BACKGROUND: Lithium is the gold-standard mood stabilizer in bipolar disorder (BD) showing putative neuroprotective effects, but its association with cognition in older adults with BD (OABD) remains unclear. AIM: To examine the association of long-term lithium treatment with cognitive performance in euthymic OABD. METHODS: tests, and Person's correlations were Bonferroni-corrected. A principal component analysis-generated general cognitive factor was entered into logistic regression models predicting lithium status, with sequential adjustment for various covariates. RESULTS/OUTCOMES: = 0.70), and its effect remained large and mostly significant across six adjusted models. CONCLUSION/INTERPRETATION: In euthymic OABD, chronic lithium treatment is associated with markedly better global cognition, independent of mood, illness severity, and polypharmacy. Our findings provide support for the role of lithium in cognitive preservation and are worthy of further investigation in larger longitudinal studies.
Tsapakis et al. (2026) studied this question.