Objective: In this study, serum aluminum in Egyptian patients with clinically diagnosed Alzheimer's disease, other dementias, and non dementing controls of similar age and sex were examined to see whether there is any significant difference between the three groups and between dementia syndrome as a whole and normal ageing.
Design: Unmatched case-control study.
Materials and Methods: The study was conducted at Alexandria University Hospital, comparing patients with a clinical diagnosis of Alzheimer's disease (NINCDS-ADRDA diagnostic criteria) and two control groups (other dementias and normal ageing), in respect of their serum aluminum levels using Atomic Absorption Spectrophotometry. The later was performed at the University Department of Biochemistry. All patients were selected from the Outpatient Clinics and Inpatient Units of Alexandria University Hospitals. The non dementing controls were selected from the same area of residence in Alexandria.
Results: There was a statistically significant difference between serum aluminum levels in Alzheimer's disease and the two control groups separately and combined (P<.05). No difference was found between serum aluminum levels in other dementias and non dementing controls. Serum aluminum levels and the age distribution among patients with Alzheimer's disease showed a statistically significant positive correlation, i.e. there was a statistically significant increase in the serum aluminum level with the progress of age for Alzheimer’s disease group
Conclusion: Since early reports of the experimentally induced neurofibrillary degeneration, a link between Alzheimer’s disease and aluminum has been suspected. Epidemiological studies of exposure to aluminum in drinking water have claimed a positive association between aluminum concentration in water and incidence of Alzheimer’s disease. Consuming large amounts of aluminium-containing antacids was studied as a potential risk factor for Alzheimer’s disease.
Although aluminum has long been thought to be implicated in Alzheimer's disease, the Alzheimer's disease - Aluminum hypothesis has been neither confirmed nor rejected.
Our study finding of a significant increase in the serum aluminum level in patients with Alzheimer's disease supports the hypothesis that aluminum maybe implicated in Alzheimer's disease in some form. Whether aluminum is an etiological factor in Alzheimer's disease or its presence is simply the result of age and changes in renal functions among Alzheimer's disease patients needs further assessment.
Prospective studies are necessary to examine the incidence of Alzheimer’s disease in high risk population exposed to neurotoxins such as aluminum. A non invasive, cost effective method to screen patients with Alzheimer’s disease for aluminum exposure and the risk of possible aluminum related cognitive changes may be the way forward.
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