Rondeau Virginie, Jacqmin-Gadda Hélène, Commenges Daniel, Helmer Catherine, Dartigues Jean-François
Division of Biostatistics, Unité 897, Institut National de la Santé et de la Recherche Médicale, Bordeaux F-33076, France.
Am J Epidemiol. 2009 Feb 15;169(4):489-96. doi: 10.1093/aje/kwn348. Epub 2008 Dec 8.
The authors examined associations between exposure to aluminum or silica from drinking water and risk of cognitive decline, dementia, and Alzheimer's disease among elderly subjects followed for 15 years (1988-2003). They actively searched for incident cases of dementia among persons aged 65 years or over living in 91 civil drinking-water areas in southern France. Two measures of exposure to aluminum were assessed: geographic exposure and individual exposure, taking into account daily consumption of tap water and bottled water. A total of 1,925 subjects who were free of dementia at baseline and had reliable water assessment data were analyzed. Using random-effects models, the authors found that cognitive decline with time was greater in subjects with a higher daily intake of aluminum from drinking water (>or=0.1 mg/day, P=0.005) or higher geographic exposure to aluminum. Using a Cox model, a high daily intake of aluminum was significantly associated with increased risk of dementia. Conversely, an increase of 10 mg/day in silica intake was associated with a reduced risk of dementia (adjusted relative risk =0.89, P=0.036). However, geographic exposure to aluminum or silica from tap water was not associated with dementia. High consumption of aluminum from drinking water may be a risk factor for Alzheimer's disease.
作者对15年（1988 - 2003年）随访的老年受试者中，饮用水中铝或二氧化硅暴露与认知能力下降、痴呆症和阿尔茨海默病风险之间的关联进行了研究。他们积极在法国南部91个民用饮用水区域内，65岁及以上的人群中寻找痴呆症的发病病例。评估了两种铝暴露指标：地理暴露和个体暴露，同时考虑了自来水和瓶装水的每日消费量。对1925名基线时无痴呆症且有可靠水评估数据的受试者进行了分析。作者使用随机效应模型发现，从饮用水中每日铝摄入量较高（≥0.1毫克/天，P = 0.005）或铝地理暴露较高的受试者，随时间的认知能力下降更大。使用Cox模型，铝的高每日摄入量与痴呆症风险增加显著相关。相反，二氧化硅摄入量每天增加10毫克与痴呆症风险降低相关（调整后的相对风险 = 0.89，P = 0.036）。然而，来自自来水的铝或二氧化硅的地理暴露与痴呆症无关。饮用水中高铝消费量可能是阿尔茨海默病的一个风险因素。
