The association between ALS and population density: A population based study

Abstract

We aimed to assess whether rural residence is associated with amyotrophic lateral sclerosis in the south-east of England using a population based register. Previous studies in different populations have produced contradictory findings. Residence defined by London borough or non-metropolitan district at time of diagnosis was recorded for each incident case in the South-East England ALS Register between 1995 and 2005. Each of the 26 boroughs or districts of the catchment area of the register was classified according to population density. Age- and sex-adjusted incidence of ALS was calculated for each region and the relationship with population density tested by linear regression, thereby controlling for the underlying population structure. We found that population density in region of residence at diagnosis explained 25% of the variance in ALS rates (r = 0.5, p < 0.01). Thus, in this cohort in the south-east of England, people with ALS were more likely to be resident in areas of high population density at diagnosis.

Key words::

• Amyotrophic lateral sclerosis
• epidemiology
• population density

Acknowledgements

The authors thank the patients and their families. We are grateful to the Sketchley family and the Walker family for support. We thank the Medical Research Council and Motor Neurone Disease Association for support.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.