Lithium treatment and risk for dementia in adults with bipolar disorder: Population-based cohort study

BackgroundLithium inhibits glycogen synthase kinase-3, an enzyme implicated in the pathogenesis of dementia.AimsTo examine the association of lithium and dementia risk in a large claims-based US cohort of publicly insured older adults with bipolar disorder.MethodThe cohort included individuals ≥50 y...

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Bibliographic Details
Published in:British journal of psychiatry 2015-07, Vol.207 (1), p.46-51
Main Authors: Gerhard, Tobias, Devanand, D. P., Huang, Cecilia, Crystal, Stephen, Olfson, Mark
Format: Article
Language:English
Subjects:
Aged
Alzheimer's disease
Anticonvulsants
Antimanic Agents - administration & dosage
Bipolar disorder
Bipolar Disorder - drug therapy
Cognitive ability
Cohort analysis
Dementia
Dementia - diagnosis
Dementia disorders
Drug dosages
Epidemiology
Female
Glycogen
Glycogen synthase kinase 3
Health care policy
Humans
Lithium
Lithium - administration & dosage
Male
Medicaid
Medical diagnosis
Medicare
Middle Aged
Mood
Older people
Pharmacy
Population
Population studies
Population-based studies
Psychiatry
Psychotropic drugs
Retrospective Studies
Risk Factors
Risk reduction
Treatment Outcome
United States
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Summary:BackgroundLithium inhibits glycogen synthase kinase-3, an enzyme implicated in the pathogenesis of dementia.AimsTo examine the association of lithium and dementia risk in a large claims-based US cohort of publicly insured older adults with bipolar disorder.MethodThe cohort included individuals ≥50 years diagnosed with bipolar disorder who did not receive dementia-related services during the prior year. Each follow-up day was classified by past-year cumulative duration of lithium use (0, 1-60, 61-300 and 301-365 days). Dementia diagnosis was the study outcome. Anticonvulsants commonly used as mood stabilisers served as a negative control.ResultsCompared with non-use, 301-365 days of lithium exposure was associated with significantly reduced dementia risk (hazard ratio (HR) = 0.77, 95% CI 0.60-0.99). No corresponding association was observed for shorter lithium exposures (HR = 1.04, 95% CI 0.83-1.31 for 61-300 days; HR = 1.07, 95% CI 0.67-1.71 for 1-60 days) or for any exposure to anticonvulsants.ConclusionsContinuous lithium treatment may reduce dementia risk in older adults with bipolar disorder.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.bp.114.154047