{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T14:26:51Z","timestamp":1793975211334,"version":"4.8.0"},"reference-count":56,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alzheimer's disease (AD) is the most common cause of dementia, affecting over 55 million people worldwide with no established disease-modifying treatments. Lithium has emerged as a potential neuroprotective agent through multiple molecular mechanisms, and observational studies suggest reduced dementia risk among users, but evidence synthesis is needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association between lithium exposure and dementia incidence through systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review following PRISMA 2020 guidelines, searching major databases through December 2024. Random-effects meta-analyses with Hartung-Knapp-Sidik-Jonkman adjustment were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-three primary studies with original data (n\u2009&gt;\u20091.2 million) were included in qualitative synthesis; 11 provided extractable quantitative data, including 8 individual-level and 3 ecological studies. Four cohort studies showed a pooled hazard ratio (HR) of 0.633 (95% CI: 0.517\u20130.775; p\u2009=\u20090.003), indicating \u223c37% lower dementia risk with lithium. Two individual-level studies showed HR 0.656 (95% CI: 0.427\u20131.009; p\u2009=\u20090.052) for AD diagnosis. Three randomized controlled trials (RCTs) of cognitive outcomes yielded SMD \u22120.410 (95% CI: \u22120.810 to \u22120.020; p\u2009=\u20090.040) based on 229 participants. Two ecological studies using incidence rate ratios (IRR 0.830, 95% CI: 0.810\u20130.850) were directionally consistent. Substantial heterogeneity reflected clinical diversity, with consistent protective effects across subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lithium exposure was consistently associated with reduced dementia risk. While observational evidence precludes definitive causal inferences, the magnitude, consistency, and biological plausibility support lithium as a promising candidate for dementia prevention research. Large-scale, long-term RCTs are needed to establish causality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261488808","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:06:46Z","timestamp":1790604406000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lithium exposure and risk of dementia and Alzheimer's disease: A systematic review and meta-analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1649-4718","authenticated-orcid":false,"given":"Lorenzo","family":"Campedelli","sequence":"first","affiliation":[{"name":"Department of Economic, Psychological and Communication Sciences, Niccol\u00f2 Cusano University, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4332-0353","authenticated-orcid":false,"given":"Andrea","family":"Cicoli","sequence":"additional","affiliation":[{"name":"Department of Economic, Psychological and Communication Sciences, Niccol\u00f2 Cusano University, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Lastretti","sequence":"additional","affiliation":[{"name":"Department of Economic, Psychological and Communication Sciences, Niccol\u00f2 Cusano University, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina","family":"Spagna","sequence":"additional","affiliation":[{"name":"Department of Economic, Psychological and Communication Sciences, Niccol\u00f2 Cusano University, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ettore","family":"D'Aleo","sequence":"additional","affiliation":[{"name":"Department of Economic, Psychological and Communication Sciences, Niccol\u00f2 Cusano University, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Economic, Psychological and Communication Sciences, Niccol\u00f2 Cusano University, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01124-1"},{"key":"e_1_3_3_3_2","unstructured":"Alzheimer\u2019s Association. 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