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Cited by 5Amyotrophic Lateral Sclerosis ResearchAmyloidosis: Diagnosis, Treatment, OutcomesDementia and Cognitive Impairment Research

Pre-Morbid Risk Factors for Amyotrophic Lateral Sclerosis: Prospective Cohort Study

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Batty, G David, Gale, Catharine R·2021·Clinical Epidemiology
DOI 10.2147/clep.s329521PMC PMC8505194

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Abstract

Abstract Background As a neurodegenerative disorder with high case-fatality, there is a need to identify primary, modifiable risk factors for amyotrophic lateral sclerosis (ALS). Their detection has, however, proved elusive and this may be ascribed to the scarcity of well-characterised, sufficiently-powered cohort studies necessary to explore the aetiology of this rare condition. Methods UK Biobank is an on-going, closed, prospective cohort study in which 502,524 participants (273,420 women) have been linked to national hospital and mortality registries. Baseline data collection took place between 2006 and 2010 when a range of psychosocial, physiological, and demographic data were captured. Results Approximately 11 years of event surveillance gave rise to 301 hospitalisations and 279 deaths ascribed to ALS. After left censoring to account for reverse causality and adjustment for confounding factors, being older (hazard ratio per 10 year increase; 95% confidence interval: 1.92; 1.58, 2.33) and male (1.37; 1.00, 1.87) were associated with elevated rates of hospitalisation for ALS. Similar effects were apparent when death due to the disorder was the outcome of interest. Of the remaining 23 potential risk indices, however, there was only a suggestion that taller people experienced an increased risk of hospitalisation (per SD increase: 1.31; 1.09, 1.59). Conclusions In the present study, a comprehensive array of potential risk indices were essentially unrelated to later ALS.

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  • Other studies, including a meta-analysis, suggested that smoking is not associated with the risk for ALS or risk of death after ALS diagnosis.

    “Nevertheless, other studies, including a meta-analysis, suggested that smoking is not associated with the risk for ALS [11, 12] or risk of death after ALS diagnosis [13].”

    From Lifestyle and medical conditions in relation to ALS risk and progression—an introduction to the Swedish ALSrisc Study (2024) · cites this paper as [13]

  • Some associations between environmental risk factors and ALS potentially vary by age, sex, and genetic factors.

    “with some of the associations potentially varying by age, sex, and genetic factors [11–15].”

    From Lifestyle and medical conditions in relation to ALS risk and progression—an introduction to the Swedish ALSrisc Study (2024) · cites this paper as [13]

    The Introduction discusses inconsistent findings for environmental risk factors and mentions genetic and non-genetic causes of ALS. The Results and Discussion identify age and sex as risk factors, but do not say that associations between environmental factors and ALS vary by age, sex, or genetics. Searches for interaction, effect modification, and stratification did not locate support for that claim; page numbers were not supplied. (LLM, conf=0.73)

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Sorted by citations

Authors
Batty, G. D., & Gale, C. R.
Affiliations
University College London (GB)
Corresponding author
Batty, G David
ORCID
Batty, G David
Venue
Clinical Epidemiology
Publisher
Informa UK Limited
Published
2021-10
Volume
Volume 13
Pages
941-947
ISSN
1179-1349 (ISSN-L)
DOI
10.2147/clep.s329521
PMC
PMC8505194
OpenAlex
W3204401045
Cited by
5
References
6
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1
FWCI
0.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Epidemiology (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by)
  • ePrints Soton (University of Southampton) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • Medical Research Council (10279, MR/P023444/1, 1R56AG052519-01, MC_PC_17228)
  • National Institute on Aging (R56AG052519, R01AG052519)
Topics
  • Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Amyloidosis: Diagnosis, Treatment, Outcomes
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords
amyotrophic lateral sclerosis, ALS mortality, age, sex differences, height, neurodegenerative diseases, UK Biobank

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