Bone Mass and Dementia in Hip Fracture Patients From Areas With Different Aluminium Concentrations in Water Supplies

Abstract

The relationship between bone mass and dementia in elderly hip fracture patients from areas with different aluminium concentrations in water supplies has been investigated, to determine whether a high concentration of aluminium in the drinking water and the negative calcium balance of age-related osteoporosis together predispose to senile dementia. Mental test scores were recorded on admission to hospital, and Singh indices of radiographs taken at that time assessed blind by a single trained observer. No significant difference in either mental test score (chi 2 = 1.253, df = 2, P = 0.53) or Singh index (chi 2 = 1.039, df = 5, P = 0.96) was found between patients resident in high versus low water aluminum areas. No correlation was detectable between mental test score and Singh index (chi 2 = 0.95, df = 1, P = 0.33).

Fracture Risk in Patients with Alzheimer's Disease

“…Reduced levels of 25‐hydroxyvitamin D and impaired calcium absorption may be seen in patients with Alzheimer's disease but do not appear to result in secondary hyperparathyroidism 18,33 . It has been suggested that calcium insufficiency might increase the toxic effects of aluminum, 33 but a study that looked specifically at hip fracture patients from areas with different aluminum concentration in water supplies did not find any significant differences in mental test score or Singh index between patients residing in high versus low aluminum areas, 34 and there was no correlation between bone mineralization and aluminum content in iliac crest biopsies of 162 elderly individuals 35 …”

Can the Controversy of the Role of Aluminum in Alzheimer's Disease Be Resolved? What Are the Suggested Approaches to This Controversy and Methodological Issues to Be Considered?

“…Two studies from Britain and Europe (Wood et al, 1988;Wettstein et al, 1991) failed to detect a relationship to Al in the drinking water supply. The failure to detect such a relationship may represent geochemical differences in the drinking water supply.…”

The biological speciation and toxicokinetics of aluminum.

“…Before each shift, miners were exposed to 20,000 to 34,000 ppm aluminum dust in an enclosed area for 10 Potentiometric data and equilibrium models. Equilibrium models, based on potentiometric data, allow a much more complete (although theoretical) description of species formed in aqueous solutions of aluminum with its ligands, compared to the analytical techniques described in earlier sections.…”

“…A number of studies (3)(4)(5)(6)(7)(8) found correlations between aluminum concentrations in drinking water and the incidence of AD, although the relative risk of AD for those exposed to the highest aluminum concentration, compared to those exposed to the lowest aluminum concentration, was less than 2 in each case. Michel et al (9) found a relative risk of about 4 for those exposed to the highest aluminum concentration (100 pg/i) compared to the lowest (10 pg/i). Studies failing to find an association were reported by Wood et al (10) and Wettstein et al (11).…”

“…Michel et al (9) found a relative risk of about 4 for those exposed to the highest aluminum concentration (100 pg/i) compared to the lowest (10 pg/i). Studies failing to find an association were reported by Wood et al (10) and Wettstein et al (11). Although drinking water aluminum constitutes only a small percentage of total daily aluminum intake, Martyn et al (5) suggested that aluminum in drinking water "is either dissolved or readily brought into solution."…”