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.; Andres, Frank; Arnold, Guy; Baier, Hartmut; Baezner, Hansjoerg; Beattie, James; Behne, Friedrich; Bengel, Dietmar; Boertlein, Axel; Vera, Bracknies; Alber, Burkhard; Buttmann, Mathias; Dempewolf, Silke; Dettmers, Christian; Freund, Wolfgang; Gasser, Thomas; Gold, Hans-Juergen; Hamann, Gerhard; Hecht, Martin; Heimbach, Bernhard; Herting, Birgit; Huber, Roman; Huelser, Paul-Juergen; HuberHartmann, Karlheinz; Jüttler, Eric; Kaspar, Attila; Kern, Rolf; Kimmig, Hubert; Christof, Klötzsch; Chatzikonstantinou, Anastasios; Klopstock, Thomas; Kohler, Andreas; Lichy, Christoph; Lindner, Alfred; Lingor, Paul; Lulé, Dorothee; Metrikat, Jens; Meudt, Oliver; Meyer, Andreas; Naegele, Andrea; Naumann, Markus; Neher, Klaus-Dieter; Neuhaus, Oliver; Neusch, Clemens; Niehaus, Ludwig; Raape, Jan; Ratzka, Peter; Reinhard, Matthias; Rothmeier, Johann; Sabolek, Michael; Schabet, Martin; SchaeffVogelsang, MDMario; Schell, Caroline; Schell, Caroline; Schweigert, Barbara; Sommer, Norbert; Stroick, Mark; Synofzik, Mathis; Tumani, Hayrettin; Volkmann, Jens; Weiler, Markus; Wick, Wolfgang; Opherk, Christian; Weiller, Cornelius; Zeller, Daniel; Baumgärtner, Jessica; Born, Christoph; Bürgy, Martin; Connemann, Bernhard; Etzersdorfer, Elmar; Friederich, Hubertus; Gahr, Maximilian; Gogolkiewicz, Alex; Greber, Ralf; Gebhardt, Jochen; Grunze, Heinz; Henkel, Karsten; Hewer, Walter; Raether, Andreas; Joos, Andreas; Köhler, Matthias; Kozian, Ralf; Laske, Christoph; Michaelides, Alexandros; Munk, Matthias; Niestroj, Andreas; Schmauss, Max; Schmauss, Max; SchoenebergerStroick, Katrin; Schoerner, Kai-Uwe; Spannhorst, Stefan; Steber, Raimund; Thomas, Christine; Vasic, Nenad;
• Is Part Of: Neurology. Volume 97:Number 19(2021)
• 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.