Life Course of Physical Activity and Risk and Prognosis of Amyotrophic Lateral Sclerosis in a German ALS Registry. (9th November 2021)

• Record Type: Journal Article
• Authors: Rosenbohm, Angela; Peter, Raphael; Dorst, Johannes; Kassubek, Jan; Rothenbacher, Dietrich; Nagel, Gabriele; Ludolph, Albert C.
• Other Names: author non-byline.; Andres Frank author non-byline.; Arnold Guy author non-byline.; Baier Hartmut author non-byline.; Baezner Hansjoerg author non-byline.; Beattie James author non-byline.; Behne Friedrich author non-byline.; Bengel Dietmar author non-byline.; Boertlein Axel author non-byline.; Vera Bracknies author non-byline.; Alber Burkhard author non-byline.; Buttmann Mathias author non-byline.; Dempewolf Silke author non-byline.; Dettmers Christian author non-byline.; Freund Wolfgang author non-byline.; Gasser Thomas author non-byline.; Gold Hans-Juergen author non-byline.; Hamann Gerhard author non-byline.; Hecht Martin author non-byline.; Heimbach Bernhard author non-byline.; Herting Birgit author non-byline.; Huber Roman author non-byline.; Huelser Paul-Juergen author non-byline.; HuberHartmann Karlheinz author non-byline.; Jüttler Eric author non-byline.; Kaspar Attila author non-byline.; Kern Rolf author non-byline.; Kimmig Hubert author non-byline.; Christof Klötzsch author non-byline.; Chatzikonstantinou Anastasios author non-byline.; Klopstock Thomas author non-byline.; Kohler Andreas author non-byline.; Lichy Christoph author non-byline.; Lindner Alfred author non-byline.; Lingor Paul author non-byline.; Lulé Dorothee author non-byline.; Metrikat Jens author non-byline.; Meudt Oliver author non-byline.; Meyer Andreas author non-byline.; Naegele Andrea author non-byline.; Naumann Markus author non-byline.; Neher Klaus-Dieter author non-byline.; Neuhaus Oliver author non-byline.; Neusch Clemens author non-byline.; Niehaus Ludwig author non-byline.; Raape Jan author non-byline.; Ratzka Peter author non-byline.; Reinhard Matthias author non-byline.; Rothmeier Johann author non-byline.; Sabolek Michael author non-byline.; Schabet Martin author non-byline.; SchaeffVogelsang MDMario author non-byline.; Schell Caroline author non-byline.; Schell Caroline author non-byline.; Schweigert Barbara author non-byline.; Sommer Norbert author non-byline.; Stroick Mark author non-byline.; Synofzik Mathis author non-byline.; Tumani Hayrettin author non-byline.; Volkmann Jens author non-byline.; Weiler Markus author non-byline.; Wick Wolfgang author non-byline.; Opherk Christian author non-byline.; Weiller Cornelius author non-byline.; Zeller Daniel author non-byline.; Baumgärtner Jessica author non-byline.; Born Christoph author non-byline.; Bürgy Martin author non-byline.; Connemann Bernhard author non-byline.; Etzersdorfer Elmar author non-byline.; Friederich Hubertus author non-byline.; Gahr Maximilian author non-byline.; Gogolkiewicz Alex author non-byline.; Greber Ralf author non-byline.; Gebhardt Jochen author non-byline.; Grunze Heinz author non-byline.; Henkel Karsten author non-byline.; Hewer Walter author non-byline.; Raether Andreas author non-byline.; Joos Andreas author non-byline.; Köhler Matthias author non-byline.; Kozian Ralf author non-byline.; Laske Christoph author non-byline.; Michaelides Alexandros author non-byline.; Munk Matthias author non-byline.; Niestroj Andreas author non-byline.; Schmauss Max author non-byline.; Schmauss Max author non-byline.; SchoenebergerStroick Katrin author non-byline.; Schoerner Kai-Uwe author non-byline.; Spannhorst Stefan author non-byline.; Steber Raimund author non-byline.; Thomas Christine author non-byline.; Vasic Nenad author non-byline.;
• Is Part Of: Neurology. Volume 97:Number 19(2021)
• Page Start: e1955
• Page End: e1963
• Publication Date: 2021-11-09
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000012829
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : Background and Objectives: Whether physical activity (PA) is a risk factor for amyotrophic lateral sclerosis (ALS) is controversial because data on lifelong PA are rare. The main objective of this study is to provide insight into PA as a potential risk factor for ALS, reporting data on cumulative PA, leisure-time PA, and occupational PA. This study also aims to gather evidence on the role of PA as a prognostic factor in disease course. Methods: Lifetime PA values collected by questionnaires addressing work and leisure time were quantified into metabolic equivalents (METs). A population-based case-control study embedded in the ALS Registry Swabia served to calculate the odds ratio (OR) of ALS by PA in different time intervals and prognosis. Results: In ALS cases (393 cases, 791 age- and sex-matched controls), we observed reduced total PA at interview and up to 5 years before interview compared to controls. Total PA was not associated with ALS risk 5 to 55 years before interview. Heavy occupational work intensity was associated with increased ALS risk (OR 1.97, 95% confidence interval 1.34, 2.89). Total PA levels were associated with survival in a nonlinear manner: inactive patients and highest activity levels (25 MET-h/wk) revealed the worst survival time of 15.4 and 19.3 months, respectively. Best median survival with 29.8 months was seen at 10.5 MET-h/wk after adjustment for other prognostic factors. Discussion: Lifetime combined PA decreased sharply several years before disease onset compared to controls. The risk of developing ALS was not associated with former total PA levels 5 to 55 years before interview in contrast to occupational PA, probably reflecting work-associated exposures. We found a strong nonlinear association of current and prediagnostic PA level and survival in ALS cases with the best survival with moderate PA. PA intensity may be a disease-modifying factor with an unfavorable outcome in sedentary and hyperactive behavior. Classification of Evidence: This study provides Class III evidence that PA was not associated with the development of ALS.