title: Population-Based Evidence that Survival in Amyotrophic Lateral Sclerosis is Related to Weight Loss at Diagnosis.
abstract: OBJECTIVE
  In a population-based setting, we aimed to (i) describe weight loss (WL) of amyotrophic lateral sclerosis (ALS) patients at the time of diagnosis and (ii) evaluate the association between WL and survival.
  
  
  METHODS
  All patients recruited in the FRALim register (2000-2013) were considered to be included in this study. Time-to-death analyses were performed using a multivariable Cox model. Model discrimination and calibration were assessed.
  
  
  RESULTS
  Among 322 patients in the register, 261 (81%) were included. At the time of diagnosis, 50.6% of patients reported a WL of more than 5%: 14.6% with WL between 5 and 10% and 36.0% with a WL of more than 10%. WL was independently associated with survival (p = 0.002). Patients with a WL of 10% or more experienced a 45% increase in the risk of death (95% CI 6-99) with respect to patients with a WL lower than 5% or no WL. The introduction of WL significantly improved the model's discrimination achieving a survival C statistic of 79.5% (95% CI 75.6-83.5, p = 0.006) at 12 months.
  
  
  CONCLUSIONS
  More than 50% of ALS patients experience a WL of more than 5% at the time of diagnosis. This finding highlights the need for randomized trials to evaluate the effect of nutritional interventions to improve ALS survival.
authors: INSERM, U1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France.
authors: Benoît
authors: B
authors: Marin
authors: Simona
authors: S
authors: Arcuti
authors: Pierre
authors: P
authors: Jesus
authors: Giancarlo
authors: G
authors: Logroscino
authors: Massimiliano
authors: M
authors: Copetti
authors: Andrea
authors: A
authors: Fontana
authors: Marie
authors: M
authors: Nicol
authors: Marie
authors: M
authors: Raymondeau
authors: Jean Claude
authors: JC
authors: Desport
authors: Pierre Marie
authors: PM
authors: Preux
authors: Philippe
authors: P
authors: Couratier
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009752:Nutritional Status; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012306:Risk; D015431:Weight Loss