Affiliation:
1. Institute of Medical Science, University of Toronto, Toronto, ON, Canada
Abstract
Background:
Alzheimer’s Dementia (AD) has a complex pathophysiology that is incompletely
understood. Chronic, low-level environmental lead (Pb) exposure is associated with cognitive
impairment, hypertension and mortality, and has been proposed as a potential cause of AD.
Objective:
We aimed to review the literature to clarify the potential role of Pb in AD and to guide future
research.
Methods:
Through a series of systematic reviews, we identified case-control studies comparing AD to
controls on 6 measures of Pb exposure or accumulation: blood, bone, cerebrospinal fluid, hair/nail, postmortem
pathology, and urine. We completed meta-analyses where possible.
Results:
The number of identified case-control studies of AD, by measurement method, was: 15 by
blood, 0 by bone, 5 by Cerebrospinal Fluid (CSF), 3 by hair/nail, 3 by postmortem, and 1 by urine. Two
meta-analyses were possible for 7 studies reporting whole blood Pb and for 8 studies of serum Pb. Both
were negative. The largest study of CSF Pb showed lower levels in AD. Similarly, lower hair Pb levels
were found in AD.
Conclusion:
The available case-control studies are insufficient to draw conclusions on the role of Pb in
AD. Most methods do not address long-term or early-life exposure. The preferred measure of chronic Pb
is in bone, which has not been utilized in case-control AD studies. Future research should measure bone
Pb in AD, together with other biomarkers, such as amyloid and tau imaging, and markers of cerebrovascular
pathology.
Publisher
Bentham Science Publishers Ltd.
Subject
Clinical Neurology,Neurology
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