Physical activity and amyotrophic lateral sclerosis: a European population-based case-control study.
OBJECTIVE
To assess whether physical activity is a risk factor for amyotrophic lateral sclerosis (ALS).


METHODS
From February 2008 to April 2012, 652 patients with ALS from European population-based registries (France, Ireland, Italy, United Kingdom, Serbia) and 1,166 population controls (matched for age, sex, and residency) were assessed. Upon direct interview, data were collected on occupation and history of sport and leisure activities, physical activity, and accidental injuries. Physical exercise was defined as having spent time doing activities that caused an individual to breath hard at least once per month and was coded as none, job-related, and/or sport-related. Sport-related and work-related physical exercise were quantified using metabolic equivalents (METs). Risks were calculated using conditional logistic regression models (adjusting for age, country, trauma, and job-related physical activity) and expressed as odds ratios (ORs) and adjusted ORs (Adj ORs) with 95% confidence intervals (CIs).


RESULTS
Overall physical activity was associated with reduced odds of having ALS (Adj OR=0.65, 95% CI=0.48-0.89) as were work-related physical activity (Adj OR=0.56, 95% CI=0.36-0.87) and organized sports (Adj OR=0.49, 95% CI=0.32-0.75). An inverse correlation was observed between ALS, the duration of physical activity (p=0.0041), and the cumulative MET scores, which became significant for the highest exposure (Adj OR=0.34, 95% CI=0.21-0.54). An inverse correlation between ALS and sport was found in women but not in men, and in subjects with repeated traumatic events.


CONCLUSIONS
Physical activity is not a risk factor for ALS and may eventually be protective against the disease.
Neurological Diseases Laboratory, Institute of Hospitalization and Scientific Care-Mario Negri Institute, Milan, Italy.
Elisabetta
E
Pupillo
Paolo
P
Messina
Giorgia
G
Giussani
Giancarlo
G
Logroscino
Stefano
S
Zoccolella
Adriano
A
Chiò
Andrea
A
Calvo
Massimo
M
Corbo
Christian
C
Lunetta
Benoit
B
Marin
Douglas
D
Mitchell
Orla
O
Hardiman
James
J
Rooney
Zorica
Z
Stevic
Monica
M
Bandettini di Poggio
Massimiliano
M
Filosto
Maria Sofia
MS
Cotelli
Michele
M
Perini
Nilo
N
Riva
Lucio
L
Tremolizzo
Eugenio
E
Vitelli
Danira
D
Damiani
Ettore
E
Beghi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D016022:Case-Control Studies; D005060:Europe / Q000453:epidemiology; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011159:Population Surveillance / Q000379:methods