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71/100

✓ Peer-reviewed alzhub usefulness score 71 out of 100. Drug development

Topic: Air pollution and environmental exposures

A total of 73 731 patients with dementia and 733 653 controls (median age, 80.3 years; interquartile range, 74.9-84.6 years; 44 760 female [60.7%] and 28 971 male [39.3%]) were included in the study. Lithium exposure was statistically significantly different between patients with a diagnosis of dementia (median, 11.5 µg/L; interquartile range, 6.5-14.9 µg/L) and controls (median, 12.2 µg/L; interquartile range, 7.3-16.0 µg/L; P < .001). A nonlinear association was observed. Compared with individuals exposed to 2.0 to 5.0 µg/L, the incidence rate ratio (IRR) of dementia was decreased in those exposed to more than 15.0 µg/L (IRR, 0.83; 95% CI, 0.81-0.85; P < .001) and 10.1 to 15.0 µg/L (IRR, 0.98; 95% CI, 0.96-1.01; P = .17) and increased with 5.1 to 10.0 µg/L (IRR, 1.22; 95% CI, 1.19-1.25; P < .001). Similar patterns were found with Alzheimer disease and vascular dementia as outcomes. Conclusions and Relevance: Long-term increased lithium exposure in drinking water may be associated with a lower incidence of dementia in a nonlinear way; however, confounding from other factors associated with municipality of residence cannot be excluded.

Key findings

A total of 73 731 patients with dementia and 733 653 controls (median age, 80.3 years; interquartile range, 74.9-84.6 years; 44 760 female [60.7%] and 28 971 male [39.3%]) were included in the study.
Lithium exposure was statistically significantly different between patients with a diagnosis of dementia (median, 11.5 µg/L; interquartile range, 6.5-14.9 µg/L) and controls (median, 12.2 µg/L; interquartile range, 7.3-16.0 µg/L; P < .001).
Compared with individuals exposed to 2.0 to 5.0 µg/L, the incidence rate ratio (IRR) of dementia was decreased in those exposed to more than 15.0 µg/L (IRR, 0.83; 95% CI, 0.81-0.85; P < .001) and 10.1 to 15.0 µg/L (IRR, 0.98; 95% CI, 0.96-1.01; P = .17) and increased with 5.1 to 10.0 µg/L (IRR, 1.22; 95% CI, 1.19-1.25; P < .001).
Similar patterns were found with Alzheimer disease and vascular dementia as outcomes.
Conclusions and Relevance: Long-term increased lithium exposure in drinking water may be associated with a lower incidence of dementia in a nonlinear way; however, confounding from other factors associated with municipality of residence cannot be excluded.

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Study details

Study designcase-control study
Participants731
Effect size60.7%; 39.3%
Evidence strengthModerate

How this study scored 71/100

Published in a leading specialty journal, and it is a case-control study. Scored zero for randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 41 of the 58 points we could judge it on, which is 71 out of 100.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (JAMA Psychiatry)
Journal's citation record	— / 4	No journal record from OpenAlex — left out of this score
Study design	6 / 12	A case-control study
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	2 / 5	2017 — within 10 year(s) of the newest study here
Sample size	2 / 4	731 participants
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	— / 7	No citation count (not found in OpenAlex) — left out of this score
Citations per year	— / 5	No citation count or no year — left out of this score
Impact for its field and year	— / 6	No field-weighted citation impact (OpenAlex has none yet) — left out of this score
Cited by studies here	— / 6	Not yet checked against this library's citation graph — left out of this score
Still being cited	— / 4	No yearly citation counts — left out of this score
Senior author's track record	— / 4	Senior author's record not available — left out of this score
Institution's track record	— / 3	No institution listed in OpenAlex — left out of this score
Multi-centre collaboration	— / 3	Institutions not listed — left out of this score
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 28832877)
Free to read	2 / 2	Free to read
Points	41 / 58	Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 41 of the 58 points we could judge it on is 71 out of 100.
Total	71 / 100	—

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Cite this study APA, Vancouver, BibTeX · download .bib or .ris

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APA 7th

Kessing, L. V., Gerds, T. A., Knudsen, N., Jørgensen, L. F., Kristiansen, S. M., Voutchkova, D. D., et al. (2017). Association of Lithium in Drinking Water With the Incidence of Dementia. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2017.2362

Vancouver

Kessing LV, Gerds TA, Knudsen N, Jørgensen LF, Kristiansen SM, Voutchkova DD, et al. Association of Lithium in Drinking Water With the Incidence of Dementia. JAMA Psychiatry. 2017. doi:10.1001/jamapsychiatry.2017.2362. PMID: 28832877.

BibTeX

@article{kessing2017-28832877,
  author  = {Kessing, Lars Vedel and Gerds, Thomas Alexander and Knudsen, N. and Jørgensen, Lisbeth Flindt and Kristiansen, Søren Munch and Voutchkova, Denitza Dimitrova and Ernstsen, Vibeke and Schullehner, Jörg and others},
  title   = {{Association of Lithium in Drinking Water With the Incidence of Dementia}},
  journal = {JAMA Psychiatry},
  year    = {2017},
  doi     = {10.1001/jamapsychiatry.2017.2362},
  pmid    = {28832877},
  url     = {https://doi.org/10.1001/jamapsychiatry.2017.2362}
}

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