- Long-term therapy with lithium (Eskalith, others) at subtherapeutic doses stabilized cognitive and functional measures among community-dwelling older adults with mild cognitive impairment (MCI).
Why this matters
- Lack of disease-modifying therapies for Alzheimer’s disease.
- 24-month changes in outcomes favored lithium over placebo:
- Alzheimer’s Disease Assessment Scale–cognitive subscale (0.83 vs 1.80; P<.05>
- Clinical Dementia Rating–Sum of Boxes (−0.22 vs 0.53; P<.05>
- Delayed recall (F=16.48; P<.001>
- Figure recall (F=6.16; P=.02); and
- Trail-Making Test–A (−0.80 vs 1.60; P<.05>
- Brazilian single-center randomized controlled trial among 61 community-dwelling, physically healthy older adults with MCI.
- Randomization: lithium (subtherapeutic concentrations of 0.25-0.5 mEq/L) vs placebo for 24 months (double-blind phase); follow-up for additional 24 months (single-blinded phase).
- Main outcomes: Alzheimer's Disease Assessment Scale–cognitive subscale; Clinical Dementia Rating–Sum of Boxes.
- Funding: Alzheimer’s Association; others.
- Small sample.
- Lack of biological eligibility criteria.
- Optimal lithium window, dose unknown.