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Long-term physical activity: an exogenous risk factor for sporadic amyotrophic lateral sclerosis?

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Harwood, Ceryl A 
Gunstone, Sue 
Wareham, Nicholas J 


OBJECTIVES: To conduct a geographically defined, UK-based case-control study, to examine any association between physical activity (PA) and amyotrophic lateral sclerosis (ALS). METHODS: A novel historical PA questionnaire was designed, validated, and subsequently administered in individual face-to-face interviews of 175 newly diagnosed sporadic ALS cases and 317 age- and sex-matched community controls. Historical PA energy expenditure and time spent in vigorous-intensity PA were derived from questionnaire data and compared between cases and controls. RESULTS: Participation in an extra 10kJ/kg/day of PA (equivalent to approximately 45minutes brisk walking) was consistently associated with an increased risk of ALS, with the strongest association observed for adulthood exercise-related PA (OR 1.47, 95% CI 1.10-1.97). An extra 10mins/day of vigorous PA was also associated with the odds of ALS (OR 1.03, 95% CI 1·01-1·05). Results were slightly attenuated following adjustment for smoking and educational attainment. CONCLUSIONS: To our knowledge this is the first study to demonstrate a positive association between ALS and PA participation using a specifically designed and validated historical PA questionnaire. Despite the well-established health benefits of PA, a high activity lifestyle may also be associated with elevated risk of ALS. Large-scale prospective studies in the future may help to confirm this association.



Amyotrophic lateral sclerosis, Epidemiology, Gene-environment interaction, Physical Activity, Risk factor, Adult, Aged, Aged, 80 and over, Amyotrophic Lateral Sclerosis, Case-Control Studies, Exercise, Female, Humans, Longitudinal Studies, Male, Middle Aged, Odds Ratio, Retrospective Studies, Risk Factors, Surveys and Questionnaires, United Kingdom

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Amyotroph Lateral Scler Frontotemporal Degener

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Informa UK Limited
MRC (MC_PC_13048)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0512-10135)
Medical Research Council (MC_UU_12015/1)
Medical Research Council (MC_UU_12015/3)
Medical Research Council (MC_U106179471)
Medical Research Council (MC_U106179473)
This study was funded by a Medical Research Council/Motor Neurone Disease Association Lady Edith Wolfson Fellowship.