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Geochemical Risk Factors for Mental Functioning, Based on the Ontario Longitudinal Study of Aging (LSA) V. Comparisons of the Results, relevant to Aluminum Water Concentrations, obtained from the LSA and from Death Certificates mentioning Dementia

  • W. F. Forbes (a1), S. Lessard (a1) and J. F. Gentleman (a1)


Previous studies in this series of papers investigated the associations between aluminum (Al) water concentrations and relatively high risks of a measure of mental impairment and also various possible other drinking water characteristics, particularly pH, turbidity, fluoride and silica. The results were based on one measure of mental impairment, which would not be expected to give the same results as the more definitive 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 AD and presenile dementia are listed as the underlying causes of death. As expected, the associations were not identical, but they were similar. More specifically, Al water concentrations were strongly associated with the recording of AD on death certificates, as were pH, fluoride, and silica concentrations. The implications of these results are discussed, and it is suggested that the evidence is sufficiently strong for methods of water purification to be modified, at least on a trial basis, because of the likelihood that this will reduce the incidence of AD.

Les études publiées antérieurement dans le cadre de cette série d'articles visaient à examiner le rapport entre le risque relativement élevé mesuré par un indicateur de déficience mentale et la concentration d'aluminium dans l'eau potable, ainsi que d'autres propriétés de cette dernière, en particulier le pH, la turbidité et la concentration de fluorures et de silice. Ces études se fondaient sur une mesure de la déficience mentale qui, en principe, ne devrait pas donner les mêmes résultats qu'un fait mieux établi (consideré comme un résultat) qu'est la mention de la maladie d'Alzheimer comme cause sous-jacente du décès sur un certificat de décès. La présente étude vise done à examiner des liens pertinents en se fondant, d'une part, sur la mesure de la déficience mentale et, d'autre part, sur les certificats de décès faisant état de la maladie d'Alzheimer et de la démence présénile comme causes sous-jacentes du décès. Tel que prévu, ces liens different, mais sont cependant similaires. Plus précisément, on note une forte corrélation entre l'enregistrement de la maladie d'Alzheimer sur les certificats de décès et la concentration d'aluminium dans l'eau, ainsi que le pH et la concentration de fluorures et de silice. Les auteurs discutent de la portée des résultats et laissent entendre qu'on dispose de preuves suffisamment concluantes pour justifier, au moins à titre d'essai, la modification des méthodes de purification de l'eau, puisqu'il est probable qu'une telle mesure réduira l'incidence de la maladie d'Alzheimer.



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