Association of Lithium in Drinking Water With the Incidence of Dementia

Kessing, Lars Vedel; Gerds, Thomas Alexander; Knudsen, Nils; Jørgensen, Lisbeth Flindt; Kristiansen, Søren Munch; Voutchkova, Denitza D.; Ernstsen, Vibeke; Schullehner, Jörg; Andersen, Per Kragh; Ersbøll, Annette Kjær

doi:10.1001/jamapsychiatry.2017.2362

Cited by 163 publications

(148 citation statements)

References 44 publications

Supporting

Mentioning

137

Contrasting

Unclassified

Order By: Relevance

“…This cognitive dysfunction is relatively stable, related to the number of mood episodes earlier in life, and does not appear to exceed normal aging in 2‐5‐year follow‐up 634, 635, 636. Lithium use has been associated with lower rates of cognitive disorders in BD,637 and higher lithium levels in drinking water may be associated with lower dementia risks,638, 639 although prospective trials are required to definitively assess this. Standardized instruments, such as the Montreal Cognitive Assessment (MoCA), should be used to quantify cognitive dysfunction.…”

Section: Specific Populationsmentioning

confidence: 98%

See 1 more Smart Citation

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

View full text Add to dashboard Cite

The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

show abstract

Section: Specific Populationsmentioning

confidence: 98%

“…There is some evidence that lithium in drinking water reduces the risk of dementia in the general population638 as does the use of lithium in patients with BD 798…”

Section: Specific Populationsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

View full text Add to dashboard Cite

show abstract

“…A number of recent epidemiological studies have provided indications that people living in areas with higher levels of lithium salts in their drinking water have lower incidence of dementia and cognition diseases [35][36][37][38][39]. While not an entirely new concept, the recent studies again raise awareness of the possibility that supplementing water or food with low dose lithium salts would be beneficial in this regard [35][36][37][38][39].…”

Section: Lithium Salts and Dementiamentioning

confidence: 99%

“…While not an entirely new concept, the recent studies again raise awareness of the possibility that supplementing water or food with low dose lithium salts would be beneficial in this regard [35][36][37][38][39]. Li levels in most water sources are in the lower microgram range.…”

Section: Lithium Salts and Dementiamentioning

confidence: 99%

“…Levels of lithium carbonate salts are known to be elevated in European mineral springs, and even bottled Perrier water contains lithium salts [41,42]. While the levels of Li in these sources are logs lower than doses effective in bipolar diseases, based on the recent epidemiological studies [35][36][37][38][39], chronic exposure to such low doses of lithium salts could potentially have an influence on risk for cognitive diseases via a role as a subtle modifier of systems relevant to cognition integrity. In contrast to bipolar disease which has acute cycles of mood behavior, loss of cognition due to dementia and Alzheimer's disease is of slow onset, likely taking decades so the process could be receptive to the influences of low levels of Li.…”

Section: Lithium Salts and Dementiamentioning

confidence: 99%

See 1 more Smart Citation

Would Adding Low Doses of Lithium Salts and/or Prebiotic Fibre Interventions to an Effective Exercise Protocol Further Enhance Retention of Cognitive Integrity? Potential for Preventing Loss of Cognition with Aging Using Combinations of Low Cost Regimens

Hart¹

2018

JBiSE

View full text Add to dashboard Cite

It is clear that loss of cognition is becoming epidemic in our aging society. Onset of dementia and diseases such as Alzheimer's are very prevalent and the prognosis is not optimistic that numbers will decrease in the coming decades. Thus, this epidemic is impacting the quality of life of a large number of people, primarily females, as well as the health care systems of many countries. Of relevance is the fact that large clinical trials of candidate drugs to treat these conditions have not been overwhelming successes, indicating that we may need to take new directions or focus on prevention. One conservative approach in this regard has been the use of exercise protocols to both retain cognition and inhibit progression of loss. With the optimization of exercise protocols, it may be time to step back and ask "how can these successes be augmented to further inhibit risk and stabilize loss early in the development of these conditions?" An example of how this could be approached is via supplementation with low doses of minerals such as lithium salts, or supplementation of the diet with prebiotics in patients with obesity and metabolic syndrome. Regarding the former, recent epidemiological studies have indicated that the content of Li in the drinking water is associated with lower incidences of cognitive diseases/conditions. While not definitive, such clues may warrant performing controlled studies using low doses of lithium salts plus exer- cise to further optimize impact on retention of cognition in those at risk, or those with early disease. Similarly, patients with obesity are at higher risk to develop dementia, and prebiotics can correct some of the metabolic derangements associated with the microbiome in such patients to impact risk. Thus, multiple low cost interventions plus exercise could further enhance retention of cognitive integrity in specific populations.

show abstract

Association Between Estimated Geocoded Residential Maternal Exposure to Lithium in Drinking Water and Risk for Autism Spectrum Disorder in Offspring in Denmark

Liew

Meng

et al. 2023

JAMA Pediatr

Self Cite

View full text Add to dashboard Cite

ImportanceLithium is a naturally occurring and trace element that has mood-stabilizing effects. Maternal therapeutic use of lithium has been associated with adverse birth outcomes. In animal models, lithium modulates Wnt/β-catenin signaling that is important for neurodevelopment. It is unknown whether exposure to lithium in drinking water affects brain health in early life.ObjectiveTo evaluate whether autism spectrum disorder (ASD) in offspring is associated with maternal exposure to lithium in drinking water during pregnancy.Design, Setting and ParticipantsThis nationwide population-based case-control study in Denmark identified 8842 children diagnosed with ASD born from 2000 through 2013 and 43 864 control participants matched by birth year and sex from the Danish Medical Birth Registry. These data were analyzed from March 2021 through November 2022.ExposuresGeocoded maternal residential addresses during pregnancy were linked to lithium level (range, 0.6 to 30.7 μg/L) in drinking water estimated using kriging interpolation based on 151 waterworks measurements of lithium across all regions in Denmark.Main Outcomes and MeasuresASD diagnoses were ascertained using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes recorded in the Danish Psychiatric Central Register. The study team estimated odds ratios (ORs) and 95% CIs for ASD according to estimated geocoded maternal exposure to natural source of lithium in drinking water as a continuous (per IQR) or a categorical (quartile) variable, adjusting for sociodemographic factors and ambient air pollutants levels. The study team also conducted stratified analyses by birth years, child’s sex, and urbanicity.ResultsA total of 8842 participants with ASD (male, 7009 [79.3%]) and 43 864 control participants (male, 34 749 [79.2%]) were studied. Every IQR increase in estimated geocoded maternal exposure to natural source of lithium in drinking water was associated with higher odds for ASD in offspring (OR, 1.23; 95% CI, 1.17-1.29). Elevated odds among offspring for ASD were estimated starting from the second quartile (7.36 to 12.67 μg/L) of estimated maternal exposure to drinking water with lithium and the OR for the highest quartile (more than 16.78 μg/L) compared with the reference group (less than 7.39 μg/L) was 1.46 (95% CI, 1.35-1.59). The associations were unchanged when adjusting for air pollution exposures and no differences were apparent in stratified analyses.Conclusions and RelevanceEstimated maternal prenatal exposure to lithium from naturally occurring drinking water sources in Denmark was associated with an increased ASD risk in the offspring. This study suggests that naturally occurring lithium in drinking water may be a novel environmental risk factor for ASD development that requires further scrutiny.

show abstract

Association of Lithium in Drinking Water With the Incidence of Dementia

Abstract: Long-term increased lithium exposure in drinking water may be associated with a lower incidence of dementia in a nonlinear way; however, confounding from other factors associated with municipality of residence cannot be excluded.

Cited by 163 publications

References 44 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Would Adding Low Doses of Lithium Salts and/or Prebiotic Fibre Interventions to an Effective Exercise Protocol Further Enhance Retention of Cognitive Integrity? Potential for Preventing Loss of Cognition with Aging Using Combinations of Low Cost Regimens

Association Between Estimated Geocoded Residential Maternal Exposure to Lithium in Drinking Water and Risk for Autism Spectrum Disorder in Offspring in Denmark

Contact Info

Product

Resources

About