GEOCHEMICAL RISK-FACTORS FOR MENTAL FUNCTIONING, BASED ON THE ONTARIOLONGITUDINAL-STUDY OF AGING (LSA) .5. COMPARISONS OF THE RESULTS, RELEVANT TO ALUMINUM WATER CONCENTRATIONS, OBTAINED FROM THE LSA AND FROMDEATH CERTIFICATES MENTIONING DEMENTIA

Previous studies in this series of papers investigated the association s between aluminum (Al) water concentrations and relatively high risks of a measure of mental impairment and also various possible other dri nking water characteristics, particularly pH, turbidity, fluoride and silica. The results were based on one measure of mental impairment, wh ich would not be expected to give the same results as the more definit ive endpoint (outcome variable) of a record of Alzheimer's Disease (AD ) as the underlying cause of death on a death certificate. The present paper therefore investigates the relevant associations, based both on the measure of mental impairment and on death certificates in which A D and presenile dementia are listed as the underlying causes of death. As expected, the associations were not identical, but they were simil ar. More specifically, Al water concentrations were strongly associate d with the recording of AD on death certificates, as were pH, fluoride , and silica concentrations. The implications of these results are dis cussed, and it is suggested that the evidence is sufficiently strong f or methods of water purification to be modified, at least on a trial b asis, because of the likelihood that this will reduce the incidence of AD.