I have been reassuring my patients that lithium staves off dementia, citing research using lithium to treat Alzheimer dementia. Yet, I had worried about a few earlier studies linked it to more dementia. Now this article from the Journal of Clinical Psychiatry find no link either way. It appears we need more research. It suspect it may be dose related.
Microdoses as low as 1mg a day of lithium (0.1%) stimulate brain derived growth factor to lead to synaptogenesis and ostensibly to reverse atrophy in the hippocampus. That would stave of memory loss. Typical doses around 900-1200mg are so much more: Perhaps too much allostatic load and diminished returns for cognition while better protection from manic or depressive episodes. A balancing act: At least this latest study reassures me that typical doses do not appear to worsen cognition while they do treat bipolar.
So at this point I will continue to use lithium, follow the literature, consider low dose for synaptogenesis, suicide prevention, and regular dose for depression or bipolar maintenance treatment.