Prevalence and prognostic impact of comorbidities in amyotrophic lateral sclerosis

Körner, Sonja; Kollewe, Katja; Ilsemann, Julia; Müller-Heine, A.; Dengler, Reinhard; Krampfl, K.; Petri, Susanne

doi:10.1111/ene.12015

Cited by 86 publications

(88 citation statements)

References 44 publications

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“…ALS patients had a significantly lower BMI than controls, similar to other studies [16], in line with metabolic changes and substantial weight loss observed in ALS patients. While there is evidence suggesting that ALS patients may be less likely than the general population to have cardiovascular disease and cardiovascular risk factors [17], no such difference was observed in our population between prevalent ALS patients and controls. The significantly lower prevalence of CKD among ALS patients compared to controls in our study is similar to a previous study, which found an odds ratio of 0.32 (95% CI 0.18-0.57) for ALS patients compared to age- and sex-matched controls [18].…”

Section: Discussioncontrasting

confidence: 77%

“…In comparison, other countries report a median survival from onset to death ranging from 20 to 48 months, with 10-20% of patients surviving more than 10 years from diagnosis [1]. Median survival times measured from ALS symptom onset are approximately 1 year longer than from ALS diagnosis [17,20,21,22,23,24]. Older age (≥40 years) of onset and bulbar (compared to limb) onset are associated with poorer prognosis [1,24].…”

Section: Discussionmentioning

confidence: 99%

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Epidemiology of Amyotrophic Lateral Sclerosis: A Population-Based Study in Israel

et al. 2016

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Background: Globally, the annual incidence and prevalence of amyotrophic lateral sclerosis (ALS) are estimated at 1.9 and 4.5 per 100,000 population, respectively. This study is aimed at describing the epidemiology of ALS in Israel in a real-world setting. Methods: A retrospective study was performed using the databases of Maccabi Healthcare Services (MHS), a 2-million-member health maintenance organization in Israel. The study included all MHS adults diagnosed with ALS between 1997 and 2013. In 2013, characteristics of ALS patients were compared to those of age-sex-matched patients without ALS. Survival after ALS diagnosis was assessed until death and until tracheostomy or death (follow-up through 2014). Results: In 2013 (n = 158), the prevalence of ALS was 8.1 per 100,000 population in MHS. In 1997-2013, a total of 375 ALS patients were diagnosed, corresponding to an average annual incidence of 1.8 per 100,000 population in MHS. The median survival from diagnosis to death was 3.5 years (95% CI 2.9-4.1), with approximately 28% surviving at least 10 years. Median tracheostomy-free survival was 2.5 years (95% CI 2.1-2.9). Conclusions: Results suggest that there is a relatively high prevalence of ALS in Israel. Further research is needed to investigate factors that may contribute to the survival of patients with ALS in Israel.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Epidemiology of Amyotrophic Lateral Sclerosis: A Population-Based Study in Israel

et al. 2016

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“…One case-control study showed no significant difference in the frequency of a range of broad disease categories (including endocrine). 8 In a cohort of 514 patients with ALS, 9 the prevalence of cardiovascular diseases and cardiovascular risk factors was significantly lower than their prevalence in the general population, confirming previously published findings (discussed in reference 10). Autoimmunity in the pathogenesis of ALS, or perhaps as a mediator of heterogeneity, has long been postulated.…”

supporting

confidence: 85%

Autoimmune disease preceding amyotrophic lateral sclerosis

et al. 2013

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Objective: To study whether the risk of amyotrophic lateral sclerosis (ALS) is increased in people with prior autoimmune disease.Methods: An all-England hospital record-linkage dataset spanning 1999-2011 was used.Cohorts were constructed of people with each of a range of autoimmune diseases; the incidence of ALS in each disease cohort was compared with the incidence of ALS in a cohort of individuals without prior admission for the autoimmune disease.Results: There were significantly more cases than expected of ALS associated with a prior diagnosis of asthma, celiac disease, younger-onset diabetes (younger than 30 years), multiple sclerosis, myasthenia gravis, myxedema, polymyositis, Sjögren syndrome, systemic lupus erythematosus, and ulcerative colitis. Conclusions:

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“…Besides FTD, the comorbidity of ALS with other neurodegenerative disorders, such as Parkinson disease, may also contribute to the association between previous depression and increased risk of ALS. 15 Finally, little research has been done regarding the potential psychological stress experienced by patients with ALS between the first symptom onset and the final diagnosis, an interval of 1 year on average. 16 Depression may therefore also be a result of the psychological distress experienced during the progressive symptom development and the often stressful diagnostic workup before ALS diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Depression in amyotrophic lateral sclerosis

et al. 2016

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Objective: To examine the relative risk of depression among patients with amyotrophic lateral sclerosis (ALS), both in terms of depression diagnosis and use of antidepressant drugs, before and after diagnosis. Methods:We conducted a nested case-control study including 1,752 patients with ALS diagnosed from July 2005 to December 2010 and 8,760 controls based on the Swedish national health and population registers, to assess the associations of depression diagnosis and use of antidepressant drugs with a subsequent risk of ALS. We further followed the patients with ALS after diagnosis to estimate the association of an ALS diagnosis with the subsequent risk of depression and use of antidepressant drugs.Results: Before diagnosis, patients with ALS were at higher risk of receiving a clinical diagnosis of depression compared to controls (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.3-2.3), and the highest risk increase was noted during the year before diagnosis (OR 3.5, 95% CI 2.1-5.6). Patients with ALS also had a highly increased risk of depression within the first year after diagnosis (hazard ratio 7.9, 95% CI 4.4-14.3). Antidepressant use was more common in patients with ALS than in controls, especially during the year before (OR 5.8, 95% CI 4.5-7.5) and the year after (hazard ratio 16.1, 95% CI 11.5-22.6) diagnosis. Approximately 30% of patients with amyotrophic lateral sclerosis (ALS) show mild cognitive impairment and 15% present with overt frontotemporal dementia (FTD). Conclusions:1,2 The overlap between ALS and FTD presents a continuum of symptoms such as memory impairment, apathy, and behavioral changes, 3,4 many of which mimic the typical symptoms of depression. 5The strong emotions evoked by receiving a serious diagnosis such as ALS may also lead to increased risk of mental illnesses, including depression. Multiple studies have shown that patients with ALS are more likely to develop depression than ALS-free individuals, although the reported prevalence of depression varies greatly.6-13 Different measurements of depression together with the varying representativeness of the patient samples used in previous studies may partly explain the different prevalences reported so far.The aim of the present study was to investigate the occurrence of depression diagnosis and use of antidepressants before and after ALS diagnosis in a nationwide sample of patients with ALS, using a matched random sample of the Swedish population as the reference.

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Prevalence and prognostic impact of comorbidities in amyotrophic lateral sclerosis

Cited by 86 publications

References 44 publications

Epidemiology of Amyotrophic Lateral Sclerosis: A Population-Based Study in Israel

Epidemiology of Amyotrophic Lateral Sclerosis: A Population-Based Study in Israel

Autoimmune disease preceding amyotrophic lateral sclerosis

Depression in amyotrophic lateral sclerosis

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