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Prevalence and prognostic impact of comorbidities in amyotrophic lateral sclerosis
Author(s) -
Körner S.,
Kollewe K.,
Ilsemann J.,
MüllerHeine A.,
Dengler R.,
Krampfl K.,
Petri S.
Publication year - 2013
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12015
Subject(s) - amyotrophic lateral sclerosis , medicine , cohort , disease , dementia , population , comorbidity , cohort study , motor neurone disease , hazard ratio , concomitant , confidence interval , environmental health
Background and purpose Amyotrophic lateral sclerosis ( ALS ) is characterized by rapidly progressive paralysis of striated muscles due to the loss of upper and lower motor neurons. The disease leads to death within 2–5 years, mainly due to respiratory failure. The pathogenesis of ALS is still unexplained for the most part. In this study, we aimed to determine the prevalence of different cardiovascular, metabolic, and neuropsychiatric comorbidities in a large ALS cohort and to evaluate their influence on the disease course. Methods A cohort of 514 patients with ALS of our ALS outpatient clinic was investigated retrospectively with reference to known prognostic factors and comorbidities. The prevalence of concomitant diseases was compared with the data from the German general population. Uni‐ and multivariate survival analyses were performed using the C ox proportional hazards model and K aplan– M eier analysis. Results The prevalence of cardiovascular diseases and cardiovascular risk factors was significantly lower in patients with ALS compared to the G erman general population, whilst the prevalence of dementia, parkinsonism, and depressive symptoms was significantly higher in the ALS cohort. None of the investigated comorbidities had an influence on the disease course or on the survival of patients. Conclusions Persons with cardiovascular diseases or risk factors seem to be at lower risk of ALS . Although these diseases are apparently somehow protective regarding ALS susceptibility, their presence did not modify disease progression and survival in patients with ALS . Our study further confirms the well‐known continuum between ALS and dementia. It also suggests a link with other neurodegenerative diseases such as Parkinson's disease.