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Record W4412389690 · doi:10.33844/cjm.2025.6048

Reversible Lithium Toxicity Misdiagnosed as Dementia in an Elderly Patient: A Case Report and Follow-Up to Previous Work on Lithium Sensitivity in Aging

2025· article· en· W4412389690 on OpenAlex
Richard A. Burns

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.
venuePublished in a venue whose home country is Canada.

Bibliographic record

VenueCanadian Journal of Medicine · 2025
Typearticle
Languageen
FieldMedicine
TopicBipolar Disorder and Treatment
Canadian institutionsQueen's University
Fundersnot available
KeywordsLithium (medication)DementiaMedicineToxicityWork-upPsychiatryInternal medicine

Abstract

fetched live from OpenAlex

Lithium is a widely used mood stabilizer but requires careful management in the elderly due to altered pharmacokinetics and pharmacodynamics. This case report describes a dramatic reversal of apparent end-stage dementia in an 85-year-old woman after recognition and correction of chronic lithium toxicity. The case is of interest because over a two-year period of the case, the average lithium level, creatinine level, and eGFR remained the same, yet the lithium became toxic. It demonstrates that even though the eGFR remains constant, the dose of lithium may need to be reduced with aging to keep the lithium level therapeutic. It reinforces and expands upon previous findings that therapeutic serum lithium levels can become toxic with aging due to physiological changes, particularly in renal function and neural sensitivity. The woman is in stage four of chronic kidney disease, which means there is a very small therapeutic region for the lithium. The paper also describes how a second, unusual form of dementia, caused by lithium toxicity, was diagnosed and treated.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.411
Threshold uncertainty score0.967

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.014
GPT teacher head0.271
Teacher spread0.257 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it