title: 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.
authors.affiliation: King's College Hospital, London, UK.
authors.forename: Kirsten M
authors.initials: KM
authors.lastname: Scott
authors.forename: Kumar
authors.initials: K
authors.lastname: Abhinav
authors.forename: Lokesh
authors.initials: L
authors.lastname: Wijesekera
authors.forename: Jeban
authors.initials: J
authors.lastname: Ganesalingam
authors.forename: Laura H
authors.initials: LH
authors.lastname: Goldstein
authors.forename: Anna
authors.initials: A
authors.lastname: Janssen
authors.forename: Andrew
authors.initials: A
authors.lastname: Dougherty
authors.forename: Emma
authors.initials: E
authors.lastname: Willey
authors.forename: Biba R
authors.initials: BR
authors.lastname: Stanton
authors.forename: Martin R
authors.initials: MR
authors.lastname: Turner
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: Ampong
authors.forename: Mohammed
authors.initials: M
authors.lastname: Sakel
authors.forename: Richard
authors.initials: R
authors.lastname: Orrell
authors.forename: Robin
authors.initials: R
authors.lastname: Howard
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Shaw
authors.forename: P
authors.initials: P
authors.lastname: Nigel Leigh
authors.forename: Ammar
authors.initials: A
authors.lastname: Al-Chalabi
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D011156:Population Density; D012042:Registries; D012424:Rural Population; D014505:Urban Population