STUDY OBJECTIVE:The aim was to examine whether a high intake of aluminium containing antacids is a risk for Alzheimer's disease. DESIGN:The mortality from dementia (1970-87), coded from death certificates as underlying or contributory cause of death, was compared with national rates in a cohort of patients who had surgery for gastroduodenal ulcer disease between 1911 and 1978. SETTING:Patient data were obtained from patient records from major hospitals in western Norway. PARTICIPANTS:4179 patients were identified who met the study criteria, which included having had a documented stomach operation, having a reliably identifiable personal number, and being alive on Jan 1, 1970. MEASUREMENTS AND MAIN RESULTS:The standardised mortality ratio for dementia was 1.10 (95% CI 0.85-1.40, n = 64) for all patients, while for patients operated on in the period 1967-78 it was 1.25 (95% CI 0.66-2.13, n = 13). CONCLUSIONS:As the majority of patients operated on after 1963 have probably been heavy consumers of aluminium containing antacids, the study provides meager evidence that a high intake of aluminium is an important risk factor for Alzheimer's disease, the major cause of dementia. However, the possibility of a raised mortality from Alzheimer's disease cannot be ruled out due to probable misclassification both in diagnosis and exposure. In addition, the observation period may have been too short to detect an effect since the latent period for Alzheimer's disease may be very long.

译文

研究目的:目的是检查高摄入量的含铝抗酸药是否会引起阿尔茨海默氏病。
设计:将1911年至1978年间接受手术治疗胃十二指肠溃疡疾病的患者队列中的痴呆死亡率(1970-87)与全国死亡率进行比较,该死亡率以死亡证明书中的基础或造成的死亡原因进行编码。
地点:患者数据来自挪威西部主要医院的患者记录。
参加者:确认符合研究标准的4179例患者,其中包括有记录的胃部手术,具有可靠可识别的个人号码以及1970年1月1日还活着。
测量和主要结果:所有患者的痴呆症标准死亡率为1.10(95%CI 0.85-1.40,n = 64),而在1967-78年间接受手术的患者为1.25(95%CI 0.66-2.13) ,n = 13)。
结论:由于1963年以后接受手术的大多数患者可能都是含铝制抗酸剂的大量消费者,因此该研究提供的证据很少,大量摄入铝是导致痴呆症主要原因的阿尔茨海默氏病的重要危险因素。然而,由于在诊断和暴露方面可能分类错误,因此不能排除阿尔茨海默氏病死亡率升高的可能性。另外,由于阿尔茨海默氏病的潜伏期可能很长,因此观察期可能太短而无法检测到效果。

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