title: Association of alcohol use disorders with amyotrophic lateral sclerosis: a Swedish national cohort study.
abstract: OBJECTIVE
  Cigarette smoking is associated with amyotrophic lateral sclerosis (ALS), but the association between alcohol consumption and ALS is not clear. Our aim was to clarify this using a national cohort study design in Sweden.
  
  
  METHODS
  Individuals with alcohol use disorders (AUDs) were identified from several nationwide registers, and they were linked to the Swedish Hospital Discharge and Outpatients Registers to identify the incidence of ALS. Standardized incidence ratios (SIRs) were used to examine the risk of ALS amongst individuals with AUDs compared to those without AUDs.
  
  
  RESULTS
  A total of 7965 patients were diagnosed with ALS during the study period 1973-2010. The incidence of ALS amongst individuals with AUD was lower compared to individuals without AUD with an overall SIR of 0.54 (95% confidence interval 0.45-0.63). The study population was further stratified by gender, educational attainment, birth country, follow-up period and a diagnosis of chronic obstructive pulmonary disease (as a proxy for smoking), and the observed inverse association between AUD and ALS was consistent for all the stratified analyses.
  
  
  CONCLUSIONS
  In this follow-up study, heavy alcohol consumption, as shown by registration for AUD, was inversely associated with the incidence of ALS. However, further studies are needed to disentangle the contribution of other potential confounding factors on the observed association.
authors: Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
authors: J
authors: J
authors: Ji
authors: Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.|Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA.
authors: J
authors: J
authors: Sundquist
authors: Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.|Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA.
authors: K
authors: K
authors: Sundquist
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D013548:Sweden / Q000453:epidemiology
keywords: alcohol use disorders; amyotrophic lateral sclerosis; incidence