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A new study headed by the University of Cambridge has discovered a relationship that suggests lithium may reduce the chance of acquiring dementia.
The findings were reported in the journal ‘PLoS Medicine.’ The study included a retrospective review of nearly 30,000 patients’ health data from the Cambridgeshire and Peterborough NHS Foundation Trust. Between 2005 and 2019, the patients were all above the age of 50 and used NHS mental health treatments.
Although the overall number of patients who took lithium was modest, the analysis revealed that those who received lithium were less likely to acquire dementia than those who did not. It also stated that lithium may be used as a prophylactic therapy for dementia and that big randomised controlled trials could be conducted.

Dementia is the biggest cause of mortality in older Western populations, however there are presently no prophylactic therapies available. Dementia affects more than 55 million people globally, with Alzheimer’s disease being the most common kind.

“The number of people with dementia continues to grow, which puts huge pressure on healthcare systems,” said Dr Shanquan Chen from Cambridge’s Department of Psychiatry, the paper’s first author.
“It’s been estimated that delaying the onset of dementia by just five years could reduce its prevalence and economic impact by as much as 40 per cent,” he added.

Previous research have advocated lithium as a viable treatment for persons who have already been diagnosed with dementia or early cognitive impairment, but it is uncertain if it may postpone or even prevent the onset of dementia entirely, due to the small sample size of these studies.
Lithium is a mood stabiliser that is commonly used for bipolar affective disorder and depression.

“Bipolar disorder and depression are considered to put people at increased risk of dementia, so we had to make sure to account for this in our analysis,” said Chen.

Chen and his colleagues examined data from Cambridgeshire and Peterborough NHS Foundation Trust patients who sought mental health treatments between 2005 and 2019. Patients were all above the age of 50, had at least one year of follow-up appointments, and had not previously been diagnosed with moderate cognitive impairment or dementia.

548 of the 29,618 individuals in the research group had had lithium treatment, whereas the remaining 29,070 had not. Their average age was slightly under 74 years, and almost 40% of the patients were male.
In the lithium group, 53 people, or 9.7 percent, were diagnosed with dementia. In the group that did not get lithium, 3,244 people, or 11.2%, were diagnosed with dementia.
Lithium usage was related with a decreased incidence of dementia after adjusting for variables such as smoking, other drugs, and other physical and mental diseases, both for short and long-term users.

However, because the total number of patients taking lithium was limited and this was an observational research, bigger clinical studies would be required to prove lithium as a possible dementia therapy. Another drawback of the study was the small number of individuals with bipolar illness, which is generally associated with an increased risk of dementia.

“We expected to find that patients with bipolar disorder were more likely to develop dementia since that is the most common reason to be prescribed lithium, but our analysis suggested the opposite,” said Chen.
“It’s far too early to say for sure, but it’s possible that lithium might reduce the risk of dementia in people with bipolar disorder,” he concluded.

A recent study headed by Brigham and Women’s Hospital researchers discovered that frequent daytime napping can raise the chance of Alzheimer’s disease in the future, and dementia accelerated the increase in daytime napping during ageing.
The study was published in the journal ‘Alzheimer’s & Dementia: The Alzheimer’s Association Journal.’

“Daytime sleep behaviours of older adults are oftentimes ignored, and a consensus for daytime napping in clinical practice and health care is still lacking,” said Peng Li, PhD, of the Medical Biodynamics Program in the Brigham’s Division of Sleep and Circadian Disorders.

“Our results not only suggest that excessive daytime napping may signal an elevated risk of Alzheimer’s dementia, but they also show that faster yearly increase in daytime napping may be a sign of deteriorating or unfavored clinical progression of the disease. Our study calls for closer attention to 24-hour sleep patterns — not only nighttime sleep but also daytime sleep — for health monitoring in older adults,” he added.

The impact of daytime napping on cognition in older persons yielded contradictory results. While some studies have found that daytime napping improves acute cognitive function, mood, and alertness, others have found that it has a negative impact on cognitive performance.

Nonetheless, Brigham researchers noted that all previous Alzheimer’s disease studies measured napping in a participant just once, and the majority of them were subjective and questionnaire-based. As a result, they intended to perform a long-term, objective examination of naps in order to discover the relationship between daytime napping and Alzheimer’s disease.

The current study put two hypotheses to the test:
1. Participants snooze longer and/or more frequently as they age, and the changes are considerably more rapid as Alzheimer’s disease progresses.
2. Participants who snooze excessively during the day are more likely to acquire Alzheimer’s disease.

The researchers used a previously established sleep scoring system that takes wrist activity counts into account to identify sleep periods. The nap length and frequency were calculated when napping episodes were detected.

Researchers discovered that nap length and frequency were positively connected with age in the unique cohort study, as well as a bi-directional, longitudinal association between daytime sleep and Alzheimer’s dementia. Longer and more frequent daytime naps were a risk factor for acquiring Alzheimer’s dementia in cognitively normal older men and women, independent of recognised dementia risk variables such as age and nocturnal sleep length and fragmentation.

“The vicious cycle we observed between daytime sleep and Alzheimer’s disease offers a basis for better understanding the role of sleep in the development and progression of Alzheimer’s disease in older adults,” said Peng Li.

Three major research limitations were mentioned by the authors. First, despite the fact that actigraphy has been widely utilised and verified in sleep field investigations, researchers acknowledged that polysomnography is the gold standard for sleep grading. Second, because the individuals in the study were older, the findings may not be easily transferred to younger cohorts. Third, future research should look at whether a direct intervention in the form of daytime napping might reduce the risk of Alzheimer’s disease or cognitive decline.

“Our hope is to draw more attention to daytime sleep patterns and the importance of patients noting if their sleep schedule is changing over time,” said co-senior author Kun Hu, PhD, of the Medical Biodynamics Program in the Brigham’s Division of Sleep and Circadian Disorders.

“Sleep changes are critical in shaping the internal changes in the brain related to the circadian clocks, cognitive decline and the risk of dementia,” he concluded.

Following an early reduction in Covid cases in Asia and Europe, the World Health Organization (WHO) stated that the virus is still’very fit’ and travelling about readily, despite the efficacy of immunizations decreasing. This creates an ideal setting for the development of novel coronavirus strains.

Noting that the virus has not ‘settled down’ into a purely seasonal or predictable pattern yet, Dr Mike Ryan, WHO’s Executive Director of the Health Emergencies Programme, said, as quoted by UN News, “So, the idea that ‘we are through with it’ in the northern hemisphere and now we have to wait until next winter, I think (for example) when we look at increasing rates in the UK, we need to be very vigilant and cautious with this.”