title: Birth cohort effects in neurological diseases: amyotrophic lateral sclerosis, Parkinson's disease and multiple sclerosis.
abstract: BACKGROUND
  Generational differences in disease rates are the main subject of age-period-cohort (APC) analysis, which is mostly applied in cancer and suicide research. This study applied APC analysis to selected neurological diseases: amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD) and multiple sclerosis (MS).
  
  
  METHODS
  The analyses were based on Swiss mortality data. Age-stratified data has been available for MS, PD and ALS since 1901, 1921, and 1942, respectively. APC analysis was performed within the framework of logit models. Main effect models were extended by implementing nested effects, i.e. age effects nested in subperiods, in order to account for the fact that age profiles may change for reasons other than generational influences.
  
  
  RESULTS
  In preliminary analyses, APC analysis yielded noteworthy birth cohort effects in all three diseases. After implementing nested effects, the birth cohort effects disappeared in ALS, and smoothed out in PD, where they were greater for the generations born before the 1920s. In MS, the birth cohort effects remained stable, and exhibited a peak in cohorts born in the 1910s and 1920s.
  
  
  CONCLUSIONS
  APC analysis yielded some evidence for birth cohort effects, i.e. predisposing risk factors that may change in historical terms, in MS and PD, but probably not in ALS.
authors.affiliation: Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland. k320256@ifspm.uzh.ch
authors.forename: Vladeta
authors.initials: V
authors.lastname: Ajdacic-Gross
authors.forename: Margareta
authors.initials: M
authors.lastname: Schmid
authors.forename: Alois
authors.initials: A
authors.lastname: Tschopp
authors.forename: Felix
authors.initials: F
authors.lastname: Gutzwiller
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000401:mortality*; D015984:Causality; D002423:Cause of Death; D015988:Cohort Effect; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009103:Multiple Sclerosis / Q000401:mortality*; D010300:Parkinson Disease / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult