title: Loss of a child and the risk of amyotrophic lateral sclerosis.
abstract: Between 1987 and 2005, the authors conducted a case-control study nested within the entire Swedish population to investigate whether loss of a child due to death is associated with the risk of amyotrophic lateral sclerosis (ALS). The study comprised 2,694 incident ALS cases and five controls per case individually matched by year of birth, gender, and parity. Odds ratios and their corresponding 95% confidence intervals for ALS were estimated by using conditional logistic regression models. Compared with that for parents who never lost a child, the overall odds ratio of ALS for bereaved parents was 0.7 (95% confidence interval (CI): 0.6, 0.8) and decreased to 0.4 (95% CI: 0.2, 0.8) 11-15 years after the loss. The risk reduction was also modified by parental age at the time of loss, with the lowest odds ratio of 0.4 (95% CI: 0.2, 0.9) for parents older than age 75 years. Loss of a child due to malignancy appeared to confer a lower risk of ALS (odds ratio = 0.5, 95% CI: 0.3, 0.8) than loss due to other causes. These data indicate that the risk of developing ALS decreases following the severe stress of parental bereavement. Further studies are needed to explore potential underlying mechanisms.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. fang.fang@ki.se
authors.forename: Fang
authors.initials: F
authors.lastname: Fang
authors.forename: Weimin
authors.initials: W
authors.lastname: Ye
authors.forename: Katja
authors.initials: K
authors.lastname: Fall
authors.forename: Mats
authors.initials: M
authors.lastname: Lekander
authors.forename: Hans
authors.initials: H
authors.lastname: Wigzell
authors.forename: Pär
authors.initials: P
authors.lastname: Sparén
authors.forename: Hans-Olov
authors.initials: HO
authors.lastname: Adami
authors.forename: Unnur
authors.initials: U
authors.lastname: Valdimarsdóttir
mesh_terms: D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology*; D001601:Bereavement; D016022:Case-Control Studies; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D016017:Odds Ratio; D010290:Parents; D010298:Parity; D010331:Paternal Age; D011247:Pregnancy; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology