Association Between Amyotrophic Lateral Sclerosis Age at Diagnosis and Comorbid Conditions
Muhammed Ors1, Mustafa Jaffry1, Kazim Jaffry1, Kranthi Mandava1, Ronak Trivedi1, Anam Shaikh1, Iqra Faiz1, Nizar Souayah1
1Rutgers New Jersey Medical School
Objective:
To identify whether there are significant differences in the age at diagnosis of ALS in the presence of comorbid conditions.
Background:
Previous literature has suggested that type 2 diabetic patients have an older age of onset of ALS when compared to non-diabetic ALS patients, suggesting a protective effect. The relationship between the presence of comorbid conditions affecting age of diagnosis of ALS has not been completely elucidated.
Design/Methods:

The New York State Planning and Research Cooperation (SPARCS) database was utilized to collect patients with ALS. The comorbid conditions of congestive heart failure, ischemic stroke and end stage renal disease were compared to the separately cohort of patients with type 2 diabetes and ALS. Multivariable binary regression was used to determine an association confounding for gender, race, and ethnicity.


Results:

6,489 patients with ALS were identified. 2,043 had Hypertension (32.9%), 357 had congestive heart failure (5.5%), 39 had ischemic stroke (0.6%), 13 had end stage renal disease requiring chronic dialysis (0.2%) and 697 had type II diabetes (10.7%). There was no significant difference between gender and appearance of comorbid conditions of ALS patients (p=0.314). Patients with comorbid conditions are significantly older than those without comorbid conditions. (69.69±11.04 vs 62.32±13.73; p<0.001). Similar findings were observed in patients in type 2 diabetic patients compared to non-diabetic patients (67.88±11.24 vs 64.55±13.51; p<0.001). 


Conclusions:

Similar to ALS patients with type 2 diabetes, patients with other comorbid conditions are significantly older when diagnosed with ALS compared to patients without comorbid conditions. This is most likely related to the fact that aging is associated with more comorbid conditions rather than these comorbid conditions including type II diabetes delaying or protecting from ALS which has been suggested in prior literature. Work is in progress to conduct subgroup analysis and identify underlying reasons and explanations for this difference. 


10.1212/WNL.0000000000203184