Lead (Pb) in Alzheimer’s Dementia: A Systematic Review of Human Case- Control Studies

Author(s): Eric E. Brown, Parita Shah, Bruce G. Pollock, Philip Gerretsen, Ariel Graff-Guerrero*.

Journal Name: Current Alzheimer Research

Volume 16 , Issue 4 , 2019

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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.

Keywords: Lead (Pb), Alzheimer's, dementia, toxicity, environmental, cognition.

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Article Details

Year: 2019
Page: [353 - 361]
Pages: 9
DOI: 10.2174/1567205016666190311101445
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