Multicentre, cross-cultural, population-based, case-control study of physical activity as risk factor for amyotrophic lateral sclerosis

Anne E Visser, James P K Rooney, Fabrizio D'Ovidio, Henk-Jan Westeneng, Roel C H Vermeulen, Ettore Beghi, Adriano Chiò, Giancarlo Logroscino, Orla Hardiman, Jan H Veldink, Leonard H van den Berg, Euro-MOTOR Consortium

    Research output: Contribution to journalArticleAcademicpeer-review

    Abstract

    OBJECTIVE: To investigate the association between physical activity (PA) and amyotrophic lateral sclerosis (ALS) in population-based case-control studies in three European countries using a validated and harmonised questionnaire.

    METHODS: Patients with incident ALS and controls were recruited from five population-based registers in The Netherlands, Ireland and Italy. Demographic and data regarding educational level, smoking, alcohol habits and lifetime PA levels in both leisure and work time were gathered by questionnaire, and quantified using metabolic equivalent of task scores. Logistic regression models adjusting for PA-related factors were used to determine the association between PA and ALS risk, and forest plots were used to visualise heterogeneity between regions.

    RESULTS: 1557 patients and 2922 controls were included. We found a linear association between ALS and PA in leisure time (OR 1.07, P=0.01) and occupational activities (OR 1.06, P<0.001), and all activities combined (OR 1.06, P<0.001), with some heterogeneity between regions: the most evident association was seen in the Irish and Italian cohorts. After adjustment for other occupational exposures or exclusion of patients with a C9orf72 mutation, the ORs remained similar.

    CONCLUSION: We provide new class I evidence for a positive association between PA and risk of ALS in a large multicentre study using harmonised methodology to objectively quantify PA levels, with some suggestions for population differences.

    Original languageEnglish
    Pages (from-to)797-803
    Number of pages7
    JournalJournal of Neurology, Neurosurgery and Psychiatry
    Volume89
    Issue number8
    Early online date23 Apr 2018
    DOIs
    Publication statusPublished - Aug 2018

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