Aluminum forms in drinking water and risk of Alzheimer's disease

The objective of this study was to assess the relation between long-term ex posure to different aluminum (AI) forms in drinking water and Alzheimer's d isease (AD). The study participants were selected from a random sample of t he elderly population (greater than or equal to 70 years of age) of the Sag uenay-lac-Saint-Jean region (Quebec). Sixty-eight cases of Alzheimers disea se diagnosed according to recognized criteria were paired for age (+/-2 yea rs) and sex with nondemented controls. Aluminum speciation was assessed usi ng established standard analytical protocols along with quality control pro cedures. Exposure to Al forms (total Al, total dissolved AI, monomeric orga nic AI, monomeric inorganic Al, polymeric Al, Al3+, AlOH, AIF, AlH3SiO42-, AlSO4) in drinking water was estimated by juxtaposing the subject's residen tial history with the physicochemical data of the municipalities. The marke rs of longterm exposures (1945 to onset) to AZ forms in drinking water were not significantly associated with AD. On the other hand, after adjustment for education level, presence of family cases, and ApoE epsilon4 allele, ex posure to organic monomeric aluminum estimated at the onset of the disease was associated with AD (odds ratio 2.67; 95% CI 1.04-6.90). On average, the exposure estimated at the onset had been stable for 44 years. Our results confirm prime the importance of estimation of Al speciation and considerati on of genetic characteristics in the assessment of the association between aluminum exposure and Alzheimer's disease. (C) 2000 Academic Press.