Can Lithium Help Cognitive Impairment in Older Adults ?

Summary: No, currently, evidence shows that lithium does not help cognitive impairment in older adults.

Key Points:

• Among older adults, finding new ways to slow or improve cognitive decline or impairment is a primary concern.
• A recent trend in dietary supplements claiming lithium can help cognitive impairment has led to older adults inquiring about prescription lithium for cognitive impairment associated with mental health disorders and/or Alzheimer’s disease.
• Lithium is a mood stabilizer proven effective for regulating emotion in people with bipolar disorder.
• New, peer reviewed research examines whether lithium can help cognitive impairment in older adults.

From the Laboratory to the Clinic: Why Researchers Hypothesized Lithium Can Help Cognitive Impairment in Older Adults

In March 2026, a group of researchers designed a clinical trial called “Low-Dose Lithium for Mild Cognitive Impairment: A Pilot Randomized Clinical Trial” in order to answer the following research question:

“Can low-dose lithium treatment delay cognitive decline in older adults with mild cognitive impairment?”

The reason they designed and conducted the experiment is twofold:

1. Cognitive impairment associated with Alzheimer’s disease can cause significant functional problems for older adults.
2. A study published in 2025 showed the potential neuroprotective effects of lithium in laboratory mice, suggesting the drug as a potential treatment for cognitive impairment in adults with Alzheimer’s dementia.

If research confirms the neuroprotective effects of lithium observed in mice can improve or slow cognitive impairment in older adults, the finding will represent an important step forward in treating the effect of Alzheimer’s dementia.

Before we go further, however, we’ll clarify what we mean by terms we’ve used already that may be unclear: cognitive impairment and dementia:

Cognitive impairment, as defined by experts at John’s Hopkins Medicine:

“Cognitive impairment refers to deficits in neurocognitive domains including attention, executive function, learning, memory, language, spatial/motor function, and social function.”

Dementia, as defined by experts at the Alzheimer’s Association:

“Dementia is an umbrella term for loss of memory and other thinking abilities severe enough to interfere with daily life.”

The most common cause of cognitive impairment and dementia in older adults is Alzheimer’s disease, defined by experts at Merck Manuals as follows:

“Alzheimer’s disease is a progressive loss of mental function, characterized by degeneration of brain tissue, including loss of nerve cells, the accumulation of an abnormal protein called beta-amyloid, and the development of neurofibrillary tangles.”

In the report “Alzheimer’s Disease Facts and Figures: 2025” published by the Alzheimer’s Association, experts estimate the prevalence of Alzheimer’s disease (AD) in the U.S. and worldwide, as well as additional facts on AD:

• S.: 7.2 million
  • Under age 65: ~250,000
  • 65-74: 1.8 million
  • 75-84: 2.6 million
  • 85+: 2.4 million
• Worldwide: 55 million
• Among people with dementia:
  • 60-70% have AD

Those figures show us why research into reducing or improving cognitive impairment in older adults is important: dementia and AD affect millions of people in the U.S. That includes our older relatives, neighbors, and community members. And although AD is not a typical part of aging, cognitive decline and/or dementia is a very real concern for everyone, because everyone ages and no one is immune to natural, progressive cognitive decline.

With all that in mind, let’s take a look at that study on lithium.

Lithium and Cognitive Impairment in Older Adults: Not Superior to Placebo

Previous research in laboratory mice suggests lithium deficiency may play a role in the development of Alzheimer’s disease and related cognitive impairment and dementia.

To assess the “feasibility, safety, and preliminary efficacy of lithium carbonate for delaying cognitive decline in older adults with MCI,” the researchers recruited 82 older adults with mild cognitive impairment and divided them into two groups:

• Experimental group: 41 adults who received a low dose of lithium carbonate for two years.
• Control group: 42 adults who received a placebo (sham medication) for two years.

Researchers collected data on the following six outcomes at baseline, at one year, and at two years following initiation of the experimental protocol:

1. Overall cognitive performance
2. Memory/delayed recall
3. Visual/Spatial Memory
4. Hippocampal volume
5. Cortical gray matter volume
6. Brain-derived neurotrophic factor

Here’s what they found:

Overall cognitive performance, determined by combined scores on cognitive performance, memory/delayed recall, and visual/spatial memory: (smaller decline = better result)

• Lithium: Scores declined 0.73 points per year
• Placebo: Scores declined 1.42 points per year
• Hippocampal, cortical, neurotropic factor: no statistically meaningful difference between placebo and experimental group.

Although the lithium group showed less cognitive decline compared to the placebo group, the difference was not statistically significant. Here’s how the researchers characterize this result:

Among cognitive outcomes, scores declined 1.42 points per year in the placebo group compared with 0.73 points per year in the lithium group, with a difference in annual decline of 0.69 points per year, which did not meet our prespecified threshold.”

Despite this result, the research team confirmed the value of the study:

“This pilot randomized clinical trial established the feasibility of recruitment and retention and confirmed the safety and tolerability of low-dose lithium in older adults with MCI…Together with findings from prior independent longer-term trials, these results support further investigation of lithium in adequately powered trials to assess its potential neuroprotective properties in MCI.”

At this point, experimental evidence does not support the use of lithium to treat cognitive decline or dementia.

But what does help people experiencing mild cognitive decline or Alzheimer’s-related dementia as they age?

Cognitive Decline, Cognitive Impairment, Dementia: Risk Protective Factors

First, let’s take a look at the signs and symptoms of age-related cognitive decline and/or AD-related dementia:

• Memory loss
• Problems with verbal and written expression
• Wandering/getting lost in familiar places
• Difficulty keeping track of bills/money
• Repeating questions
• Slow performance of typical tasks
• Loss of interest in favorite activities
• Problems with balance and movement

Risk factors for dementia include:

• Sedentary lifestyle/lack of physical activity
• Obesity
• Poorly managed/unmanaged diabetes
• Elevated blood pressure
• Loss of hearing
• Alcohol use
• Tobacco use

According to the Centers for Disease Control  (CDC), close to “45 percent of dementia cases can be prevented or delayed” by addressing modifiable risk factors – see list above – by taking the following actions:

1. Stay physically active: get at least 20 minutes of aerobic activity per day.
2. Manage diabetes if present: adhere to medication and follow a treatment plan developed by a qualified physician.
3. Keep track of and manage blood pressure: maintain healthy weight and follow a treatment plan developed by a qualified physician.
4. Address hearing loss: use of hearing aids or other hearing assistance tools can reduce the impact and speed of cognitive decline and is also associated with increased social contact.
5. Reduce or eliminate alcohol and tobacco use: alcohol use, especially binge drinking, and tobacco use can increase risk of dementia and cognitive decline.

While most experts agree there’s no way to completely eliminate age-related cognitive decline and – as yet – no evidence-based treatment to reverse Alzheimer’s-related dementia, the current body of research shows taking the steps above can delay and/or mitigate age-related cognitive decline and Alzheimer’s-related dementia.

Cognitive Decline and Mental Health for Older Adults: Whose Advice to Take?

We encourage you to listen to trained and qualified medical professionals on any topics related to the treatment of physical disease or mental health disorders.

The good news about the steps above – offered by medical experts – is that they’re simple, effective, and completely within reach for most older adults, and align with virtually all other general advice about healthy aging for the mind and body. The takeaway:

Be wary of claims on labels made by dietary supplement makers: most are not approved by the FDA to treat medical conditions.

To close, we’ll reiterate our suggestion to follow your primary care physician’s advice on healthy levels of exercise, activity, and diet as related to healthy aging. They know what they’re talking about, they have the training, and when acting in their capacity as physicians, their advice is supported by their medical qualifications and their professional licensure.