Department of Neuropsychiatry, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu, Oita 879-5593, Japan.
Int J Environ Res Public Health. 2021 Jul 22;18(15):7756. doi: 10.3390/ijerph18157756.
Despite the unavailability of essential anti-dementia drugs, lithium may inhibit glycogen synthase kinase-3 (GSK-3) and decrease beta-amyloid and hyper-phosphorylated tau. In this review, we hypothesized that trace to standard levels of lithium (i.e., corresponding to the therapeutic levels for bipolar disorder) may be effective for dementia prevention. Excluding three insufficient level studies, we obtained two and one excellent clinical studies on standard and trace lithium levels, respectively, all of which supported the effects of lithium for dementia prevention. In addition, we identified good clinical and epidemiological studies (four each) on standard lithium levels, of which six studies supported the effects of lithium. Moreover, of three good epidemiological studies on trace lithium levels, two supported the aforementioned effects of lithium. The number of studies were substantially small, particularly those on trace lithium levels. Moreover, studies on standard lithium levels were insufficient to establish the efficacy of lithium for dementia prevention. This necessitates accumulating good or excellent clinical evidence for the effects of trace to standard lithium levels on dementia prevention.
尽管抗痴呆药物短缺,但锂可能抑制糖原合酶激酶-3(GSK-3),减少β-淀粉样蛋白和过度磷酸化的 tau。在这篇综述中,我们假设痕量到标准水平的锂(即,对应于双相情感障碍的治疗水平)可能对预防痴呆有效。排除三项水平不足的研究,我们分别获得了关于标准锂和痕量锂水平的两项和一项优秀的临床研究,所有这些研究都支持锂对预防痴呆的作用。此外,我们还确定了关于标准锂水平的四项良好临床和流行病学研究,其中六项研究支持锂的作用。此外,在三项关于痕量锂水平的良好流行病学研究中,有两项支持上述锂的作用。研究数量非常少,尤其是痕量锂水平的研究。此外,关于标准锂水平的研究还不足以确定锂预防痴呆的疗效。这需要积累痕量到标准锂水平对预防痴呆的影响的良好或优秀的临床证据。