Original article| Volume 43, ISSUE 1, P35-44, 1990

The association between aluminum-containing products and Alzheimer's disease

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      The association between exposure to aluminum through the lifetime use of antiperspirants and antacids and Alzheimer's disease (AD) was explored in a case-control study of 130 matched pairs. Cases were clinically diagnosed between January 1980 and June 1985 at two geriatric psychiatric clinics in Seattle, Wash. Controls were friends or non-blood relatives of the case. Subjects were matched by age, sex, and the relationship between the case and his or her surrogate. For all antiperspirant/deodorant use, regardless of aluminum content, there was no association with AD (adjusted odds ratio (OR) = 1.2, 95% CI= 0.6–2.4). For aluminum-containing antiperspirants, the overall adjusted OR was 1.6 (95% CI = 1.04–2.4) with a trend toward a higher risk with increasing frequency of use (p for trend = 0.03), the adjusted OR in the highest tertile being 3.2. For antacids regardless of aluminum content, the overall adjusted OR was 3.1 (95% CI= 1.2–7.9). Here, a steep dose-response gradient was found (p for trend = 0.009), with an adjusted OR for the highest tertile of 11.7. However, when only aluminum-containing antacids were analyzed, the overall adjusted OR was only 0.7 (95% CI = 0.3–2.0) and there was no significant dose-response trend. These results are provocative but inconclusive due to methodologic problems relating to the necessary use of surrogate respondents and the long time period of potential exposure for this dementing disease.


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      1. Neurotox. 1980; 1: 139-141
        • Davies I.
        Aluminum, neurotoxicology and dementia.
        Rev Envir Health. 1986; VI: 251-296
        • Klatzo I.
        • Wisniewski H.
        • Streicher E.
        Experimental production of neurofibrillary degeneration. I. Light microscopic observations.
        J Neuropath Exp Neurol. 1965; 24: 187-199
        • Terry R.D.
        • Pena C.
        Experimental production of neurofibrillary degeneration. 2. Electron microscopy, phosphatase histochemistry and electron probe analysis.
        J Neuropath Exp Neurol. 1965; 24: 200-210
        • Wisniewski H.M.
        • Narkewicz O.
        • Wisniewski K.
        Topography and dynamics of neurofibrillary degeneration in aluminum encephalopathy.
        Acta Neuropathol. 1967; 9: 12-133
        • Crapper D.R.
        • Dalton A.J.
        Alterations in short-term retention, conditioned avoidance response, acquisition and motivation following aluminum induced neurofibrillary degeneration.
        Physiol Behav. 1973; 10: 925-933
        • Crapper D.R.
        • Krishnan S.S.
        • Dalton A.J.
        Brian aluminum distribution in Alzheimer's disease and experimental neurofibrillary degeneration.
        Science. 1973; 180: 511-512
        • Crapper D.R.
        • Krishnan S.S.
        • Quittkat S.
        Aluminum, neurofibrillary degeneration and Alzheimer's disease.
        Brain. 1976; 99: 67-80
        • Perl D.P.
        • Brody A.R.
        Alzheimer's disease: x-ray spectrometric evidence of aluminum accumulation in neurofibrillary tangle-bearing neurons.
        Science. 1980; 208: 297-299
        • Perl D.P.
        Relationship of aluminum to Alzheimer's disease.
        Envir Health Perspect. 1985; 63: 149-153
        • Perl D.P.
        Aluminum and Alzheimer's disease: intraneuronal x-ray spectrometry studies.
        in: 3rd edn. Banbury Report 15, Biological Aspects of Alzheimer's Disease. Cold Spring Harbor Laboratory, New York: Cold Spring Harbor1983: 425-431
        • Markesbery W.R.
        • Ehmann W.S.
        • Hossain T.I.M.
        • et al.
        Instrumental neutron an analysis of brain aluminum in Alzheimers' disease and aging.
        Ann Neurol. 1981; 10: 511-516
        • McDermott J.R.
        • Smith A.I.
        • Iqbal K.
        • Wisniewski H.M.
        Brain aluminum in aging and Alzheimer's disease.
        Neurology. 1979; 29: 809-814
        • Trapp G.A.
        • Miner G.D.
        • Zimmermann R.L.
        • et al.
        Aluminum levels in brain in Alzheimer's disease.
        Biol Psychiat. 1978; 13: 709-718
        • Perl D.P.
        • Gajdusek D.C.
        • Garruto R.M.
        • et al.
        Intraneuronal aluminum accumulation in amyotrophic lateral sclerosis and parkinsonism dementia of Guam.
        Science. 1982; 217: 1053-1054
        • Perl D.P.
        Presentation at Symposium on Senile Dementia and Alzheimer's Disease. Society for Neuroscience Annual Meeting, Anaheim, California1984
        • Heston L.L.
        • Mastri A.R.
        • Anderson V.E.
        • et al.
        Dementia of the Alzheimer type: clinical genetics, natural history and associated conditions.
        Arch Gen Psychiat. 1981; 38: 1085-1090
        • Heyman A.
        • Wilkinson W.E.
        • Stafford J.A.
        • et al.
        Alzheimer's disease: a study of the epidemiological aspects.
        Ann Neurol. 1984; 15: 335-341
        • Alfrey A.C.
        • Le Gendre G.R.
        • Kaehny W.D.
        The dialysis encephalopathy syndrome: possible aluminum intoxication.
        N Engl J Med. 1976; 294: 184-188
        • Shore D.
        • Wyatt R.J.
        Aluminum and Alzheimer's disease.
        J Nerv Ment Dis. 1983; 171: 553-558
        • Martyn C.N.
        • Osmond O.
        • Edwardson J.A.
        • et al.
        Geographical relation between Alzheimer's disease and aluminum in drinking water.
        Lancet. 1989; (Jan. 14): 59-62
        • Candy J.M.
        • Klinowski J.
        • Perry R.H.
        • et al.
        Aluminosilicates and senile plaque formation in Alzheimer's disease.
        Lancet. 1986; (Feb 15): 354
        • Wisniewski H.M.
        • Iqbal K.
        • McDermott J.R.
        Aluminuminduced neurofibrillary changes: its relationship to senile dementia of the Alzheimer type.
        Neurotox. 1980; 1: 121-124
        • Delaney J.D.
        Spinal fluid aluminum levels in patients with Alzheimer disease.
        Ann Neurol. 1979; 5: 580-581
        • Katzman R.
        Alzheimer's disease.
        N Engl J Med. 1986; 314: 964-973
        • McLaughlin A.I.G.
        • Kazantzis G.
        • King E.
        • et al.
        Pulmonary fibrosis and encephalopathy associated with the inhalation of aluminum dust.
        Br J Indus Med. 1962; 19: 253-263
        • Kobayashi S.
        • Hirota N.
        • Sito K.
        • Utsuyama M.
        Aluminum accumulation in tangle-bearing neurons of Alzheimer's disease with Balint's syndrome in a long term aluminum refiner.
        Acta Neuropathol (Berlin). 1987; 74: 47-52
        • Larson E.B.
        • Reifler B.V.
        • Sumi S.M.
        • Canfield C.G.
        • Chinn N.M.
        Diagnostic evaluation of 200 elderly outpatients with suspected dementia.
        J Gerontol. 1985; 40: 536-543
        • American Psychiatric Association Task Force
        3rd edn. Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association, Washington D.C., APA1980
        • McKhann G.
        • Drachman D.
        • Folstein M.
        • et al.
        Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease.
        Neurol (NY). 1984; 4: 939-944
        • Folstein M.F.
        • Folstein S.E.
        • McHugh P.R.
        “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician.
        J. Psychiat Res. 1975; 12: 189-198
        • Pickle L.W.
        • Brown L.M.
        • Blot W.J.
        Information available from surrogate respondents in casecontrol interview studies.
        Am J Epidemiol. 1983; 118: 99-108
        • Lione A.
        The reduction of aluminum intake in patients with Alzheimer's disease.
        J Environ Pathol Toxicol Oncol. 1985; 6: 21-32
        • Breslow N.E.
        • Day N.E.
        Statistical Methods in Cancer Research. Vol. 1, The Analysis of Case-control Studies. International Agency for Research on Cancer, Lyon1980
        • Fleiss J.L.
        Statistical Methods for Rates and Proportions.
        John Wiley, New York1973
        • Hollingshead A.B.
        4-factor Index of Social Status.
        Yale University, Department of Sociology, 1975 (Unpublished manuscript)
        • Kahn R.L.
        • Goldfarb A.I.
        • Pollock M.
        • Peck A.
        Brief cognitive measures for the determination of mental status in the aged.
        Am J Psychiat. 1960; 117: 326-328
        • Food and Drug Administration
        • Department of Health, Education, and Welfare
        Antiperspirant Drug Products for Over-the-Counter Human Use: Establishment of a Monograph. 1978; (Proposed Rule. Part 111)
        • Patocha J.
        The influence of Al+++ on cholinersterase and acetylcholinesterase activity.
        Acta Bio Med Germanica. 1971; 26: 845-846
        • Food and Drug Administration
        • Department of Health, Education and Welfare
        Aerosol Drug and Cosmetic Products Containing Zirconium. 1977; (Part III)
        • Perl D.P.
        • Good P.F.
        Uptake of aluminum into central nervous system along nasal-olfactory pathways.
        Lancet. 1987; : 1028
        • Pearson R.C.A.
        • Esiri M.M.
        • Hiorns R.W.
        • Wilcock G.K.
        • Powell T.P.S.
        Anatomical correlates of the distribution of the pathological changes in the neocortex in Alzheimer disease.
        in: Proc Natl Acad Sci USA. 82. 1985: 4531-4534
        • Esiri M.M.
        • Wilcock G.K.
        The olfactory bulbs in Alzheimer's disease.
        J Neurol Neurosurg Psychiat. 1984; 47: 57-60
        • Amaducci L.A.
        • Fratiglioni L.
        • Rocca W.A.
        • et al.
        Risk factors for clinically diagnosed Alzheimer's disease: a case-control study of an Italian population.
        Neurology. 1986; 36: 922-931