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display very clear spatial variations, and appear to be increasing Looking for a link between Alzheimer's disease and total quite rapidly in number. There is extensive evidence to suggest drinking water aluminium may be too simplistic. In 2000, that such environments are areas where drinking water is high in Gauthier and co-workers* described a case control study in which dissolved aluminium [aluminum] (especially in its monomeric the chemical characteristics of the water historically drunk by 58 form) together with depressed levels of magnesium and calcium. elderly Alzheimer's patients were compared with those of potable This water is also typically low in silicic acid. These conditions water used by age- and gender-matched non-demented controls. occur where low-alkalinity surface waters have very little ability This was conducted in the Saguenay-Lac-Saint-Jean region of to buffer the impacts of acid rain, one of which is increased Quebec. Aluminium (Al) specification was assessed using aluminium solubility.” In such low-alkalinity, high-acid-rain standard analytical protocols. Long-term drinking water exposure regions, rising levels of dissolved aluminium, found in both soil (from 1945 to the onset of Alzheimer's disease) was estimated for water and run-off, are resulting in widespread ecological damage. total aluminium, total dissolved aluminium, monomeric organic It appears that this element is also the dominant environmental and inorganic aluminium, polymeric aluminium and five other risk factor in Alzheimer's disease. species of this metal. While there was no obvious relationship Clear evidence was provided in 1988 that excess aluminium in _ between total aluminium in potable water and Alzheimer's potable water can affect memory. An accident at a water supply isease, after adjustment for educational level, family cases of the plant at Camelford in Cornwall, England, resulted in water that disorder and the APO E4 allele, exposure to monomeric contained enormously elevated levels of aluminium sulphate aluminium clearly was associated with this form of dementia being drunk by the local population. (odds ratio 2.67). Memory loss was an extremely The importance of monomeric (single common complaint amongst those molecule) aluminium has been con- unfortunate enough to use such firmed again by a more recent study contaminated water.” conducted by Prolo and colleagues* in Significant evidence of the link H H northwest Italy, where the drinking between dementia and aluminium also The negative impact of water contained between 5 mcg and comes from McLachlan's Ontario aluminium, however, appears 1,220 meg per litre of total aluminium. study involving 668 autopsy-verified to be mitigated by silicic acid Levels of monomeric aluminium (the 3 Alzheimer's brains.* These demon- type of this element most easily able to strated that the risk of developing calcium and magnesium. enter human cells) ranged from 5 mcg Alzheimer's disease had been about to 300 mcg per litre. These researchers 2.5 times greater in individuals from from the University of California at communities that drank water that Los Angeles established that contained more than 100 mcg per litre Alzheimer's disease was most common of aluminium than it had been in those where drinking water levels of from areas where the potable water had monomeric aluminium were highest. contained less than this level of aluminium. McLachlan's results They also discovered that monomeric aluminium interfered with were even more spectacular for those who had drunk water that cell function in cultures, accelerating cell death especially in the contained 175 mcg per litre of aluminium. Depending on how presence of beta-amyloid protein. those patients were grouped, the odds ratio of developing The great bulk of evidence from numerous geographical and Alzheimer's disease varied from 6.7 to 8.14; that is, their brains epidemiological studies, therefore, supports a strong link between were some 7-8 times more likely to show the characteristic signs aluminium consumption, especially monomeric aluminium from of Alzheimer's disease if such patients had normally consumed drinking water, and an elevated incidence of Alzheimer's disease. water that was very high in aluminium. The negative impact of aluminium, however, appears to be miti- Several authors have attempted to quantify the strength of the gated by silicic acid, calcium and magnesium, especially in association between Alzheimer's disease and aluminium. Forbes potable water with a pH of between 7.85 and 8.05. Acidic drink- and McLachlan,’ for example, studied this link in the very ing water that is high in aluminium and lacking in silicic acid, cal- elderly, those aged eighty-five years or more. They discovered cium and magnesium seems to be particularly dangerous. that, after controlling for six other factors such as fluoride, silicic Fluoride is a well-established antagonist of aluminium and may acid, iron, pH and turbidity, those living in districts that supplied also protect against Alzheimer's disease when the water pH is drinking water that contained more than 250 mcg of aluminium high; but unfortunately, elevated water fluoride levels are known per litre were almost 10 times more likely to develop Alzheimer's to cause other health problems. disease. This confirmed an earlier Ontario longitudinal study” which established that men aged seventy-five years and older, HOW ALUMINIUM CAUSES ALZHEIMER'S DISEASE who were drinking water containing at least 0.0847 mg per litre of If aluminium causes Alzheimer's disease, how does it trigger aluminium, were 1.72 times as likely to show impaired mental this form of dementia? It seems that individuals who inherit the functioning. Similarly, after statistical control for five other APO E4 gene(s) are less capable than the general population of variables, Alzheimer's mortality displayed an odds ratio of 3.54 removing the beta-amyloid and tau brain proteins that form the for those who had drunk water that contained at least 0.336 mg bulk of neuritic plaques and neurofibrillary tangles. As a result, per litre of aluminium.” such people are at higher risk of developing Alzheimer's disease A more recent eight-year longitudinal study involved 3,777 in regions that promote the deposition of beta-amyloid and tau. people aged sixty-five years and older who lived in southwest Such "harmful environments" are those in which the potable water France in 1988-1989. It confirmed that double the risk of devel- is acidic, high in monomeric aluminium and lacks silicic acid, cal- oping Alzheimer's disease occurred in those who drank water with cium and magnesium. Under such circumstances, aluminium can an aluminium concentration greater than 0.1 mg per litre.” enter the brain and impair the enzyme choline acetyltransferase, The negative impact of aluminium, however, appears to be mitigated by silicic acid, HOW ALUMINIUM CAUSES ALZHEIMER'S DISEASE If aluminium causes Alzheimer's disease, how does it trigger this form of dementia? It seems that individuals who inherit the APO E4 gene(s) are less capable than the general population of removing the beta-amyloid and tau brain proteins that form the bulk of neuritic plaques and neurofibrillary tangles. As a result, such people are at higher risk of developing Alzheimer's disease in regions that promote the deposition of beta-amyloid and tau. Such "harmful environments" are those in which the potable water is acidic, high in monomeric aluminium and lacks silicic acid, cal- cium and magnesium. Under such circumstances, aluminium can enter the brain and impair the enzyme choline acetyltransferase, NEXUS = 35 calcium and magnesium. AUGUST - SEPTEMBER 2005 www.nexusmagazine.com