Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-26T14:46:19.208Z Has data issue: false hasContentIssue false
  • English
  • Français

Lithium and prevention of cognitive impairment

Published online by Cambridge University Press:  13 June 2014

Zareena Abidin ,
Colm Cooney ,
Deirdre Jackson  and
Aideen Freyne
Zareena Abidin
Affiliation:
St Vincent's University Hospital
Colm Cooney*
Affiliation:
Department of Old Age Psychiatry, St Vincent's University Hospital, Dublin 4
Deirdre Jackson
Affiliation:
Department of Old Age Psychiatry, St Vincent's University
Aideen Freyne
Affiliation:
Department of Old Age Psychiatry, St Vincent's University Hospital, Ireland
*
*Correspondence Email: c.cooney@st-vincents.ie
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: To examine the rate of cognitive decline and occurrence of dementia among patients attending a lithium clinic for those aged 65 years and over.

Method: Retrospective chart review of the cognitive function of 29 patients receiving maintenance lithium treatment attending the Dublin South East Old Age Psychiatry service, over a nine-year time period.

Results: Twenty-nine patients were included in the study (20 female, nine males), with a mean age of 79 years. Two patients had concurrent dementia. Six patients fulfilled ICD10 criteria for mild cognitive disorder and all of these patients also fulfilled revised consensus criteria for mild cognitive impairment amnestic subtype. Sixteen patients were commenced on lithium as an augmentation treatment for recurrent depressive disorder, 12 patients were on treatment for bipolar affective disorder and one patient on treatment for schizoaffective disorder. Patients had been receiving lithium treatment for an average of 109 months with follow-up by the service for a mean duration of 38 months. The initial mean MMSE score of patients at first presentation to the service was 26.9 (SD = 5.6) compared to a mean MMSE score 25.8 (SD = 5.8) (CI of change in MMSE score at 95% level = −2.1 and 0) at follow-up. The mean MMSE of patients with mild cognitive impairment prior at first contact with the service was 26.8 (SD = 3.2) and at follow-up was 26 (SD = 3.2) which was not statistically significantly different (p=0.40) (CI for change in MMSE at 95% level = −3.2 to 1.5). No patient had developed incident dementia during the follow-up period of the study.

Conclusion: The results tentatively suggest that lithium may have a protective effect against cognitive decline and a neuroprotective role in patients with concurrent affective disorder and cognitive impairment. Multi-centre prospective studies of cognitive function in patients attending lithium clinics are needed to examine the neuroprotective properties of lithium.

Keywords

LithiumCognitive FunctionDementia
Type
Brief Reports
Information
Irish Journal of Psychological Medicine , Volume 28 , Issue 3 , September 2011 , pp. 148 - 150
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Cade, J. Lithium salts in the treatment of psychotic excitement. Med J Australia 1949; 2: 349–352.CrossRefGoogle ScholarPubMed
2.Geddes, JR., Burgess, S, Hawton, K, Jamison, K and Goodwin, GM. Long-term lithium therapy for bipolar disorder: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Psychiatry 2007; 161:217–222.CrossRefGoogle Scholar
3.Ferrier, IN., Ferrie, LJ., Macritchie, KA. Old drug, new data. Revisiting Lithium therapy. Advances in Psychiatric Treatment 2006; 12: 256–264.CrossRefGoogle Scholar
4.Cipriani, A, Pretty, H, Hawton, K and Geddes, J R. Lithium in the Prevention of Suicidal Behavior and All-Cause Mortality in Patients with Mood Disorders: a Systematic Review of Randomized Trials. Am J Psychiatry 2005; 162: 1805–1819.CrossRefGoogle ScholarPubMed
5.Fahy, S, Lawlor, B. Lithium use in octogenarians. Int J of Geriat Psych 2001; 16:1000–1003.CrossRefGoogle ScholarPubMed
6.Young, AH., Hammond, JM. Lithium in mood disorders: increasing evidence base, declining use. Brit J Psychiatry 2007; 191: 474–476.CrossRefGoogle ScholarPubMed
7.Kozman, MN., Wattis, J and Curran, S. Pharmacological management of behavioural and psychological disturbance in dementia. Human Psychopharmacology Clinical Experience 2006; 21: 1–12.CrossRefGoogle ScholarPubMed
8.Terao, T, Nakano, H, Inoue, Y, Okamoto, T, Nakamura, J and Iwata, N. Lithium and dementia: a preliminary study. Prog Neuropsychopharmacology Biol Psychiatry 2006; 30(6): 1125–1128.CrossRefGoogle ScholarPubMed
9.Nunes, PV., Forlenza, OV., Gattaz, WF. Lithium and risk for Alzheimer's disease in elderly patients with bipolar disorder. Brit J Psychiatry 2007; 190:359–360.CrossRefGoogle ScholarPubMed
10.Kessing, LV., Sondergard, L, Forman, JL and Andersen, PK. Lithium Treatment and Risk of Dementia. Arch Gen Psychiatry 2008; 65(11): 1331–1335.CrossRefGoogle ScholarPubMed
11.Folstein, ME., and Folstein, SE. Mini-Mental State. A practical method for grading the cognitive state of patients for the clinician. J Psychiatric Research 1975; 12: 189–195.CrossRefGoogle Scholar
12.Winblad, B, Palmer, K, Kivipelto, M, Jelic, V, Fratiglioni, L, Wahlund, L.O. et al.Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Int Medicine 2004; 256: 240–246.CrossRefGoogle Scholar
13.Cleveland, W.S. Robust Locally Weighted Regression and Smoothing Scatterplots. J Am Statistical Association 1979; 74: 368, 829–836.CrossRefGoogle Scholar
14.Kessing, LV., Nilsson, FM. Increased risk of developing dementia in patients with major affective disorders compared to patients with other medical illnesses. Journal of Affective Disorders 2003; 73(3):261–269.CrossRefGoogle ScholarPubMed
15.Gauthier, Set al.Mild Cognitive Impairment. Lancet 2006; 367:1262–1270.CrossRefGoogle ScholarPubMed
16.Morris, JCet al.Mild cognitive impairment represents early-stage Alzheimer's disease. Arch Neurology 2001; 58: 397–405.CrossRefGoogle Scholar
17.Petersen, RC., Steven, JC., Ganguli, M, Tangalos, EG., Cummings, JL. DeKosky, ST. Practice parameter: early detection of dementia: mild cognitive impairment (an evidenced-based review). Report of the Quality Standards Subcommittee of the American Academy of neurology. Neurology 2001a; 56: 1133–1142.CrossRefGoogle Scholar
18.Phiel, CJ., Klein, PS. Molecular targets of lithium action. Ann Rev Pharm Toxicology 2001; 41: 789–813.CrossRefGoogle ScholarPubMed
19.Rockenstein, E, Torrance, M, Adame, A, Mante, Met al.Neuroprotective effects of regulators of the Glycogen Synthase Kinase-3β Signaling pathway in a transgenic model of Alzheimer's disease are Associated with Reduced Amyloid Precursor Protein Phosphorylation. J Neuroscience 2007; 27(8): 1981–1991.CrossRefGoogle Scholar
20.Phiel, JC., Wilson, CA., Lee, VMY and Klein, PS. GSK-3α regulates production of Alzheimer's disease amyloid-β peptides. Nature 2003; 423: 435–439.CrossRefGoogle ScholarPubMed
21.Moore, GJ., Bebchuck, JM., Wilds, IB., Chen, G, and Manji, HK. Lithium-induced increase in human grey matter. Lancet 2000; 356(9237): 1241–1242.CrossRefGoogle Scholar
22.Yucel, K, Taylor, VH., McKinnon, MC., MacDonald, K, Alda, M, Young, LT., et al.Bilateral hippocampal volume increase in patients with bipolar disorder and short term lithium treatment. Neuropsychopharmacology 2008; 33: 361–367.CrossRefGoogle ScholarPubMed
23.Yucel, K, McKinnon, C, Taylor, VH., MacDonald, K, Alda, A, Young, LT., et al.Bilateral hippocampal volume increases after long-term lithium treatment in patients with bipolar disorder: a longitudinal MRI study. Psychopharmacology 2007; 195: 357–367.CrossRefGoogle ScholarPubMed
24.Beyer, J, Kuchibhatla, M, Payne, M, Moo-Young, M, Cassidy, F, McFall, J, et al.Hippocampal Volume Measurement in Older Adults with Bipolar Disorder. Am J Geriatr Psychiatry 2004; 12(6): 613–620.CrossRefGoogle ScholarPubMed