Duthie Ashleigh C, Hannah Jean, Batty G David, Deary Ian J, Starr John M, Smith Daniel J, Russ Tom C
Division of Neuroscience, University of Dundee, Dundee, UK.
University of Stirling, Stirling, UK.
Int J Geriatr Psychiatry. 2023 Mar;38(3):e5890. doi: 10.1002/gps.5890.
Lithium, a mood stabilizer, is known to exhibit neuroprotective effects in animal models and may have anti-dementia effects.
We used data from Scottish Mental Survey 1932, a population-based cohort study, to investigate the association between lithium in drinking water and dementia rate in humans.
Lithium levels in drinking water from 285 sampling sites across Scotland dating from 2014 were obtained from the sole public water provider (Scottish Water). Dementia and non dementia cases were identified from cohort data by electronic health records until 2012, and linked to postcode.
The mean lithium level at all sampling sites was 1.45 μg/L (SD 1.83, range 0.5-18.2) and was 1.26 (SD 0.63, range 0.55-9.19) for sites matched to participant data. Of 37,597 study members, 3605 developed dementia until June 2012. Lithium levels were positively associated with the risk of dementia in women (highest in second quartile, HR 1.17, 95%CI 1.04-1.32), but there was no relationship in men (highest in second quartile, HR 0.95, 95% CI 0.81-1.12). The pattern of association was explored further by decile, and in females there was an association between lithium level and increased dementia risk compared to the lowest decile (0.55-0.68 μg/L) in all deciles except the highest, corresponding with lithium levels 0.68-2.1 μg/L.
Lithium levels in drinking water are very low across Scotland which limited detection of potential effect. Our results do not support an association between extremely low levels of lithium and later dementia risk. We found a trend to increased risk in females at lithium levels below but not above 2.1 μg/L.
锂作为一种情绪稳定剂，在动物模型中具有神经保护作用，可能具有抗痴呆作用。
我们利用基于人群的队列研究——1932年苏格兰精神调查的数据，来研究饮用水中的锂与人类痴呆率之间的关联。
从唯一的公共供水商（苏格兰水务公司）获取了2014年苏格兰285个采样点的饮用水锂含量。通过电子健康记录从队列数据中识别出痴呆和非痴呆病例，直至2012年，并与邮政编码相关联。
所有采样点的锂平均含量为1.45μg/L（标准差1.83，范围0.5 - 18.2），与参与者数据匹配的采样点的锂平均含量为1.26（标准差0.63，范围0.55 - 9.19）。在37597名研究对象中，到2012年6月有3605人患痴呆症。锂含量与女性患痴呆症的风险呈正相关（第二四分位数中最高，风险比1.17，95%置信区间1.04 - 1.32），但男性中无此关联（第二四分位数中最高，风险比0.95，95%置信区间0.81 - 1.12）。通过十分位数进一步探究关联模式，在女性中，除最高十分位数外，所有十分位数的锂含量与痴呆风险增加之间均存在关联，与最低十分位数（0.55 - 0.68μg/L）相比，对应锂含量为0.68 - 2.1μg/L。
苏格兰各地饮用水中的锂含量非常低，这限制了对潜在影响的检测。我们的研究结果不支持极低水平的锂与后期痴呆风险之间存在关联。我们发现，锂含量低于2.1μg/L但不高于该水平时，女性患痴呆症的风险有增加趋势。
