Atlanta metropolitan area amyotrophic lateral sclerosis (ALS) surveillance: incidence and prevalence 2009–2011 and survival characteristics through 2015

Abstract

Amyotrophic lateral sclerosis (ALS) is a fatal, rare, and hard to diagnose neurological disease with unknown etiology. Objective: To understand the incidence, prevalence, and survival characteristics of ALS cases in the Atlanta metropolitan area. Methods: Neurologists in Clayton, Cobb, DeKalb, Fulton, and Gwinnett counties provided case reports for ALS patients under their care from 1 January 2009 to 31 December 2011. Incidence and prevalence rates were calculated for 2009, 2010, and 2011 by sex, race, and ethnicity. Using data from the National Death Index, survival time was calculated for age, sex, race, ethnicity, and El Escorial criteria. Results: There were 281 unique ALS cases reported, which is approximately 104% of the expected cases. The majority of the 281 cases were white, non-Hispanic, male, and in the 50-59 age category. The overall average incidence rate for 2009 to 2011 was 1.54 per 100,000 person-years, with higher annual incidence rates for whites, males, and non-Hispanics. The prevalence rates for 2009, 2010, and 2011 were 5.05, 5.44, and 5.56 per 100,000, respectively. Median survival time was highest for the 18-39 age group, Asians, non-Hispanics, and males. Additionally, the log-rank tests for homogeneity across strata indicate a statistical significance between strata for the age category for survival time. Conclusion: The findings for Atlanta are similar to other populationbased studies in the United States. Although the Atlanta metropolitan area was selected to over-represent the minority population, the strongest predictor of survival time was age at diagnosis.

Fat mass loss correlates with faster disease progression in amyotrophic lateral sclerosis patients: Exploring the utility of dual-energy x-ray absorptiometry in a prospective study

“…There are several limitations to our study. First the sample size was small although representative of the demographics and clinical features of larger groups of ALS patients previously reported by our group and others [ 33 , 34 ]. Second, follow up studies were hampered by patient drop out related to such factors as poor mobility, transportation challenges, and death.…”

Intravenous edaravone treatment in ALS and survival: An exploratory, retrospective, administrative claims analysis

“… 1 , 2 , 3 The clinical trajectories and survival experiences are similar in population- and clinic-based observational studies. 2 , 3 , 4 …”

Incidence of and Mortality From Amyotrophic Lateral Sclerosis in National Football League Athletes

“…1 The incidence of ALS in the United States is 1.5 to 2.2 per 100 000 but varies markedly depending on age, sex, and race. [2][3][4][5][6][7][8] The incidence of ALS generally increases with age and peaks during the seventh decade of life. [2][3][4][5] Men have a higher incidence of ALS (1.7-2.6 per 100 000) than women (1.1-1.5 per 100 000), [2][3][4][5][6][7] and White individuals (1.7-2.5 per 100 000) have a higher incidence than Black individuals (0.7-1.5 per 100 000).…”