Epidemiological evidence linking aluminum in drinking water and Alzheimer's disease (AD) has been inconsistent, with previous studies often limited by small sample sizes. The present study addresses this issue using data from the Canadian Study of Health and Aging (CSHA), a prospective cohort of 10,263 subjects followed-up from 1991-1992 through 2001-2002. Participants' residential histories were linked to municipal drinking water sources in 35 Canadian municipalities to obtain ecologic pH, aluminum, fluoride, iron and silica concentrations in drinking water. Cox proportional hazards models were used to examine associations between aluminum and incident AD [Hazard Ratios (HRs), 95% confidence intervals (CIs)], adjusting for age, gender, history of stroke, education, and high blood pressure. A total of 240 incident AD cases were identified during follow-up of 3, 638 subjects derived from the CSHA cohort with complete data on all covariates. With categorical aluminum measurements, there was an increasing, but not statistically significant, exposure-response relationship (HR = 1.34, 95% CI 0.88-2.04, in the highest aluminum exposure category; p = 0.13 for linear trend). Similar results were observed using continuous aluminum measurements (HR=1.21, 95% CI 0.97-1.52, at the interquartile range of 333.8 μg/L; p = 0.09 for linear trend). In a subsample genotyped for ApoE-ε4, there was some evidence of an association between aluminum and AD (p = 0.03 for linear trend). Although a clear association between aluminum in drinking water and AD was not found, the linear trend observed in ApoE-ε4 subsample warrants further examination.

中文翻译：

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加拿大健康与衰老研究队列中饮用水中的铝与阿尔茨海默病事件之间的关联。

将饮用水中的铝与阿尔茨海默病 (AD) 联系起来的流行病学证据并不一致，以前的研究往往受到样本量小的限制。本研究使用来自加拿大健康与老龄化研究 (CSHA) 的数据来解决这个问题，这是一个由 1991-1992 年至 2001-2002 年随访的 10,263 名受试者的前瞻性队列。参与者的居住历史与加拿大 35 个城市的市政饮用水源相关联，以获得饮用水中的生态 pH 值、铝、氟化物、铁和二氧化硅浓度。Cox 比例风险模型用于检查铝与 AD 事件 [危险比 (HR)，95% 置信区间 (CI)] 之间的关联，并根据年龄、性别、中风史、教育程度和高血压进行调整。在来自 CSHA 队列的 3 名 638 名受试者的随访期间，总共发现了 240 例 AD 病例，这些受试者具有所有协变量的完整数据。对于分类铝测量，暴露-反应关系增加，但没有统计学意义（HR = 1.34，95% CI 0.88-2.04，在最高铝暴露类别中；线性趋势 p = 0.13）。使用连续铝测量观察到类似的结果（HR=1.21，95% CI 0.97-1.52，四分位间距为 333.8 μg/L；线性趋势 p = 0.09）。在 ApoE-ε4 基因分型的子样本中，有一些证据表明铝和 AD 之间存在关联（线性趋势 p = 0.03）。尽管未发现饮用水中的铝与 AD 之间存在明显关联，但在 ApoE-ε4 子样本中观察到的线性趋势值得进一步检查。