Prevalence and prognostic impact of comorbidities in amyotrophic lateral sclerosis
Article first published online: 25 OCT 2012
© 2012 The Author(s) European Journal of Neurology © 2012 EFNS
European Journal of Neurology
Volume 20, Issue 4, pages 647–654, April 2013
How to Cite
Körner, S., Kollewe, K., Ilsemann, J., Müller-Heine, A., Dengler, R., Krampfl, K. and Petri, S. (2013), Prevalence and prognostic impact of comorbidities in amyotrophic lateral sclerosis. European Journal of Neurology, 20: 647–654. doi: 10.1111/ene.12015
- Issue published online: 12 MAR 2013
- Article first published online: 25 OCT 2012
- Manuscript Accepted: 18 SEP 2012
- Manuscript Received: 25 JUL 2012
- amyotrophic lateral sclerosis;
- cardiovascular risk factors/diseases;
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.
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 Cox proportional hazards model and Kaplan–Meier analysis.
The prevalence of cardiovascular diseases and cardiovascular risk factors was significantly lower in patients with ALS compared to the German 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.
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.