Low-dose oral lithium appeared to slow the decline of verbal memory - the ability to remember and recall words and sentences - in older adults with mild cognitive impairment, according to an exploratory clinical trial from the University of Pittsburgh published March 2 in JAMA Neurology. The effect was most apparent in participants who had evidence of amyloid beta, one of the hallmark biomarkers of Alzheimer's disease.
The trial was led by Dr. Ariel Gildengers, a professor of psychiatry at Pitt and a geriatric psychiatrist at UPMC whose earlier research followed older adults with bipolar disorder. In that work, people who had taken lithium long term tended to show markers of better brain integrity, which raised the question the new trial was built to test: whether those apparent neuroprotective effects extend beyond mood disorders and can be measured in a prospective study.
The design point matters for how the results should be read. This was not a trial meant to prove that lithium treats Alzheimer's disease. It was structured to answer an earlier, narrower question - whether lithium looks promising enough to justify a larger trial aimed at slowing Alzheimer's-related cognitive decline. On that count, the signal in verbal memory, and the stronger signal among amyloid-positive participants, is the kind of result that supports going further.
Lithium is a familiar, inexpensive drug with decades of use in psychiatry, so a repurposing pathway would be attractive if larger studies hold up. For now, the findings identify a direction for research rather than a treatment option, and confirmation will depend on the bigger trial this study was designed to inform.