Steadiness of amyotrophic lateral sclerosis in the province of Parma, Italy, 1960-1990

Abstract

A clinical and epidemiological study on amyotrophic lateral sclerosis (ALS) was conducted in the province of Parma, Italy, from 1960–1990. A total of 121 cases were collected from hospital records. The average annual incidence was 0.98 per 100000 inhabitants, with a male/female ratio of 1.1. Age‐specific incidence was maximal in the age group 60–69 years. No difference between rural and urban areas was found. Prevalence on October 26th, 1981 was 2.5 per 100000. Mean age at onset was 60 years, with no significant sex difference. Mean duration of the disease was 30 (sd 21.4) months. Bulbar forms were significantly (p<0.05) shorter than conventional forms, with a mean duration of 23.4 (sd 21.4) months. Age at onset did not influence prognosis. A comparison of three decades was made, to verify whether possible variations of the disease had occurred with time. From our data a definite stability was found in such epidemiological parameters as incidence, prevalence, mean duration and mortality of ALS in the period.

An all‐Ireland epidemiological study of MND, 2004–2005

“…Prevalence was noted to decline sharply in females after the age group 70-74 years, while continuing to rise in males. Other studies have demonstrated that females are more likely to present with progressive bulbar palsy (PBP) [7,20,21] and that survival in this clinical subtype of MND is associated with a poorer prognosis [20]. It is possible that the decline in age-specific prevalence among older females is due to increased mortality from PBP, as has been also shown in a previous Irish study [7].…”

Amyotrophic lateral sclerosis in Sardinia (Italy): epidemiologic features from 1957 to 2000

“…These factors are likely to exert their influence in all the regions of the world, albeit not in a uniform manner, either in relation to the chronology and intensity of their action. On this basis, it might be possible to explain the delay, observed in Sardinia, in the appearance of the phenomenon, its more precocious evidence in some regions and the stability of the findings noticed in other regions, for ALS (36,37,45,46,(50)(51)(52) as well as for MND (53,54).…”

“…However, the increase in life expectancy does not fully explain the changes in ALS incidence. On this basis, it might be possible to explain the delay, observed in Sardinia, in the appearance of the phenomenon, its more precocious evidence in some regions and the stability of the findings noticed in other regions, for ALS (36,37,45,46,(50)(51)(52) as well as for MND (53,54). Some authors (18,24,49) pointed out that the increase in the incidence rates is higher than expected, considering the mere ageing of the general population.…”

“…To explain the increase in incidence rates, various hypotheses have been proposed. Some authors deny or doubt a real increase exist; the observed changes could be due to methodological, sociological and operational factors operating in the considered regions (3,5,13,20,36,37,(42)(43)(44)(45)(46).…”

How Common Are the “Common” Neurologic Disorders?

“…Nine Class I [233][234][235][236][237][238][239][240][241] (one from the United States) and 10 Class II [242][243][244][245][246][247][248][249][250][251] (one from the United States) studies of ALS incidence (table E-12a) were found. Most of these studies identified cases from a combination of hospital and clinic administrative data, neurologist practices, or vital records; in all cases, a neurologist made or reviewed the diagnosis.…”