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OABD patients often experience more severe physical comorbidities compared to younger BD patients, but systematic evidence regarding lithium's association with these conditions is lacking. This study examined the association between lithium use and physical comorbidities across age groups using the international Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE\u2010BD) dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional analysis was conducted using combined Wave 1 and 2 data from GAGE\u2010BD project, encompassing 37 studies from 20 sites worldwide. Participants aged \u2265\u200918\u2009years with BD were classified according to current lithium use. Physical comorbidities were harmonised into eight organ\u2010system domains. Sociodemographic and clinical variables were compared between individuals receiving lithium treatment and those not prescribed lithium. Generalised linear mixed models adjusted for age, site and lithium\u2009\u00d7\u2009age interaction were applied to evaluate associations with physical comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 2873 total participants included in the study, 1069 were currently receiving lithium treatment and 1804 were not prescribed lithium. Participants treated with lithium showed a lower overall prevalence of physical comorbidities compared with those not receiving lithium. Regression analyses revealed significant age\u2010by\u2010lithium interactions for cardiovascular (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20099.27,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), respiratory (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20097.56,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), genitourinary (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20098.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and endocrine (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200916.96,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) comorbidities. Model\u2010estimated curve crossings occurred at approximately 43\u2009years (cardiovascular), 32\u2009years (respiratory), 51\u2009years (genitourinary) and 59\u2009years (endocrine), above which predicted prevalence was lower among participants treated with lithium, whereas no differences were observed for gastrointestinal, hepatic, renal or musculoskeletal systems.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lithium use in OABD was associated with a lower burden of specific physical comorbidities, particularly cardiovascular, respiratory and endocrine conditions. Although prescription bias cannot be excluded, the findings challenge the perception that lithium exacerbates physical health risks in older adults. Instead, they support lithium's continued use\u2014with appropriate monitoring\u2014as a safe and effective treatment option for OABD, and highlight the need for prospective studies to further clarify the relationship between lithium exposure and physical health outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.70134","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T12:45:31Z","timestamp":1787143531000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association Between Lithium Use and Physical Comorbidities Across Age Groups: A Cross\u2010Sectional Study From the Global Aging and Geriatric Experiments in Bipolar Disorder (\n                    <scp>GAGE<\/scp>\n                    \u2010\n                    <scp>BD<\/scp>\n                    ) Project"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4207-5655","authenticated-orcid":false,"given":"Ni","family":"Xu","sequence":"first","affiliation":[{"name":"Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University) National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital)  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6962-5899","authenticated-orcid":false,"given":"Orestes V.","family":"Forlenza","sequence":"additional","affiliation":[{"name":"Laboratory of Neuroscience (LIM\u201027), Department and Institute of Psychiatry, Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo (HCFMUSP) University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6076-1894","authenticated-orcid":false,"given":"Peijun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Geriatric Psychiatry Division, Geriatric Research, Education and Clinical Center (GRECC) Case Western Reserve University School of Medicine, VA Northeast Ohio Healthcare System  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soham","family":"Rej","sequence":"additional","affiliation":[{"name":"Lady Davis Institute\/Jewish General Hospital McGill University  Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9216-988X","authenticated-orcid":false,"given":"Ariel G.","family":"Gildengers","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania 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