2018, an international consensus statement was published outlining the research (Smith 2018): individuals with just moderately elevated homocysteine (levels that are still considered normal) may raise their risks for dementia by up to 2.5 times.

Fortunately, high homocysteine is easily identified with a simple blood test and effectively treated with three B vitamins: B12, folate and B6. And the research shows that treating homocysteine makes a difference, reducing age-related brain atrophy and slowing cognitive decline.

Beyond the B vitamins for elevated homocysteine, lithium also has a role to play. Long known for its impressive benefits for bipolar disorder, evidence suggests lithium is also effective for preventing dementia.

Clinical trials have shown that lithium treatment, in both low and microdoses, can halt the progression of the illness in its early stages (Nunes 2013, Forlenza 2019). Other studies on bipolar patients treated with lithium and exposure from lithium’s presence in tap water have also found benefits.

The research clearly shows that tools for preventing dementia are already available. Using these simple, safe and effective tools may help prevent immeasurable levels of untold suffering throughout the world. The time to adjust our treatment approach is now. 

Want to learn more?


Smith AD, Refsum H, Bottiglieri T, et al. Homocysteine and Dementia: An International Consensus Statement. J Alzheimers Dis. 2018;62(2):561-570. doi:10.3233/JAD-171042

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

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