Nunes Paula V, Forlenza Orestes V, Gattaz Wagner F
Department and Institute of Psychiatry,Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Br J Psychiatry. 2007 Apr;190:359-60. doi: 10.1192/bjp.bp.106.029868.
Bipolar disorder is associated with increased risk for dementia. We compared the prevalence of Alzheimer's disease between 66 elderly euthymic patients with bipolar disorder who were on chronic lithium therapy and 48 similar patients without recent lithium therapy. The prevalence of dementia in the whole sample was 19% v. 7% in an age-comparable population. Alzheimer's disease was diagnosed in 3 patients (5%) on lithium and in 16 patients (33%) who were not on lithium (P<0.001). Our case-control data suggest that lithium treatment reduced the prevalence of Alzheimer's disease in patients with bipolar disorder to levels in the general elderly population. This is in accordance with reports that lithium inhibits crucial processes in the pathogenesis of Alzheimer's disease.
双相情感障碍与痴呆风险增加有关。我们比较了66例接受慢性锂盐治疗的老年双相情感障碍心境正常患者与48例近期未接受锂盐治疗的类似患者中阿尔茨海默病的患病率。整个样本中痴呆的患病率为19%,而在年龄匹配的人群中为7%。接受锂盐治疗的3例患者(5%)被诊断为阿尔茨海默病,未接受锂盐治疗的16例患者(33%)被诊断为阿尔茨海默病(P<0.001)。我们的病例对照数据表明,锂盐治疗将双相情感障碍患者中阿尔茨海默病的患病率降低至一般老年人群的水平。这与锂盐抑制阿尔茨海默病发病机制中关键过程的报道一致。