Your incompetent? doctor already has protocols on uses of lithium for your stroke or TBI, and Alzheimers' prevention, right? Oh no, you DON'T have a functioning stroke doctor, do you?
Low-dose lithium shows promise in slowing verbal memory decline in older adults
In a 2-year randomised, placebo-controlled pilot trial of 80 older adults with mild cognitive impairment (MCI), low-dose lithium carbonate did not meet prespecified significance thresholds for cognitive, neuroimaging, or biomarker outcomes, although it was associated with a slower annual decline in verbal memory compared with placebo.
Results of the study, published in JAMA Neurology, showed that lithium was generally safe and feasible in this population, providing critical effect size estimates to inform larger trials aimed at preventing progression to Alzheimer disease.
“The key point is that lithium doesn’t restore lost memory,” said Ariel G. Gildengers, MD, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. “What it appears to do -- if the signal holds up -- is slow deterioration. That distinction matters enormously when you’re designing trials and interpreting results.”
To examine the feasibility, safety, and preliminary efficacy of low-dose lithium carbonate in adults aged ≥60 years with MCI, the researchers randomised participants to receive daily lithium or placebo for 2 years, with 80 starting treatment between February 2018 and August 2024. The trial assessed 6 coprimary outcomes, including cognitive performance measures, hippocampal and cortical gray matter volumes, and brain-derived neurotrophic factor levels.
Over the 2-year follow-up, none of the coprimary outcomes reached prespecified significance thresholds. However, lithium-treated participants showed a slower annual decline in verbal memory compared with placebo (0.73 vs 1.42 points per year on the California Verbal Learning Test-II delayed recall; P = .05). Brain volumes declined in both groups, with no significant differences, and serious adverse events were similar between groups.
When the trial was launched nearly a decade ago, blood‑based tests for Alzheimer’s pathology were not yet available. As a result, participants were enrolled based on clinical symptoms alone, and only a subset turned out to be amyloid‑positive -- a limitation that may have diluted the study’s ability to detect stronger effects.
“If we were designing this study today, we would enroll participants based on amyloid status from the start,” said Dr. Gildengers. “That’s exactly what we’re planning for next.”
“This study tells us that the approach is feasible, safe and worth pursuing, but it also reminds us why careful, adequately powered trials are essential -- especially when the stakes are this high,” he added.
Reference: https://jamanetwork.com/journals/jamaneurology/fullarticle/2845746
SOURCE: University of Pittsburgh
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