Topics outlined in an earlier paper by Eichhorn are expanded, with par
ticular emphasis on the implications of the associations between alumi
num (Al) concentrations and various indications of mental impairment.
These associations represent the main thrust of the evidence that Al i
s a contributory cause for some forms of dementia. Of particular inter
est are the more recently observed associations between Al concentrati
ons in drinking (finished) water and various indications of mental imp
airment, and the relevance of other water quality variables such as si
lica, fluoride, and pH. Various unresolved questions are also identifi
ed.