Aluminum in the Diet and Alzheimer's Disease: From Current Epidemiology to Possible Disease-Modifying Treatment

Article type: Review Article

Authors: Frisardi, Vincenza^{a; *} | Solfrizzi, Vincenzo^a | Capurso, Cristiano^b | Kehoe, Patrick G^c | Imbimbo, Bruno P.^d | Santamato, Andrea^e | Dellegrazie, Flora^a | Seripa, Davide^f | Pilotto, Alberto^f | Capurso, Antonio^a | Panza, Francesco^{a; *}

Affiliations: [a] Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Bari, Italy | [b] Department of Geriatrics, University of Foggia, Foggia, Italy | [c] Dementia Research Group, Institute of Clinical Neurosciences, Frenchay Hospital, University of Bristol, Bristol, UK | [d] Research and Development Department, Chiesi Farmaceutici, Parma, Italy | [e] Department of Physical Medicine and Rehabilitation-“OORR Hospital”, University of Foggia, Italy | [f] Geriatric Unit and Gerontology-Geriatrics Research Laboratory, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy

Correspondence: [*] Correspondences to: Vincenza Frisardi, MD, Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Policlinico, Piazza Giulio Cesare, 11, 70124 Bari, Italy. Tel.: +39 080 5473685; Fax: +39 080 5478860; E-mail: eziafrisardi@yahoo.it. Francesco Panza, MD, PhD, Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Policlinico, Piazza Giulio Cesare, 11, 70124 Bari, Italy. Tel.: +39 080 5473685; Fax: +39 080 5478860; E-mail: geriat.dot@geriatria.uniba.it.

Abstract: In recent years, interest in the potential role of metals in the pathogenesis of Alzheimer's disease (AD) has grown considerably. In particular, aluminum (Al) neurotoxicity was suggested after its discovery in the senile plaques and neurofibrillary tangles that represent the principal neuropathological hallmarks of AD. Al is omnipresent in everyday life and can enter the human body from several sources, most notably from drinking water and food consumption. The evidence supporting association from ingestion of Al from drinking water is somewhat stronger than for its ingestion from food. However, other elements present in drinking water, such as fluoride, copper, zinc, or iron could also have an effect on cognitive impairment or modify any Al neurotoxicity. Some epidemiological studies, but not all, suggested that silica could be protective against Al damage, because it reduces oral absorption of Al and/or enhances Al excretion. Some epidemiological investigations suggested an association between chronic exposure to Al and risk of AD, although this relationship falls short of all the criteria generally attributed to causation. Future studies need to be more rigorous to truly test the validity of previous findings and in doing so attempt to identify dose-response relationships between Al and AD risk which may provide new routes to disease-modifying treatment of AD or possibly some lifestyle modification, to supplement existing symptomatic approaches.

Keywords: Age-related cognitive decline, aluminum, Alzheimer's disease, drinking water assessment, food consumption assessment, mild cognitive impairment

DOI: 10.3233/JAD-2010-1340

Journal: Journal of Alzheimer's Disease, vol. 20, no. 1, pp. 17-30, 2010