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 population-based 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.

Keywords:

• Amyotrophic lateral sclerosis (ALS)
• surveillance
• minority populations
• incidence
• prevalence
• survival characteristics
• Atlanta
• National ALS Registry

Acknowledgements

The authors thank the state and local health departments, ALS specialty clinics in Georgia, and other organizations that assisted with data. This project was funded by the Agency for Toxic Substances and Disease Registry.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official positions of ATSDR, CDC, and/or the HHS.

Declaration of interest

The authors declare no conflicts of interest. The conclusions of this article are those of the authors and do not necessarily represent the views of ATSDR, the Centers for Disease Control and Prevention (CDC), or the U.S. Department of Health and Human Services (HHS).