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The question 'Does aluminum really cause the disease of Alzheimer's?' could be more accurately re-stated as 'Could exposure to aluminum cause Alzheimer's disease and could a causal link even be proven?' simply because aluminum is such a pervasive element in modern life, it's practically impossible to pinpoint frequency, duration and dosage of exposure at the individual level, let alone establish a cause-and-effect linkage between this one element, aluminum, on the one hand, and a complex, obviously multi-factorial disease such as Alzheimer's (AD) on the other hand. Simply, conclusive data's lacking. Rather epidemiological support of link between cumulative aluminum exposure and correlative risk of developing AD is confusing and inconclusive.This answerOutlines some basic facts about aluminum as it pertains to degree and variety of biological exposure.Summarizes conclusions from some recent meta-analyses, and systematic and umbrella reviews on the link between Aluminum and AD.Aluminum’s Pervasive in Human Foods, Daily Use Products and EnvironmentThird only to oxygen and silicon in its prevalence, aluminum is estimated the most abundant metal in the Earth's crust (1). Although there's as yet no evidence it is metabolized or even metabolizable by living things, its exponential industrial use from mid-20th century onwards has likewise exponentially increased human exposure to it. Though since the early 1970s, the pervasive soda can is a poster child of such use, it's far from the only one since aluminum has now become ubiquitous in not just human food and drinks but also in construction and the aircraft industry. After all, industrial aluminum use is pervasive, being used in everything from water treatment to generate drinking water to cosmetics, food, medical use and vaccines (see sequentially below from 1, 2),'The largest markets for aluminium metal and its alloys are in transportation, building and construction, packaging and in electrical equipment. Transportation uses are one of the fastest growing areas for aluminium use. Aluminium powders are used in pigments and paints, fuel additives, explosives and propellants. Aluminium oxides are used as food additives and in the manufacture of, for example, abrasives, refractories, ceramics, electrical insulators, catalysts, paper, spark plugs, light bulbs, artificial gems, alloys, glass and heat resistant fibres. Aluminium hydroxide is used widely in pharmaceutical and personal care products. Food related uses of aluminium compounds include preservatives, fillers, colouring agents, anti-caking agents, emulsifiers and baking powders; soybased infant formula can contain aluminium. Natural aluminium minerals especially bentonite and zeolite are used in water purification, sugar refining, brewing and paper industries.'Source of ingested aluminum is thus either natural, or through food and drug additives and daily use products, which constitute both consumer as well as occupational exposure (in the form of work in aluminum production and user industries).Natural: from its presence in foods grown in aluminum-containing soils. This can vary widely since aluminum compounds are more soluble in low pH soil, which is often the consequence of acid rain. This in turn increases aluminum content in plants animals and surface water (1, 3). Drinking water is another source since Flocculation - Wikipedia, a commonly used water treatment process, uses aluminum salts (1, 2), though the concentration is estimated low, <0.2mg/liter (4).Food and drug additives: With regard to aluminum in foods, starting sometime in the late 19th century and progressively more so since the mid-20th century, large-scale industrial food production the world over has enabled the abrupt and dramatic switch from a largely unprocessed to processed diet, the so-called 'Western' diet. Doing so has only increased aluminum bioavailability, especially human oral exposure. Such additives are found in dairy (milk, processed cheese, yogurt), staples (cereals, flours, grains), sweets (sugar, jams, jellies, baking sodas, powdered or crystalline dessert products (1, 2, 4). Use in food thus ranges from anticaking agents to buffers, emulsifying agents, firming agents, leavening agents, neutralizing agents and texturizers (2, see below from 4).While diet-based aluminum consumption is estimated to be ~10mg/day, over-the-counter drugs such as analgesics and antacids can increase this by several grams per day (5). Aluminum hydroxide for example is a common antacid ingredient that helps neutralize stomach acid while aluminum in antacids helps increase bioavailability of the active ingredient which is typically poorly soluble in the stomach's acidic environment (4).Daily use products: Cosmetics (perspirants, sunscreens, lotions, pigments), cookware, packaging are aluminum-containing daily use products. Aluminum's heat conductivity explains its pervasive presence in cookware. Leaching from cookware and packaging is estimated to add 2 to 4mg of aluminum per day in food, representing ~20% of daily aluminum intake (6, 7, 8).Estimated daily exposure between countries varies as much as 4-to 8-fold (see below from 4). This makes the task of estimating cumulative exposure in epidemiological studies attempting to discern a link between aluminum and AD or any other disease all the more challenging.Aluminum and Alzheimer's Disease (AD): Conclusions from Meta-analyses, & Systematic and Umbrella ReviewsAlzheimer's disease is classified as either the less frequent familial (1 to 5%) or the far more prevalent late-onset AD (LOAD), which is presumed the outcome of complex genetic, epigenetic and environmental interactions. Since hereditary factors fail to explain most AD cases, environmental factors have become prime research focus.Aluminum emerged as a candidate in the 1960s when a 1965 study observed neurofibrillary tangle (NFT)-like degeneration after directly injecting aluminum into rabbit brains (9), i.e., lesions similar but not identical to those considered a hallmark of AD. A 1973 study followed-up with the report of higher levels of Aluminum in post-mortem AD brain samples (10).Numerous mechanistic studies in the succeeding decades have proven inconclusive. After all, brain tissue degeneration in AD may simply make it better suited to accumulate metals such as aluminum. How to prove cause and effect? In addition, AD brain increase in aluminum levels isn't always accompanied by aluminum level increase in CSF (cerebrospinal fluid) with some studies suggesting it does and others not (11).Thus, establishing a conclusive link between increased human bioavailability of Aluminum and Alzheimer's disease remains elusive. For example, aluminum use in cosmetics such as antiperspirants became a focus of attention starting in the 1980s and yet, after decades of cumulative study, the FDA concluded (12),'The agency does not find the current evidence sufficient to conclude that aluminum from antiperspirant use results in Alzheimer’s disease.'Epidemiological studies trying to establish link between aluminum exposure through food and risk for AD are extremely complicated since it's present in such a wide variety of foods. Since AD's assumed to require years if not decades to develop, such studies would have to monitor aluminum exposure not just long-term but also at great depth, examining large study populations so that subset numbers remain large even after stratification, all amounting to a prohibitively expensive proposition.OTOH, epidemiological studies that tried to establish link, if any, between aluminum exposure through drinking water or occupational exposure and risk for AD have more promise since there's less ambiguity about the degree of daily and cumulative exposure. One 2016 meta-analysis of 8 such studies (4 drinking water, 4 occupational) on a total population of 10567 individuals found a significant association between aluminum exposure and risk for AD (13). Specifically, this study established chronic exposure to aluminum increased AD risk by 71%, where chronic exposure was defined as >100µg/liter aluminum in drinking water or its equivalent occupational exposure.A 2016 umbrella review of systematic reviews and meta-analyses (14), also concluded suggestive link between aluminum and AD. Other factors that also showed up as suggestive included factors as disparate as education, herepesviridae infection, low frequency electromagnetic fields and NSAIDs. OTOH, factors they concluded were highly suggestive included cancer, depression at any age, physical activity (high level being protective). However, the authors concluded cautiously (see below from 14, emphasis mine),'Several risk factors present substantial evidence for association with dementia and should be assessed as potential targets for interventions, but these associations may not necessarily be causal.'Thus, as of 2017, there is no consensus on whether and how aluminum exposure, specifically its bioavailability, influences AD risk. This is because numerous meta-analyses and systematic reviews that examined the totality of aluminum exposure, not just through drinking water or occupational exposure but also through cosmetics, over-the-counter drugs, processed food, vaccines, found the evidence to be inconclusive. For example, following a massive 2007 systematic review (1) that concluded there was little unambiguous evidence that aluminum exposure increased AD risk, a 2014 systematic review examined in great detail a total of 469 peer-reviewed studies, delving into not just exposure sources but also routes, amounts and potential toxicity to different organ systems. Evaluating the data by comparing to existing standards and guidelines for aluminum, it too concluded that (see below from 15, emphasis mine),'The results of the present review demonstrate that health risks posed by exposure to inorganic Al depend on its physical and chemical forms and that the response varies with route of administration, magnitude, duration and frequency of exposure. These results support previous conclusions that there is little evidence that exposure to metallic Al, the Al oxides or its salts increases risk for AD, genetic damage or cancer'Bibliography1. Krewski, Daniel, et al. "Human health risk assessment for aluminium, aluminium oxide, and aluminium hydroxide." Journal of Toxicology and Environmental Health, Part B 10.S1 (2007): 1-269. https://www.researchgate.net/profile/Robert_Yokel/publication/5764224_Human_Health_Risk_Assessment_for_Aluminium_Aluminium_Oxide_and_Aluminium_Hydroxide/links/0fcfd50187fc6a9eb4000000.pdf2. Yokel, Robert A. "Aluminum in food–the nature and contribution of food additives." (2012): 203. http://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1030&context=ps_facpub3. http://www.who.int/ipcs/publications/jecfa/reports/trs940.pdf4. Vignal, C., P. Desreumaux, and M. Body-Malapel. "Gut: An underestimated target organ for Aluminum." Morphologie 100.329 (2016): 75-84. http://www.spritzer.com.my/wp-content/uploads/2016/09/Vignal-Morphologie-Gut-Al-2016.pdf5. Reinke, Claudia M., Jörg Breitkreutz, and Hans Leuenberger. "Aluminium in over-the-counter drugs." Drug Safety 26.14 (2003): 1011-1025.6. Jorhem, Lars, and Georg Haegglund. "Aluminium in foodstuffs and diets in Sweden." Zeitschrift für Lebensmitteluntersuchung und-Forschung A 194.1 (1992): 38-42.7. Wang, L., D. Z. Su, and Y. F. Wang. "Studies on the aluminium content in Chinese foods and the maximum permitted levels of aluminum in wheat flour products." Biomedical and environmental sciences: BES 7.1 (1994): 91-99.8. Al Juhaiman, Layla A. "Estimating Aluminum leaching from Aluminum cook wares in different meat extracts and milk." Journal of Saudi Chemical Society 14.1 (2010): 131-137. http://ac.els-cdn.com/S1319610309000751/1-s2.0-S1319610309000751-main.pdf?_tid=45465cbe-999a-11e7-968e-00000aab0f02&acdnat=1505427532_7874942c940894faf91bf7c71b0a5f059. Klatzo, Igor, Henryk Wiśniewski, and Eugene Streicher. "Experimental production of neurofibrillary degeneration: I. Light microscopic observations." Journal of Neuropathology & Experimental Neurology 24.2 (1965): 187-199.10. Crapper, D. R., S. S. Krishnan, and A. J. Dalton. "Brain aluminum distribution in Alzheimer's disease and experimental neurofibrillary degeneration." Science 180.4085 (1973): 511-513.11. Kapaki, Elisabeth N., et al. "Cerebrospinal fluid aluminum levels in Alzheimer's disease." Biological psychiatry 33.8 (1993): 679-681.12. FR Doc 03-1414013. Wang, Zengjin, et al. "Chronic exposure to aluminum and risk of Alzheimer’s disease: A meta-analysis." Neuroscience letters 610 (2016): 200-206. http://ac.els-cdn.com/S0304394015302512/1-s2.0-S0304394015302512-main.pdf?_tid=a04de4d8-99a9-11e7-90f5-00000aab0f02&acdnat=1505434127_91565c1d9cca3832c1bc29264a97ff4214. Bellou, Vanesa, et al. "Systematic evaluation of the associations between environmental risk factors and dementia: An umbrella review of systematic reviews and meta-analyses." Alzheimer's & Dementia 13.4 (2017): 406-418.15. Willhite, Calvin C., et al. "Systematic review of potential health risks posed by pharmaceutical, occupational and consumer exposures to metallic and nanoscale aluminum, aluminum oxides, aluminum hydroxide and its soluble salts." Critical reviews in toxicology 44.sup4 (2014): 1-80. https://www.researchgate.net/profile/Thomas_Wisniewski/publication/265790897_Systematic_review_of_potential_health_risks_posed_by_pharmaceutical_occupational_and_consumer_exposures_to_metallic_and_nanoscale_aluminum_aluminum_oxides_aluminum_hydroxide_and_its_soluble_salts/links/54ca2caf0cf298fd2627a86d.pdf

Poor air quality has been linked with cardiovascular and respiratory problems.[1]Beyond that some studies suggest it may impair your ability to think. This study was done on people 50 and older but some of the same mechanisms may be at work for younger people:air pollution influences cognitive function in a national sample of older men and women. It suggests that fine air particulate matter -- composed of particles that are 2.5 micrometers in diameter and smaller, thought to be sufficiently small that if inhaled they can deposit deep in the lung and possibly the brain -- may be an important environmental risk factor for reduced cognitive function.The study sample included 14,793 white, black, and Hispanic men and women aged 50 and older who participated in the 2004 Health and Retirement Study (a nationally representative survey of older adults). Individual data were linked with data on 2004 annual average levels of fine air particulate matter from the Environmental Protection Agency's Air Quality System monitors across the country. Cognitive function was measured on a scale of 1 to 35 and consisted of tests assessing word recall, knowledge, language, and orientation.Ailshire discovered that those living in areas with high levels of fine air particulate matter scored poorer on the cognitive function tests. The association even remained after accounting for several factors, including age, race/ethnicity, education, smoking behavior, and respiratory and cardiovascular conditions.Fine air particulate matter exposures ranged from 4.1 to 20.7 micrograms per cubic meter, and every ten point increase was associated with a 0.36 point drop in cognitive function score. In comparison, this effect was roughly equal to that of aging three years; among all study subjects, a one-year increase in age was associated with a drop 0.13 in cognitive function score.[1]Here's a study on how children's IQ may drop in response to air pollution.[6]Some other studies have shown air pollution to cause neurological inflammation in mice.[2][3] Learning in mice was also affected.[4][5] Depression-like behavior was also noted in mice.[5][1] Bad air means bad news for seniors' brainpower[2] Vehicle pollution significantly damages the brain, mouse study suggests[3] PMC - NCBI[4] Air pollution linked to learning and memory problems, depression[5] http://www.nature.com/mp/journal/v16/n10/full/mp201176a.html[6] Children's IQ Can Be Affected By Mother's Exposure To Urban Air Pollutants, Study Suggests[7] Will Wister's answer to What are the health risks to an adult of living within a half-mile of a freeway?